Financial Assistance Program For Health Coverage

It is no secret that the cost of American healthcare is becoming increasingly more expensive. However, the issue of the rising cost of healthcare and its severity needs to be recognized as a major problem. Health prices are steadily increasing in the United States, and there is no sign of it stopping. Since 1970, spending on American health care has grown 9.8%, which is a rate that is growing faster than the economy (“New Technology”.) Furthermore, health insurance premiums are also increasing at a rate five times faster than American salaries, which makes it difficult for families to afford health care coverage (Zuckerman 28). Therefore, it has become an obligation to address why the cost of American health care is soaring and to seek out a solution to lower the cost. Many would jump to the conclusion that the United States simply charges too much for their medical services, but there are deeper influences that need to be analyzed. The causes of the rising cost of health care are people not using preventive health care, the development of modern technology, and the treatments being overprescribed. A possible solution is to have preventive health care services available in clinics of low-income areas.

In 2012-2013, Mr. Carl Heastie, Assembly man for the North-East Bronx, was instrumental in restoring the budgetary costs to cover the Elderly Pharmaceutical Insurance Coverage (EPIC) program. Prior to his involvement, seniors enrolled in the EPIC program, were forced to pay up to 25% of the cost of each medication. With his input in the decision making, the co-pay, was decreased to &20,00 for payment for each prescription. This paper will attempt to show, his commitment towards this health care issues, intended to be depicted during a set interview with him.

The purpose of this paper is to give an overview of two federally and/or state funded programs. The programs that will be discussed are Medicare and Medicaid. In this paper will be information about who receives Medicaid/Medicare, the services offered by these programs, and those long term services that are not.

I was intrigued by the amount of pill bottles that one patient had in his kitchen cupboard which made me reflect on the cost of health care produced by the older adult. I began to research the cost of living longer and found that as of 2011, 24 percent of the Medicare population were over the age of 80. I also found that Medicare spending for those above the age of 85 averages around $14,745 (Neuman, Cubanski, Huaung, & Damico, 2015). So I ended up learning that the older

The cost of health care has been at the forefront of politics for years. It is one of the most talked about topics not just in political venues but also country wide. Every American has an opinion on how our economy can be fixed and they are passionate about health care reform. The price of insurance alone causes many Americans to not have coverage. For those that can afford coverage, the struggle to pay co pays is immensely crippling their bank accounts. Of these burdens on Americans today, the most frightening fact lies in the cost of prescription medications.

Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the

This exercise point out some very important factors with regard to health care cost.  nursing homes and other health care delivery systems are faced with significant shortfalls in reimbursement for various reasons.  Medicare reimbursement often does not cover the full extent of treatment of individuals.  McPike (2008) notes that, “The insurance and hospital industries released a study today showing that underpayment by Medicare and Medicaid costs consumers and employers $88 billion more a year for health care as providers attempt to make up the difference.” Today with continue cutbacks in medicare reimbursement this number is significantly higher.  In an attempt to reclaim these losses, both self pay and privately insured patients are charge

That is the highest number in the nation and more than double the next highest of 302,000 children in California.

The rise in costs of prescription medicines affects all sectors of the health care industry, including private insurers, public programs, and patients. Spending on prescription drugs continues to be an important health care concern, particularly in light of rising pharmaceutical costs, the aging population, and increased use of costly specialty drugs. In recent history, increases in prescription drug costs have outpaced other categories of health care spending, rising rapidly throughout the latter half of the 1990s and early 2000s. (Kaiseredu.org, 2012).

The Commonwealth Fund, New York. (2006). US Medicare Prescription Drug Coverage. Retrieved from US Me

One of the problems of Medicare itself is that it doesn't cover the costs of prescription drugs for its members; this has led to one of the major reasons that the program is in danger. A great deal of personal healthcare relies on the use of drugs, and since the program doesn't cover these costs, the individual must bear them. According to the AARP, in 1999 out-of-pocket costs for prescription drugs were estimated to be $450 per person each year (AARP). Obviously, members have joined the program to defray their medical costs, but these figures indicate that they still have large costs to pay. The other problem faced by the Medicare program is that it is also suffering from a lack of funds. According to Governor George W. Bush, the financial health of Medicare is in serious jeopardy and might face deficit as soon as 2010 (Bush). As a result of these major problems, one might wonder why the plan isn't scrapped for another program; well according to polls done by the Public Agenda, an Internet public policy site, American citizens are strongly in favor of Medicare, and would rather see the problems ironed out (Public Agenda). Therefore it is necessary to come up with a solution, so that the Medicare program remains intact.

The growing concern regarding the financial security of Medicare is one of particular interest to the nearly 72 million baby boomers that become eligible for this government-assisted, and tax-payer bolstered, program over the next two decades. According to the U.S. Census Bureau (2010), there will be a rapid increase in baby-boomers between 2010 and 2030, as the entire baby boomer population move into the 65 years and over category (p.3). Political and financial revisions must be made to ensure the security of Medicare as the numbers of individuals paying into this program are soon to be surpassed by the number of individuals drawing-off this program (U.S. Census Bureau, 2010). The elderly are also at a disadvantage with transportation to health care visits, picking up prescriptions, and rehabilitation services. There needs to be an establishment of access not only to primary care providers, hospitals, and rehabilitation services, but access to other aspects of the health care system for the elderly population.

Research conducted indicates that this method of fund raising will increase the state resources by approximately 11% and as a result more low income individuals and families will have access to appropriate health services to manage their conditions (CPBB, 2015). It is proposed that the federal and state government allocate the funds obtained towards the Medicare and Medicaid programs. This will expand the services offered by these programs and with additional funds; they can provide individuals with access to specialized care and services needed to manage their condition. However, it is imperative that the federally established poverty guideline be periodically re-evaluated, to increase the percentage of individuals that are eligible for subsidized health care. The idea is to have individuals with chronic illness sign up for the packages that offer the services and care needed. With the aforementioned, proposal for increasing both the federal and states health care budget, the goal of providing all Americans with access to health care, will become realistic. The goal of the ACA is to ensure that everyone has access to healthcare, so by providing government assistance to individuals in need to manager their illness will ultimately reduce the long term health care cost. Chronically

After four decades of failure to enact a universal healthcare program, advocates decided to refine their approach in the 1950s, and the strategy that ultimately led to the passage of Medicare and Medicaid was formulated. Wilbur Cohen and I.S. Falk recognized that a health insurance plan focused on Social Security beneficiaries would be much easier to sell than a plan for all Americans. By limiting its benefits to the elderly, Medicare could be portrayed as a program for people who met two important criteria: they had greater need for healthcare coverage and they were especially deserving of public assistance. Because of their age, seniors have relatively high medical costs--when Medicare was passed, average healthcare expenses for people sixty-five or older were twice the average expenses for younger persons. (Orentlicher, D. (2012).

assistance to low income individuals and families. An estimate of 1.8 million New Yorkers and a total of 46.3 million Americans participate in the SNAP program. Despite the large number of individuals on food stamp the Census Bureau reports in 2010 3.9 million people were lifted above the poverty line and 5 million in 2012 all because of the assistance from SNAP. However the federal government has threaten to cut back on the budget for SNAP. In January 2014 the Farm bill was proposed which included an 8.7 million cut to the SNAP program for the next 10 years. Obama later signed the bill into law on February 7, 2014 saying that the Bill would help create more jobs, move the economy forward and give Americans more equal opportunity (Resnikoff 1). Despite the government’s reasons for the budget cut 850 thousand households would be losing an average of 90 dollars per month (Resnikoff 1). This is unfortunate because reports have shown that SNAP is not only an effective federal program but it also has a positive outcome for individuals. Even in the previous statistics, going from 3.9 million to 5 million people lifted above the poverty line in only a two year difference is a significant breakthrough for low income individuals. It is often easy to find yourself falling under the poverty line, but harder to pick yourself back up. Many individuals who are against the program believe that being on food stamps makes an individual more government dependent and takes away the drive for