What categories of services should Medicare cover? Should its coverage be identical to employment related benefit packages or should it vary in some respects? What items might be more, or less, important to its beneficiary population than to working-age Americans? Should Medicare cover nursing home care- a benefit of obvious interest to the elderly to a greater extent? Should Medicare take cost into account in setting coverage policy for new technologies? if so, what role should cost play in coverage determinations? Though "added value" is among the criteria that CMS proposed in 200 for evaluation technologies, CMS asserts that it does not consider cost explicitly. Does it serve the public interest to have private "contractors" make many coverage decisions with limited opportunities for appeal