Depletion of Medicare's Hospital Insurance Trust Fund is expected by the early 1990s.1 The complexities of the Old Age, Survivors, and Disability Insurance programs, which pay monthly stipends to over 35 million people, have overshadowed Medicare in quadrennial reviews mandated by the Social Security Act. Even the National Commission on Social Security Reform,2 whose 1983 report led to major legislative changes, gave little attention to Medicare's looming problems. The 1982–1983 Advisory Council on Social Security, for the first time, was asked to concentrate its review and recommendations on Medicare. The council's report,3 sent to Congress in March 1984, formally begins . . .