A Social Justice Perspective on Medicare Part D in an Age of Reform: Critical Implications of Trends in Health Care Policy and Advocacy

Abstract

This article examines the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) in its current form and explains why a critical perspective is useful when analyzing the policy and reform efforts. Using this approach, we consider the development of the policy and describe ways that gender and racial differences may hinder equal access to medications for some of the most vulnerable older adults. This article explores the implications of gender and racial disparities under the MMA and ramifications of health care reform efforts that could potentially impede, rather than promote, a social justice agenda. Beyond the political advantage of the MMA's current structure, reconsideration should include the potentialfor disproportionate negative economic and health effects for women and people in historically disadvantaged minority groups.