TAKE HOME EXAM --QUESTION #1:
Medicare and Medicaid share many similarities and have many differences in terms of the populations that are eligible for benefits; the general benefits or services covered; and how the programs are funded and administered. Furthermore, a closer inspection of Medicare reveals both strengths and flaws in the program.
Medicare, otherwise known as Title 18, is a federal program that provides healthcare for all those who are 65 years and older. Anyone 65 and older who qualifies for Social Security is automatically eligible for Medicare. In addition, Medicare covers those who are permanently disabled, as well those with kidney failure (end-stage renal disease, ESRD). (Barr, 2007)
All those who qualify for Medicare qualify for Medicare Part A and B. Under the Part A plan which is universal for all seniors receiving Social Security, the government pays for all hospitalization-related costs for 60 days. Benefits include hospice care, skilled nurse facility following hospitalization, and hospice care for terminally ill people. (Barr, 2007)
Funding for Medicare is primarily drawn from three sources: general revenues (40 percent), payroll taxes (38 percent) and premiums paid by beneficiaries (12 percent). (Foundation, 2010) Funding for Part A comes from a 1.5 % payroll tax levied on all workers and employers which is then deposited into a Hospital Insurance Trust Fund. The money paid into the Medicare Trust Fund is not used by those who are contributing to the fund but by those who are already retired. In essence, current workers are subsidizing for those who are retired. Nevertheless patients enjoying the benefits of Part A are still expected to pay a deductible unless they purchase supplementary...
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...f-pocket costs, or at the very least a stagnation of such costs, policy makers are less willing to oblige. One service that is glaringly absent from Medicare is long term care for the elderly but it does not appear as though this will be addressed by Congress soon.
Bibliography
Barr, D. A. (2007). Introduction to US Health Policy: The Organization, Financing and Delivery of Health Care in America. Baltimore: The Johns Hopkins University Press.
Foundation, T. H. (2010). Medicare: A Primer.
Winakur, J. (2005). What are we going to do with dad? Health Affairs .
Bibliography
Barr, D. A. (2007). Introduction to US Health Policy: The Organization, Financing and Delivery of Health Care in America. Baltimore: The Johns Hopkins University Press.
Foundation, T. H. (2010). Medicare: A Primer.
Winakur, J. (2005). What are we going to do with dad? Health Affairs .
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...
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.
During the study of various reforms that were proposed and denied, both the GOP and Democrats attempted to find a balance that would guarantee the success of their proposals. Years of research, growing ideologies, political views and disregard for the country's constitution sparked an array of alternatives to solve the country's healthcare spending. The expenditure of US healthcare dollars was mostly due to hospital reimbursements, which constitute to 30% (Longest & Darr, 2008). During the research for alternatives, the gr...
Niles, Nancy J. Basics of the U.S. Health Care System. Sudbury, MA: Jones and Bartlett, 2011. Print.
hospitalization and 60 days of nursing home care, coverage for doctor’s bills was even an
Medicare and Medicaid are one of important government programs. According to Medicaid.gov site, there are more than 4.6 million low-income seniors enrolled in Medicare and about 8.3 million people that are enrolled in both Medicare and Medicaid. Anyone that enrolled with Medicare and limited income and resources are eligible to get assistance paying for their premiums and out-of-pocket medical expenses from Medicaid. Not only does Medicaid cover additional services, but, services covered by both programs are first paid by Medicare with Medicaid in the difference up to the state’s payment limit (Medicaid.gov, 2015) .
In 1965 President Johnson signed both Medicare and Medicaid programs into law (Nile, 2011). According to Medical news today, “Medicare is a social insurance program that serves more than 44 million enrollees as of 2008” (MediLexicon International Ltd, 2011, para2). It cost about $432 billion or 3.2% of GDP, as of 2007(par2).Medicare is broken down into parts, Part A is hospital Insurance Part B is medical Insurance, and Part D is Medicare prescription drug coverage (medicare.gov). Like we previously stated Medicare is a health insurance for people who are 65 and older, people under 65 with certain disabilities, and people of any age with End- Stage Renal Disease. Medicaid is a joint federal-state program of medical assistance for low income persons (Benefit.gov). It is administered by the Illinois Department of Human Services (DHS) and Illinois Department of Public Aid (IDPA). Medicaid serves about 40 million people as of 2007; it cost $330 billion, or 2.4% of GDP, in 2007.(par.2) “In Illinois you may be eligible for Medicaid if you are a child, pre...
Medicare Part A is meant to be a major medical hospitalization plan that is offered to everybody US citizen that has turned 65 years old. It covers inpatient care in hospitals and skilled nursing facilities, hospice care, some home health care services, a semi-...
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.
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 and Medicaid are two of the United States largest broken systems, which must sustain themselves in order to provide care to their beneficiaries. Both Medicare and Medicaid are funding by a joint effort between the federal government and the local state government. If and when these governments choose to cut funding or reduce spending, Medicare and Medicaid take the biggest hit. Most people see these two benefits as one in the same, two benefits the government takes out of their pay check to help fund health care. While the government does deduct a sum from paychecks everywhere, Medicare and Medicaid are very two very different programs.
Medicare is a federal health insurance program for people, who are age sixty five or older, or people that have End Stage Renal Disease and permanent disabilities. There are four different entities of Medicare to include; Medicare Part A which is the Hospital Benefit that covers inpatient hospital services, hospice treatment, skilled nursing facilities and other home health services. Medicare Part B that covers the Professional component of the physicians' services, preventive services and medical supplies then there is Medicare Part C which is considered a Medicare Advantage Plans that is offered by a private company that has a contract with Medicare to provide the patient with both Part A and Part B benefits. A Medicare Advantage Plans consist of Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Private Fee for Special Needs Plans, Service Plans, and Medicare Medical Savings Account Plans.
Niles, N. J. (2011). Basics of the U.S. health care system. Sudbury, MA: Jones and Bartlett.
Medicare and Medicaid are programs that have been developed to assist Americans in attainment of quality health care. Both programs were established in 1965 and are federally supported to provide health care coverage to vulnerable populations such as the elderly, the disabled, and people with low incomes. Both Medicare and Medicaid are federally mandated and determine coverage under each program; both are run by the Centers for Medicare & Medicaid Services, a federal agency ("What is Medicare? What is Medicaid?” 2008).
Medicare is the federal program that provides health coverage for people who are 65 and older (Green, 2003). Although many assume that Medicare provides long-term care, these benefits are very limited and are not efficient enough to accommodate the much needed care services for older adults. For example, Medicare programs do not help to pay for personal care services such as eating, dressing or using the bathroom even though these “activities of daily life” are the most needed services for most seniors (Green, 2003). These care services can be provided to seniors by the long term care insurance program. According to the national survey that was conducted among people who are 55 and older, just 36% believed that they would need long term insurance (Carter, 2008). However, it's estimated that at least 60% of people over age of 65 will require some long-term care services at...