1. The two major differences between Medicare and Medicaid are who the plan is provided for and who is in charge of providing each plan. The majority of other differences stem from these two dissimilarities. Medicare is a health insurance plan for people over 65 years of age (also includes a few other smaller groups such as younger children with certain disabilities), while Medicaid is provided for citizens who cannot afford other healthcare insurance plans due to their low income. Because of this, Medicaid pays the providers less, so it is not uncommon that doctors will refuse to take patients who use Medicaid. Medicare, on the other hand, hardly ever negotiates prices, so doctors usually end up receiving what they charge. Medicare is completely …show more content…
There are many reasons as to why healthcare is more expensive in the United States than any other country. One of them is because of the high profit margins that are protected by pharmaceutical companies. In other countries like the UK, the government can negotiate lower prices which brings down the cost, while the US is stuck paying higher prices because legislation greatly reduces negotiating power of the US government. Another reason is that consumers in America are not the direct payer, therefore, they generally do not care about how much providers charge because it does not directly affect them (through direct pay or taxes). Along the same lines, in many other countries, the government is the only buyer of medical services because patients pay for services through taxes. This causes the healthcare market to essentially be a “buyer’s market,” which drives the cost down. Another major reason for expensive healthcare is because American doctors are paid much more than doctors in other countries. A big part of this has to do with the very long and expensive road of medical school in the US, necessitating that doctors get paid more so that the process is worth it for them financially. Finally, the healthcare system is very bloated, with payments usually going through multiple intermediaries and each insurance company taking a percentage of the payment. The government does not regulate the costs in the industry very well, essentially creating a “seller’s market.” These are just some of the reasons of why the most expensive healthcare in the world is in the United
Eligibility for Medicaid programs in Michigan is based on either income only or income and assets. In addition, many of the programs available have age restrictions and/or require applicants to have certain health conditions (e.g. pregnancy). Eligibility requirements for Medicaid in Indiana are similar to those of Michigan. The two programs, however, do contrast in three substantial ways. Two out of three of these ways indicates that Indiana has the better program.
The United States of America accounts for only 5% of the world’s population, yet as a nation, we devour over 50% of the world’s pharmaceutical medication and around 80% of the world’s prescription narcotics (American Addict). The increasing demand for prescription medication in America has evoked a national health crisis in which the government and big business benefit at the expense of the American public.
On a global scale, the United States is a relatively wealthy country of advanced industrialization. Unfortunately, the healthcare system is among the costliest, spending close to 18% of gross domestic product (GDP) towards funding healthcare (2011). No universal healthcare coverage is currently available. United States healthcare is currently funded through private, federal, state, and local sources. Coverage is provided privately and through the government and military. Nearly 85% of the U.S. population is covered to some extent, leaving a population of close to 48 million without any type of health insurance. Cost is the primary reason for lack of insurance and individuals foregoing medical care and use of prescription medications.
Last year the average cost of an insurance policy for a family of four was $20,728.00 according to the Milliman Medical Index (2012 Milliman Medical Index, figure 1). The median household income for 2012 was $51,017.00 according to Steve Hargreaves for CNN Money (2013, para. 1). This means the average American spends almost 40.62 percent of health care premiums. This figure is simply too high to sustain. By comparison the median household income in 2005 was $67,019 according to the United States Census Bureau ( Median Income for 4-Person Families n.d.). The average cost of healthcare according to the Milliman Medical Index for 2005 was $12,214 which was only 18.22 percent. (2005 Milliman Medical Index, figure 1). The percentage Americans spend on health care has more than doubled since 2005. If we don't find a way to get the costs of providing health care under control, then this country cannot survive.
Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities and people of any age with End-Stage Renal Disease. There are four subcategories of Medicare. Part A is for hospital stays or, with certain restrictions, at-home care for a limited number of days. Part B is more like regular medical insurance. It covers ambulatory care and physician fees. There is a deductible and are sometimes co-pays as well. Part C is presented as an alternative to parts A and B. It is where private insurance companies can contract with the federal government to offer Medicare benefits through their own policies. It can offer benefits not covered under original Medicare, although there might be a premium charged. Part D is the prescription plan for enrollees. (Centers for Medicare and Medicaid Services, 2010)
for Medicare, you must meet certain conditions. A person qualifies if they are 65 years of age
The author identifies some of the federal and state legislators that are also opposed to the Medicaid expansion in the writer’s district. US Senator John Cornyn says that the Obamacare Medicaid expansion program is formed to be wasteful, fraudulent, and abusive to the nation (Cornyn, 2010). According to US Senator Cornyn, “The $3.4 trillion federal taxpayers spend on the Medicaid program is a target for waste, fraud, and abuse. Instead of fixing these problems, the President’s new health care overhaul includes the largest expansion of the broken Medicaid program since its creation in 1965: it’s only going to get worse from here” (John Cornyn, 2010).
According to Medicare’s WebPage Medicare is a Health Insurance Program for people 65 years of age and older, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). Medicare has two parts, Part A which is for basically hospital insurance. Most people do not have to pay for Part A. In addition it has a Part B, which is basically medical insurance. Most people pay a small monthly fee for Part B. Medicare first went into effect in 1966 and was originally administered by the Social Security Administration. In 1977 the control of it was switched over to the newly formed Health Care Financing Administration. Beginning in July 1973 Medicare was extended to persons under the age of 65 with certain disabling conditions. In 1988 Congress passed legislation to expand the program to cover health care costs of catastrophic illnesses.
Medicare was designed for beneficiaries sixty five years and older and enrollees who are permanently disabled and are unable to work. Medicare benefits are applied for at the Social Security office, where proof of eligibility is required. Medicaid however is health care benefits for those who are low income and do not have insurance through their job (Medicare.gov, 2008).
Medicare Advantage plans is different insurance companies that offer insurance coverage for patients that qualify for traditional Medicare. These plans are produced by private companies and approved by Medicare. Medicare in turns pays a fixed amount to the companies to provide coverage for these patients. Each company has different out-of-pockets and different rules. Some may require referrals or authorizations for services and some my only offer in network benefits to name a few (How do Medicare Advantage Plans work?).
Medicare is the nation’s largest health insurance program. Generally, you are eligible for Medicare if you or your spouse worked for at least ten years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States. Medicare-covered services include hospital insurance, inpatient hospital care, skilled nursing facility care, home health care, hospice care, and medical insurance (Medicare U.S.) With such an encompassing effect on the health insurance field, Medicare provides a haven for older individuals, and end-stage renal disease (ESRD) patients who require the best medical care for whatever possible reason. The only problem with this scenario is that doctors are turning many older patients away because they have Medicare. Why do doctors turn away Medicare patients? Is there a reason why certain doctors turn away certain patients?
Medicare is a national social insurance program, run by the U.S. federal government since 1966 that promises health insurance for Americans aged 65 and older and younger people with disabilities. Being the nation’s single largest health insurance program, covering a large population for a wide range of health services, Medicare's funding is a fundamental part of it sustainability. Medicare is comprised of several different parts, serving different purposes, some of which require separate funding. In general, people at the age of 65 and older who have been legal residents of the United States for at least 5 years are eligible for Medicare. Same is true with people that have disabilities under 65, if they receive Social Security Disability Insurance benefits. Medicare involves four parts: Part A is hospital insurance. Part B is additional medical insurance, that Part A doesn't cover. Part C health plans, also mostly known as Medicare Advantage, are another way for original Medicare beneficiaries to receive their Part A, B and D benefits. Medicare Part D covers many prescription drugs, some of which are covered by Part B. Medicare is a major operation, not only needing adequate administering but the necessary allocated funds to keep this massive system afloat.
The U.S. expends far more on healthcare than any other country in the world, yet we get fewer benefits, less than ideal health outcomes, and a lot of dissatisfaction manifested by unequal access, the significant numbers of uninsured and underinsured Americans, uneven quality, and unconstrained wastes. The financing of healthcare is also complicated, as there is no single payer system and payment schemes vary across payors and providers.
As of 2013 data, the US per capita government expenditure was $4307 while total per capita expenditure on health spending was $9146, which is 17.1 percent of the GDP (2013) for the total expenditure on health. The annual rate of growth in per capita government spending on healthcare has been roughly 5.1 percent over the past thirty years (WHO, 2015). This rate of spending on health care growing faster than the economy for many years creates challenges ...
The recession has had a toll on all off this and nobody knows when it will all recover to the way it was before. The prices of medical insurance and procedures and even simple walk-ins are flying through the roof and less people are bale to even afford them. India and China have had a significant growth in their economy where the prices have been much cheaper than the prices America has; even for the same quality and product or even procedure. My grandparents both needed knee replacement surgery while they resided in Texas and the doctors had slammed them with a quote of $75,000 for one knee; Back in India they had a quote of $75,000 for two knees. The procedure was the same and the materials were the same and even the equipment was the same; the doctor who performed the surgery was educated in the US at Harvard Medical School and went back to India to help the people who can afford the surgeries rather than hurt them even more in America with the large costs. So why do the doctors in America charge so