Medicare was designed as a universal healthcare program for individuals 65 years old and older. This program is funded by Medicare taxes and general federal funding withholding taxes. Medicare is a partnership between federal and state with the goal to provide medical insurance to the elderly that is poor and disabled. Generally all people who are 65 years or older and qualify for social security will automatically qualify for Medicare.
There are four components to the Medicare program, part A, B, C and D. Part A of Medicare covers in patient hospital services; patients have a financial responsibility to cover a deductible that is equivalent to 1 day of hospitalization, thereafter cost is covered at 100 percent for a maximum of 60 days. This also includes nursing facilities, home and hospice care. Part B covers outpatient surgery and physician office visits. This is an elective component of Medicare in that there is a premium associated with this plan that is paid for directly through social security payments. Part C is know as Medicare Advantage and is a supplemental policy that is purchased directly from employers; one may be denied for health reasons depending one when the plan is acquired. Part D is prescription drug coverage that is eligible to all individuals that qualify for Medicare. Beneficiaries of the Medicare choose which prescription plan they want and pay a corresponding monthly premium.
The increasing number of enrollees, new prescription drug benefit, Part B utilization and availability of enhanced technology has led to a rise in Medicare cost. Out of all the contributing factors of the rise in cost in Medicare, Part B utilizations have been a major cost driver.
Thus far the affordable care act (ACA) has made...
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...ple less than or equal to 133% of the FPL, starting 2014 eligibility will be expanded to people that are 138% or les of the FPL. Also the expansion will cover more parents and expand to adults who are childless. Fore states that choose to accept the expansion this means that they will have to cover more individuals in their Medicaid programs. The government will provide 100% funding for the first 3 years of the Medicaid expansion; thereafter the states will have to figure out how they will fund the program with the absence of federal funding. The stipulation with expanding Medicaid that after the three years are up the state cannot modify the program to not cover the expanding individuals. States that in financial ruins before the ACA, now with the expansion they will need to find alternative ways that will serve the same purpose as Medicaid in order to lower cost.
Kaiser Permanente’s mission is to provide care assistance to those in need. As a health maintenance organization, Kaiser Permanente provides preventive care such as prenatal care, immunizations, diagnostics, hospital medical and pharmacy services. Also, they take responsibility and provide exceptional training for their future health professionals for better clinical performance and treatment for the patients. The organization is to ensure fair and proper treatment towards their employees for a pleasant working environment in hospital and to provide medical services especially in a growing population in suburban communities, such as Tracy and Stockton in California.
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.
(II) The enacting of Medicare Part D in 2006 only helped to fuel America’s hunger for prescription medication. In 2003, President George W. Bush announced and signed the Medicare Prescription Drug, Improvement, and Modernization Act (also known as the Medicare Modernization Act, or MMA) on December 8th. The roughly $400 billion dollar measure was marketed to the American public as something that will provide care for the millions of senior citizens who, at the time, were struggling to afford prescription medication. This was the largest development of Medicare since 1965, which is when the program was initially created, and gave hope to those wishing for positive medical reform. According to title XI of the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003”, the most significant change will be the affordability of prescription drugs by implementing the importation of drugs from Canada, along with necessary safety measures, in order to lessen the cost (United States Congress, 832). For those who were in retirement homes and lacked a steady income, the affordability of drugs was often a deciding factor in the decision to seek medical attention and the idea that those individuals ceased to live simply because they lacked the funds tugged at the heartstrings of many Americans.
There are several issues concerning the uninsured and underinsured patient population in America. There are many areas of concern the congressional efforts to increase the availability of health insurance, the public image of the insurance industry illustrated by the movie "John Q", the lack of good management tools, and creating health insurance coverage for all low income Americans. Since the number of uninsured Americans has risen to 43 million from 37 million in the flourishing 1990s and could shoot up even more severely if the economy continues to decrease and health care premiums keep increasing (Insurance No Simple Fix, 2001).
As part of the Affordable Care Act, beginning this year Medicaid will expand eligibility to include all uninsured individuals under the age of 65 whose incomes fall at or below 138 percent of the Federal Poverty Level, or about $32,500 for a family of four. However, the 2012 Supreme Court ruling that upheld the law also allowed states more flexibility concerning what parts of the ACA they can implement and said that those same states would not lose federal funding for their existing programs. This result would leave the decision to opt out of the law's provision into the hands of state legislators. While twenty-six states have chosen to expand healthcare coverage, twenty-one states have not and four have yet to make a decision. The state of Florida is among those not seeking to expand coverage and that decision alone could cost Florida millions of dollars a year in tax penalties. As conservative and liberal state lawmakers square off into a maelstrom of debate over whether Medicaid should cover more people, thousands of uninsured Floridians will be caught in the crossfire.
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
Medicare provides healthcare coverage for individuals over the age of 65, in addition, to others meeting certain criteria. The government funds Medicare through the administration of the federal Centers for Medicare and Medicaid and spends billions annually, on the program. Fraud runs rampantly throughout the healthcare program due to the enormous amount of money spent and the large number of people enrolled in the program. Fighting fraud of this nature necessitates diligence by everyone. Protecting oneself entails understanding what constitutes fraud, identifying it, noting suspicious practices, and taking steps towards prevention.
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 is a federally funded program that provides health insurance to Americans with end-stage renal disease, those at age 65, and younger people who qualify for Social Security disability benefits. It was initially passed as Part A (hospital care) and Part B (outpatient care) until the Balanced Budget Act of 1997 was created. Under this act, Part C (aka Medicare+Choice, now Medicare Advantage) combined A and B into a voluntary managed care program. Later, voluntary Part D was created, offering outpatient prescription coverage. Medicare expenditures increased from $4.2 billion in 1967 to $205 billion per year by 2000, $554.3 billion in 2011, and it’s expected to surpass $1 trillion by 2022. Medicaid provides free or low-cost healthcare
...erring income from working-age persons to retired or disabled former workers. There are two parts in financing of Medicare. Part A (hospital insurance) comes from payroll taxes paid on and by all workers in the U.S. labor force. Individuals who have paid into the social security system for ten years are automatically enrolled in Part A upon reaching their sixty-fifth birthday.
Medicare plan Part A covers hospital care, skilled nursing facility care, nursing home care, hospice, and home health services, but its only up to a certain amount of days or per benefit period. And Part B covers clinical research, ambulance services, durable
However, Medicare part A and Medicare part B do not cover prescription drugs expenses automatically. This is why Medicare had designed a different part to deal with prescription drugs coverage, that is, Medicare part D.
Access to health care refers to the ease with which an individual can obtain needed medical services. Many Americans face barriers that make it difficult to obtain basic health care services. These barriers to services include lack of availability, high cost, and lack of insurance coverage. "Limited access to health care impacts people's ability to reach their full potential, negatively affecting their quality of life." (Access to Health Services, 2014) Access to health services encompasses four components that include coverage, services, timeliness, and workforce
...ue to numerous medical errors. With the amount of medical errors that currently do occur which is a current health care issue it cost the health care billions of dollar each year to fix the mistakes that were made.
Health care has always been an interesting topic all over the world. Voltaire once said, “The art of medicine consists of amusing the patient while nature cures the disease.” It may seem like health care that nothing gets accomplished in different health care systems, but ultimately many trying to cures diseases and improve health care systems.