Essay On Medicare

MEDICARE: Problems and Solutions

Status of Medicare:

Medicare is source of health insurance for nearly 54 million in 2014, which covers people aged greater than 65 years and younger individuals living with permanent disabilities.1

In 2013, average per capita Medicare spending is about $12,000(Boards of Trustees, 2012). People starts paying throughout their working lives so that they and their spouses will get benefit after they turn 65. But, they use some amount of medical care in any given year while majority is concentrated among the beneficiaries with significant needs and medical expenses. Between 2010 and 2030, the number of people on Medicare would increase from 46 million to 78 million while the Medicare Part A Hospital Insurance Fund will have

inadequate funds to pay for full benefits beginning in 2019.2 According to Congressional Budget office, annual Medicare cost in 2012 is $556 billion, which will increase to $1.041 trillion by 2022. Thus the Financial care for future generations is at risk as the rise in health care costs, the aging of U.S. population and decreasing ratio of workers to beneficiaries.1And also, the spending of Medicare on healthcare is increasing day by day.

Proposed course of action:
To sustain the Medicare for future generations: Medicare should accept the site neutral payments as it would reduce the overall healthcare cost and it would also be beneficial to Medicare as well as beneficiaries.

According to MedPAC’s 2013 report, beneficiaries would collectively save about $800 million annually. And it also identifies that if outpatient hospital payment rates are lowered and made same as the rate in ambulatory surgical centers for the services that are commonly performed in ambulatory surgical centers then Medicare can save about $ 600 million annually.3

It should come up with new plan having comprehensive benefit package, as an alternative to Medicare Advantage and traditional Medicare. Additionally, it should try to remove the “Fee for Service” as it has spends $362 billion for “Fee for Service” in2014 and should develop patient’s care oriented payment system which would eventually reduce its spending on health care.4

Even the Physicians and Specialist doctors should try to avoid the unnecessary tests and unnecessary readmission in hospital, which would reduce the Medicare spending on Health care. And also, patient should avoid fraudulent home- health

services.

Opposition and Support:
Medicare supports are increasing like as in 2013, 13 family physicians in McAllen, Texas could save $ 6 million of Medicare in first year, by just reducing patient’s use of unnecessary or fraudulent home health services.5 And even alternate payment system is set up under Affordable Care Act where physicians, hospitals and specialty doctors form networks for care of patient and entire network is responsible for cost and care of the patient.

Rehabilitation providers are against the MedPAC’s proposal regarding site neutral payments. They believe that it would place beneficiaries in trouble and also by giving priority to cost over patient outcomes would be more risky. They believe that quality of care provided by nursing homes and rehabilitation center is different so how can the cost be same in both center. It could be problematic because site neutral payment doesn’t have any evidence regarding quality of care provided to patient and it is untested too.6

Conclusion:
Medicare should implement the site neutral payment as by giving different pay to different Physicians or to different service providers for same service, the atmosphere of health care system would seems to be more business oriented rather than patient focused atmosphere. And by doing so, it would reduce the overall cost of healthcare and savings of Medicare would increase which would benefit the future generations.