Should Medicare be expanded to include not just older Americans and those with certain disabilities, but other people as well? Discuss.

Based on your understanding of the topic, answer the following:

Should Medicare be expanded to include not just older Americans and those with certain disabilities, but other people as well? Discuss.

Has the implementation of Medicare actually forwarded the cause for national health insurance or impeded its progress? Discuss.

Textbook: Patel, K. (2019). Healthcare politics and policy in america (5th ed.). Routledge

History of Medicare

At its inception, the designers of the Medicare program probably did not realize what the growth of the program would be. With the aging of the baby boomer population (1946–1965), the number of Medicare eligible recipients is expected to grow even more significantly. The data depicts shows the two main areas of Medicare. One of the challenges to the viability of Medicare is how legislators have anticipated and will continue to anticipate growth in the number of enrollees. In addition to the financial pressure, aging baby boomers will put on Medicare from 2010 to 2030; Generation X members (1964–1984) will also have an effect on Medicare. As this generation approaches the age of sixty five years, there will be more people who may be receiving Medicare benefits than people who are contributing to Medicare through their payroll taxes. To address the fiscal challenges facing the program, the Affordable Care Act established the independent payment advisory board to make recommendations on extending the life of the Medicare trust fund and the Centers for Medicare and Medicaid Services (CMS) innovations center to research methods of reducing the rate of growth of Medicare and Medicaid costs. Medicare is at the center of contentious political debates because it is such a large program, making up to 16% of the federal budget. Medicare’s budget in 2011 was $3.6 trillion. The program is expected to grow to $8 million beneficiaries as baby boomers reach the age of sixty-five between the years 2010 and 2030.The main problem with Medicare’s financing is that the budget for Medicare part A relies on the social security payroll tax. As the numbers of US workers shrink, there will be fewer workers to pay into the system and fund future generations of beneficiaries.

Medicare Basics

Medicare is a federal healthcare insurance program designed for the following categories of individuals: (1) Sixty five years and older; (2) Under the age of sixty five with certain disabilities; (3) Have end-stage renal disease. For Medicare Part A, beneficiaries have access to an open network, single-payer plan. Part A covers hospital insurance and services such as hospital based costs, home healthcare services, and hospice care. Today, it also covers skilled nursing services up to hundred days of care. Medicare Part A is paid through payroll taxes and does not cost the beneficiary out of pocket expenses. Medicare Part A does not cover physician services and supplies. However, these services are included in Medicare Part B, which is mainly medical insurance. It includes doctor’s services, outpatient services, physical and occupational therapies, and durable medical equipment. Preventive services were added through the Affordable Care Act in 2011 and limited prescription drug coverage is available. Most recipients are required to pay a premium for Medicare part B. The premium for 2012 was $99.90 and the deductible was $140. Premiums increase for individuals with incomes above $85,000 and households with incomes above $170,000. You would have thought the framers of the Medicare program would have included a prescription medication benefit, but at the time (1960s), access to inpatient hospitalization and medically necessary services to treat disease and illness prescription drug coverage was not added to the Medicare program until 2003, when the Medicare Modernization Act was passed. This benefit became available to enrollees in 2006 under Medicare Part D. Beneficiaries are able to choose their own prescription drug plan through private healthcare insurance companies approved by Medicare. The plan requires a premium payment as well as deductibles

Regulations and Reimbursement Issues

To protect its beneficiaries, Medicare has put in place regulations that set standards for quality care and safety. These standards apply to all healthcare providers and suppliers. In particular, all healthcare facilities must, such as hospitals and skilled nursing facilities must be accredited by a national accreditation organization, such as the joint commission. Such accreditation organizations must be deemed to have satisfied the Medicare Hospital Conditions of Participation. The accrediting organization must set and survey safety standards that meet or exceed those set by CMS. Regulations set forth by CMS cover everything from the temperature of food to the protection of patients’ rights to requirements for licensed staff. Medicare regulations also oversee reporting and billing processes. In an attempt to control costs, Medicare reimbursement for hospital services was changed from a fee-for-service (FFS) plan to a Prospective Payment System (PPS) in 1983. Prospective payments are based on a predetermined payment for services based on a number of factors. These factors are derived from the Diagnostic Related Groups (DRG).The DRG is derived from the primary diagnosis and related complications (other diagnoses that exasperate the primary diagnosis or treatment) as well as the region or area in which care is given. The DRG allows for a matrix to be created determining the cost of services for that particular diagnosis and related factors. The region is included in the matrix because the cost of care, like the cost of living, varies from region to region in the United States (rural versus urban areas)

Collepals.com Plagiarism Free Papers

Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.

Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS

Why Hire Collepals.com writers to do your paper?

Quality- We are experienced and have access to ample research materials.

We write plagiarism Free Content

Confidential- We never share or sell your personal information to third parties.

Support-Chat with us today! We are always waiting to answer all your questions.