To order. Today the finance committee focuses its attention on what in my view is the biggest challenge ahead for medicare and the future of Americas Health care system. That is managing chronic illness. To understand why this is a growing issue, one need only to look at how medicare has changed over the years. When the Medicare Program began, in those early days i was codirector of the cancer, full head of hair and rugged good looks. Medicare was mostly about caring for seniors who needed to go to the hospital. If a senior slipped on the Kitchen Floor and broke an ankle for example and head to the hospital, they would get treatment and they would head home. In 1970, nearly 70 of medicare spending was for hospital care. Now that number is close to 40 . The change shows how medicare is very different than it was for four decades ago. Other than broken ankles or new money medical care is dominated by chronic conditions such as cancer, diabetes and Heart Disease. More than two thirds of t