Obama wants to make direct reductions in how much money Medicare spends, while Romney wants to turn Medicare into a voucher system where our elderly shop for care through private insurance.

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This scheme would rely on private health-care companies to compete to offer insurance to the elderly covering a full range of services, from hospital care to prescription drugs, now only partly covered by different Medicare premiums.

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In 2008 Korea introduced an earned-income tax credit, a universal basic pension and an insurance scheme providing long-term care for the elderly.

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In part because of a new government insurance scheme, which covers nursing care for the elderly, the number of nurses in Japan is expected to double in the next five years, to 1m.

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For example, Medicare, the federal health-insurance scheme for the elderly, makes no allowance for palliative care, which eases suffering rather than attempting to cure the sufferer.

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ACOs last year began providing medical care services to seniors through contracts with the Medicare health insurance program for the elderly.

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Though the hospital industry is taking a huge whack from spending reductions in what they have historically received from the Medicare health insurance program for the elderly, they are also going to see massive reductions in spending on charity care and uncompensated care, which is the amount they eat when patients cannot pay their bills.

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