Medicare at 40: Are We Showing Our Age?

To understand what Medicare aimed to achieve, we need to revisit the medico‐politics of the time, and the fear of the spectre of socialised medicine. That determined what could be changed (universal insurance and contributions according to means) and what could not (private medical service provision and fee‐for‐service). We consider what Medicare has achieved in terms of community acceptance, fairer contributions, affordability at its establishment; and how those aims can be assessed today. While Medicare is undoubtedly a success, there are inflexibilities in its structure that are challenging in ensuring it is fit for the next four decades .