The Balanced Budget Act of 1997 In 1997 the Clinton Administration signed into law the Balanced Budget Act. One of the key provisions of this act was reduction in Medicare payments to health care providers. The reductions threw a health care system that was essentially in equilibrium into turmoil. “Let me describe the BBA’s phase-out methodology in this way. Imagine a grocery store buys a gallon of milk from their wholesaler for $4.00, but the law allows the purchaser to buy that same gallon of milk for $3.00. Does anyone believe the purchaser won’t buy the milk for $3.00? How long would that store sell milk? If they did decide to sell milk, how long would they stay in business?” (D.H. Impact of Budget…) The answers to the questions are fairly obvious, but in fact this is exactly what the Balanced Budget Act of 1997 did to hospitals across the country. By substantially lowering the payments for Medicare patients, the government forced many hospitals and out of business and managed-care companies to stop caring for Medicare patients. 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. The Balanced Budget Act of 1997 was designed to lower spending in some areas to help balance the budget. Hence the name Balanced Budget Act. The main area from which the BBA cuts back spending is Medicare. Changes in the Medicare program were an essential part of the budget agreement that led to the Balanced Budget Act of 1997. Without the $191.5 billion in net spending reductions over the next five years, a balanced budget would not have been achieved.
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...
(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 is an ongoing debate on the topic of how to fix the health care system in America. Some believe that there should be a Single Payer system that ensures all health care costs are covered by the government, and the people that want a Public Option system believe that there should be no government interference with paying for individual’s health care costs. In 1993, President Bill Clinton introduced the Health Security Act. Its goal was to provide universal health care for America. There was a lot of controversy throughout the nation whether this Act was going in the right direction, and in 1994, the Act died. Since then there have been multiple other attempts to fix the health care situation, but those attempts have not succeeded. The Affordable Care Act was passed in the senate on December 24, 2009, and passed in the house on March 21, 2010. President Obama signed it into law on March 23 (Obamacare Facts). This indeed was a step forward to end the debate about health care, and began to establish the middle ground for people in America. In order for America to stay on track to rebuild the health care system, we need to keep going in the same direction and expand our horizons by keeping and adding on to the Affordable Care Act so every citizen is content.
2008). Started in 1965 as a portion of the Social Security Act, Medicare’s chief objective is to
Medicare and Medicaid together "are the single biggest contributor to [the United States] long term [budget] deficit." This idea was expressed by President Obama during his 2011 state of the Union Speech. After saying this, the president said that health care costs need to be reduced, including these two services. Medicare and Medicaid are beneficial to those who receive their services, and the criteria for eligibility currently allow many to qualify for either program. This is most likely the cause of the major deficit that the president spoke of. However, downsizing or eliminating these programs to lessen the deficit will affect many people and their ability to receive healthcare.
From the precursor of the 1960 Medicaid program, the Kerr-Mills Act, to the establishment of the Medicare and Medicaid in 1965, and the implementation of today’s Patient Protection and Affordable Care Act, the process signified our national leaders worked vigorously to pave the way creating accessible healthcare coverage for the citizen. The Affordable Care Act (ACA), change the structure in the delivery of health care, reduce health care cost and improve quality of care.
This act actually amended the Social Security Act of 1935 to include the initiation of health insurance programs for the elderly called Medicare, as well as for the poor, which is called Medicare. This would shelter the over 65 aged individual and the disabled or indigent person from the expense of hospitals and similar medical care procedures. What was originated to assist the most vulnerable citizens has bettered our health care in other ways too. For example, it has raised the life expectancy of all people higher. It has improved the services received by all patients in medical facilities. Also, children that were on Medicare grew up as healthier teenagers and adults alike. It would be safe to assume that the healthier the individual is the more probability of success the person
American people look at their insurance bills, co-pays and drug costs, and can't understand why they continue to increase. The insured should consider all of these reasons before getting upset. In 2004, employee health care premiums increased over 11 percent, four times more than the rate of inflation. In 2003, premiums rose 10.1 percent and in 2002 they rose 15 percent. Employee spending for coverage increased 126 percent between 2000 and 2004. Those increases were lower than expected. (National Coalition on Health Care, 2005, Facts on health care costs). Premiums have risen five times faster than workers wages, on average. If medical spending continues to rise by just two percent more than personal income, by 2040 Medicare and Medicaid would hit 18.5 percent of the gross domestic product, leading the federal deficit to be 20.7 of the gross domestic product. (Melcer, R., 2004, St Louis Post-Dispatch, Rising Costs of healthcare pose huge challenges).
Throughout the years, there have been many individuals and families who have not been able to afford healthcare. Some programs have helped to provide for those in need, but they have not provided to all needy citizens. In an effort to provide more people with the healthcare and insurance they truly need, the United States government has developed the Affordable Care Act. The act’s purpose is to expand Medicare, which was originally developed to provide for the elderly and the disabled, to those who are not disabled but are in times of financial hardship. The Affordable Care Act was originally developed to ensure healthcare to all individuals who could not afford it on their own. It would seem that the increase in the number of patients would benefit hospitals, but this act does the opposite of its intended outcome. There are more patients visiting the hospitals, but the act lowers the costs of their medical bills, which in turn decreases the hospitals’ incomes. This decreased source of income causes both the patients and the employees to find new solutions to the increased amount of issues that they now endure.
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).
In the United States, spending on Medicaid's forty million beneficiaries is projected to an overall of two hundred twenty billion during the fiscal year of 2001. In the year 1998, the federal government's share of medicaid expenditures averaged about fifty-seven percent in every state. Eleven percent is the average rate the Medicaid spending grew during the years between 1980 to 2000. Moderate spending caused a concern to both the federal legal and regulatory efforts aimed at states use of financing mechanisms. For example most states used a huge amount of disproportionate share hospital payments, intergovernmental transfers, and provider taxes and donations. However, this did not impact the enrollment of people to Medicaid due to a strong economy along with state welfare reform and fewer expansions in eligibility. Services provided to Medicaid recipients were provided at costs that remained constant due to moderate health care price inflation along with expanded use of managed care and increased use of home and community-based alternative to costly institutional long term care.
Many pivotal events over the last century have brought our healthcare system to where it is today. Some were indirect, such as World War II (and how it led to direct events such as medical advances that shifted focus from critical care and managing contagion to preventive medicine and health insurance as an employee benefit) and the internet (which has provided a wealth of tools and resources that were once only available to healthcare providers and has served to foster technological advancements such as Electronic Health Records and telemedicine). Others were targeted interventions, such as the Hill-Burton Act, which was enacted in 1946 and provided infrastructure dollars to healthcare facilities that agreed to provide a significant volume of free or reduced cost services to those with limited ability to pay (HRSA, 2014). Perhaps the most influential targeted event was the passage of Medicare and Medicaid programs, which was the point at which the government became the administrator for insurance programs for the poor, creating a system that would continuously grow and impact service delivery through regulatory control.
While President Harry Truman had proposed a centralized health care scheme in the late 1940’s, the bill failed to pass in Congress. With Lyndon Johnson’s strong leadership and gift of persuasion, Congress enacted both Medicare and Medicaid on July 30th, 1965 as amendments to the Social Security Act. Medicare and Medicaid became the United States first public health insurance programs. Medicaid became a federal-state partnership program in which voluntarily participating states would receive grants for those eligible in a state to access a defined set of medical and long-term care benefits. (http://kaiserfamilyfoundation.files.wordpress.com/2008/04/5-02-13-medicaid-timeline.pdf).
The bill created a Job Corps similar to the New Deal Civilian Conservation Corps; a domestic peace corps; a system for vocational training. The bill also funded community action programs and extended loans to small businessmen and farmers. This helped people to get jobs with good wages.Then came the Medicare Act of 1965 which help people to get better health coverage. “No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they might enjoy dignity in their later years” (1) In 1964 more than 44 percent senior had no health coverage or insurance. Senior citizens were dragged down to poverty as they were not able to pay the medical bills. But after the Medicare Act of 1965 which provide everyone with the medical coverage of all people age 65 and above this issue was almost solved. Along with the Medicare, the Johnson Administration established the Medicaid program to provide healthcare to the poor. Different from Medicare, this Federal-state partnership is largely determined in form and construct by each individual state. In the first three years of the program, nearly 20 million beneficiaries were enrolled
On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173). This landmark legislation provides seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. One month later, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the figure presented by the Bush administration during Congressional debate. The inaccurate figure helped secure support from fiscally conservative Republicans. It was reported that an administration official, Thomas A. Scully, had concealed the higher estimate and threatened to fire Medicare Chief Actuary Richard Foster if he revealed it. By early 2005, the White House Budget had increased the 10-year estimate to $1.2 trillion.