Significant Medicare and Medicaid healthcare event
Medicaid plays an important function in making sure that over 50 million low-income earners gain access to health care. The expansion of the Medicare and Medicaid programs over the past 2 decades has contributed towards improved health care access for millions and millions of people who are disadvantaged due to financial constraints. At the time that Medicare and Medicaid were enacted only a few percentage of the total population were enrolled. However, today, the number of people enrolled in this program has risen to great numbers. Medicaid is a multiparty state-federal plan which was originally small as it only comprised of those people who received help from the government (Carlson et al 2006). It is, however, one of the largest insurance organizations in the US and it is responsible for covering millions of low-income earners. Changes in Medicare and Medicaid programs have occurred over the years and it has contributed towards a considerable shift in public insurance. These two health care programs have thus become a framework of the healthcare industry. This paper will, therefore, seek to present the impacts of Medicare and Medicaid programs both in short-term and in long-term. Secondly, the paper will seek to discuss on how the Medicare and Medicaid program impact the historical evolution of the health care system, how it contributes to the formation of Affordable Care Act. Lastly, the paper will seek to present the unanticipated outcomes and new problems brought about by Medicare and Medicaid programs.
Medicare and Medicaid have contributed to the remarkable development in contact with the medical care by the financially disadvantaged persons and have greatly increased the access of the aged of all income economic classes to institutional services, for instance, nursing home care. It is also important to note that the Medicare plays much more role than offer health insurance to poor Americans. It plays a significant role in influencing the pricing for most of the medical treatments offered in the United States. For most of all procedures, Medicare comes up with prices which they regard as fair prices for service rendering (Carlson et al 2006). Due to its big size and popularity, Medicare’s pricing seems to influence on the pricing by other health insurers.
The programs have done exceedingly great things as they not only covered millions of people, but they eliminated the racial segregation that is often practiced by healthcare amenities and in many ways, it has assisted in delivering quality health care. By making sure that admittance to care is guaranteed, Medicare has added the life expectancy higher than the one witnessed in the past when the act was passed. Children, who are enrolled in the Medicaid plan, grow into in good health adolescents and young people (Carlson et al 2006).
Innovations have been vital to the advancement of the healthcare system in the US. Medicare and Medicaid government-sponsored health insurance have enormously related a way for these advancements. Medicare has been ranked to be in the front position of increasing new approaches, and the private division tends to follow it. At the time when Medicare was signed into law, it only comprised of hospital and doctor services coverage. However, with time the state enacted Medicaid and in the present day, all plans are inclusive of prescription drug coverage (Carlson et al 2006).
Medicare and Medicaid have significantly helped the American population to make better use of their resources. Home care is a good example of how Medicare and Medicaid have made better use of resources. Due to Medicare and Medicaid programs, home care amenities may play a vital role in the delivery of healthcare services and long-term care in the future than it has in the past years. Medicare and Medicaid programs are empowering the growth of comprehensive services through the use of home health agencies. Through the home care benefit, Medicare and Medicaid programs have promoted a concept of care that is patient oriented. It promotes a continuous focus on the patients and his or her needs (Quinn et al 2016).
Medicare and Medicaid programs are also playing an important role in the sector of human rights all the way through its relations with title VI of the civil rights Act. This is concerned with prejudice in amenities participating in the federal plans. Across the world and across all parts of US, quality medical care is offered equally to sick people regardless of their personality or ethnic group. Black Americans are now able to visit and receive treatment from hospitals that were previously reserved for white people. Therefore, with Medicare and Medicaid programs as an instrument, the issues of discrimination in health care systems are being brought to an end (Carlson et al 2006). Medicare and Medicaid programs offer us a foundation for promoting alternatives to hospital healthcare systems. It has the aspect of one system of enhanced and coordinated services. It offers coverage for a variety of services such as the outpatient health care, extended care amenities, managed home care services and professional review of the practices of utilization.
Medicare programs have also helped in creating a new picture of the state health department and that of the public health experts. It has thus enabled the preparing of responsibilities that are in the present day so as to strengthen Medicare plan in the service of the ill people. Thus they are focused to continually improve the potential of the all-inclusive health care for all the US citizens (DeWalt 2005).
Medicaid was approved in 1965 and it primarily covered people who received welfare. It lacked its own eligibility restrictions and application process. They used to use a card for those who qualified for cash assistance from the program. Its reach was limited as they only assisted the very deserving poor. However, for the program to keep up with the operative welfare standards and budget deliberations, enrolment was discouraged. Therefore, most low-income earners in America remained uninsured (Klees et al 2010).
The Affordable Care Act completed Medicaid’s evolution process from being a welfare program into being an insurance program for low-income earners in America. It removed the reschedule from the welfare of covering only a certain group of low-income people. It is after this that the Medicaid was made available to all the adults in all nations depending on their income regardless of whether they had children or not (Klees et al 2010). The ACA significantly established a new Medicaid eligibility standards and processes that are not associated with welfare but with the marketplace. Medicare and Medicaid’s evolution and transformation is a significant lens through which one can reflect on the present day policies as well as the next generation policies.
Before the inception of the Affordable Care Act, the healthcare system in the United States was subject to a fee for service reimbursement system. These systems often reprimanded health care institutions and health care experts who searched for ways to convey care more competently. Due to this weakness, Medicare came in to prove that it was a blank check for the healthcare systems. Medicare’s goal was to finance access for the aged people to mainstream medicine. It is quite evident that the Medicare and Medicaid effectively enhanced access to medical care for both the low-income earners and the aged people in the US. Most importantly, the Medicare and Medicaid programs have a huge influence on the healthcare industry (Klees et al 2010). The evolution of the Medical care starting from its financing and the various expectations attached to it by the American people for high-quality health care and the coherent use of resources, have associated CMS to clinical medicine.
The Affordable Care Act was established so as to make amendments to the health insurance plans that were assisted by the government. This was aimed at increasing the number of people covered under these plans. ACA, therefore, aims at expanding Medicaid program to a more disadvantaged group f people who are inclusive of middle range people who tried so hard to save so much money so as to qualify for Medicaid but also failed to afford to buy private insurance. It is through this covering of numerous amounts of people that the ACT contributed towards change that is witnessed in five decades of Medicare and Medicaid (Klees et al 2010).
The ACA is one of the foundations of the Obama management’s hard work to strengthen Medicare. Therefore, the ACA was formed with an aim of reducing costs so as to make the Medicare program a success and more sustainable and still help in improving the quality of healthcare delivered to the aged and the disabled people on the Medicare plan. In addition, the formation of the ACA has enabled the Centers for Medicare and Medicaid services to tie reimbursement to quality standards, providing patient’s safety and providing for new incentives for health providers who offer high quality and coordinated care (Klees et al 2010).
Unintended costs of health care legislation intimidate the financial and social welfare of the United States. Spending for Medicare and Medicaid is now seen as unsustainable of the federal budget. If this continues under the current law without necessary amendments in administration and funding, the projected Medicare and Medicaid programs cost will increase to a high level of the state expenditure and in the Gross Domestic Product over the next decades (Thrall 2011). This will create a need for considerable reduction in the amount of the federal budget for other divisions. This may result in the cutting of providers’ compensation so as to reduce Medicare and Medicaid programs expenditure. However, this could increase the rate of occurrence of unanticipated outcomes. Most beneficiaries, therefore, use the traditional Medicare while only a small percentage use the Medicare Advantage which is a private sector alternative that settles at least some of the payments that are not covered by Medicare (Thrall 2011).
Medicaid and Medicare are one of the programs that have the largest items in the government budget. Expenses typically increase during the economic downturns as registration into the programs increases rapidly when people lose their employment and health benefits. That puts the government in a quandary since they struggle to keep up with the higher expenditures as the tax revenues also decrease. Medicaid registration and expenditures increased strikingly during the last recession and the enrollment exploded further in 2014 following the 2010 health law (Klees et al 2010). Governments normally try to control these expenditures through cutting of payments rates to the doctors and the hospitals or even minimizing on the benefits. All these strategies are risky as they pose a negative effect on enrollees by making it difficult for them to enroll in the program.
According to the ruling made by the Supreme Court in 2012, it stated that states could choose to get involved in the health laws and in specific the Medicaid expansion. This weakened Democrats’ efforts to develop their eligibility countrywide. More than twenty states have refused to participate in these programs raising concerns about the program’s efficiency and cost (Grabowski 2007). As a result of this a large number of people have been left out uncovered as are lack any health insurance to cover them due to their inadequate ability to make enough money to qualify them for federal subsidies so as to purchase the private coverage on the health laws exchange despite them being ineligible for the Medicare and Medicaid plans.
Medicaid is often associated with helping the poor and is regarded as the safety net for millions of the middle range people who need long-term care at long-term at home care facilities or even nursing homes. Approximately, more than 60% of the entire population of the nursing homes solely depends on Medicaid for help (Grabowski 2007). With the rapid increase in the aging population in the next two decades, the demand for this long-term care is expected to rise high. US people are aging while the elderly use better health care services. Their population is expected to double over the years. It is also important to note that most of these aging people are currently living longer and this means that they will use additional Medicare and Medicaid assistance and enrollments for a longer period of time than it is expected. Demographic changes form one component of the trouble as the health care expenditures are increasing faster as compared to the economy. The core rationale for these high levels of expenditure on health care in America is due to the high cost of treatment in the US healthcare industry including the high charge of compensation for physicians and other health professionals with high prices for prescribed medicine and rise in the use of medical technology (Grabowski 2007).
Currently, the state is overspending by billions on Medicare and Medicaid programs. However, due to the influence that these programs have on pricing set by private insurance organizations, these errors are being repeated by payers across the healthcare industry. Economists confidently believe that rectifying Medicare and Medicaid pricing mistakes will be vital in stabilizing health care costs (Thrall 2011).
According to the discussion above, it is important to note that the Medicare and Medicaid programs are not so much interested in what they are but rather they are so much interested in what they can offer to their consumers. Their accomplishments, as well as failures, have only helped in improving the health care system. The effect of Medicare and Medicaid programs has been to speed up the progression through an increase in the use of services among the population that was deprived of accessing the health care system. In regards to quality, the major direct contribution of Medicare and Medicaid programs has been to increase the utilization of health care systems. However, the net effect of these programs has been to provide more accessible and better health care to all. In the long term, the greatest achievement that Medicare and Medicaid programs will have made to the quality of the healthcare systems is to have paid attention to all of their downfalls and to have institutionalized the public task on it. Medicare and Medicaid programs have therefore in the past 40 years contributed to the improvement of the quality of life for the poor and the aged. Without the necessary changes, this program will require resources that are expected to severely affect the health care system and potentially other divisions.
References
DeWalt, D. A., Oberlander, J., Carey, T. S., & Roper, W. L. (2005). The significance of Medicare and Medicaid programs for the practice of medicine. Health care financing review, 27(2), 79.
Carlson, M. J., DeVoe, J., & Wright, B. J. (2006). Short-Term Impacts of Coverage Loss in a Medicaid Population: Early Results From a Prospective Cohort Study of the Oregon Health Plan. Annals of Family Medicine, 4(5), 391.
Grabowski, D. C. (2007). Medicare and Medicaid: Conflicting Incentives for Long-Term Care. The Milbank Quarterly, 85(4), 579-610.
Thrall, J. H. (2011). Unintended consequences of health care legislation. Journal of the American College of Radiology: JACR, 8(10), 687.
Klees, B. S., Wolfe, C. J., & Curtis, C. A. (2010). Brief Summaries of Medicare and Medicaid: Title XVIII & Title XIX of the Social Security Act as of November 1, 2010. Retrieved May 26, 2011.
Quinn, K., Weimar, D., Gray, J., & Davies, B. (2016). Thinking About Clinical Outcomes in Medicaid. JOURNAL OF AMBULATORY CARE MANAGEMENT.
