Bruce C. Vladeck

As the arbiter of all that is fair in reimbursement under Medicare and Medicaid, the Health Care Financing Administration (HCFA) occupies a unique and powerful position in American medicine. Viewed by some as the only effective bulwark against medical rip-offs of the federal treasury, HCFA has been seen by others as the embodiment of government bureacuracy with regulations which often defy comprehension. At the helm of HCFA is Bruce C. Vladeck. Vladeck has served as HCFA Administrator since May 1993, overseeing both the Medicare and Medicaid programs with a total budget last year of approximately $285 billion. Interviewed in his office in the Hubert H. Humphrey Health and Human Services Building in Washington, Vladeck discussed the changing scope of Medicare, revisions in the funding of graduate medical education, and the role of the federal government in financing health care.