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Medicare is the only socialized health insurance in the United States and covers those aged sixty-five and over. Since Medicare cover allows for considerable excesses or “copayments”, insured individuals generally take out a private top-up policy. However, a new scheme may also be taken up by Medicare recipients: a contract known as “Medicare Advantage”, offered by a private insurer managing a care network. This type of contract is financed by Medicare and provides the same cover, except that it also offers supplementary cover. The proportion of Medicare users selecting Medicare Advantage – currently 40% – is rising each year. For users of social health cover, the networks restrict choice of care providers but also bring savings, in that users receive better cover than Medicare without paying more. However, competition between private insurers imposes contracts which have the effect of diminishing solidarity between the sick and the healthy.