Health Care Dilemmas

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).

The benefits and drawbacks of having state health programs verses one that is uniform across the country can vary on a broad basis. Medicare and Medicaid are state and federally funded health programs; programs that must be fair and allow access to everyone across the country that are enrolled and eligible to receive such benefits. In addition, these programs have unlimited caps so that there is flexibility to continue financing care without delay. The Medicare program was designed to provide access to health care for those who are not able to afford appropriate health care and meet the needs of vulnerable communities. If it were not for the assistance of the federal government in providing states the necessary funds to continue providing health

The Medicare and Medicaid federal programs were put in place as a way to help the less fortunate. Individuals with severe disabilities or over the age of 65 qualify for Medicare. This program helps them with health coverage, so the disabled and elderly who have Medicare do not have to worry about their medical bills and not going to the hospital when they are sick. Medicaid is a similar program, however, it only applies to low income families who cannot provide for their children. Similar to Medicare, this program covers any health related problems and takes away the worry and troubles that come with hospital bills.

Part A covers hospitalization, emergency hospitalization, subacute care, home health, and end of life care depending on the situation. Part B covers Doctors’ visits, and covers subacute, end of life, and in home care that Part A will not cover if the patient qualifies. While part C covers medications and needed medical equipment (Center for Medicare and Medicaid Services, 2014). What Medicaid pays for depends on what state you live in, and what your specific situation is. Universally Medicaid covers hospitalization, day procedures, doctors’ visits, nursing facilities, home care, child health check, nurse practitioners, and transportation to doctors’ visits (Medicaid.gov, n.d). Medicaid offers different services in each state, but the aforementioned are the mandatory areas of coverage for every state. Medicare is aimed at helping the older population, while Medicaid is aimed at people in every stage of life. But who exactly is covered under which

Medicare is the federal health insurance program for people with certain disabilities, end stage renal disease, and for those who are over the age of 65. There are four different parts to Medicare, part A, part B, part C, and part D. Medicare Part A, also known as hospital insurance, covers inpatient hospital stays, care in nursing facilities, hospice care, and some in home health care. Part B is often referred to as medical insurance; it covers certain doctors’ services, outpatient care, medical supplies, and preventative care services. Medicare Part C, otherwise known as Medicare advantage plan is offered by a private

Part A The central point of this scenario is far more than just healthcare management. Instead, it has elements of medical ethics and the huge amount of bureaucracy often engendered by the American healthcare system. Medicare Part A is hospital insurance that helps cover care in hospitals and skilled nursing facilities. In general, it covers inpatient care and inpatient rehabilitation costs. Medicare Part B covers medically necessary services: doctors', medical equipment, home

Medicaid and Medicare are two programs that are very different but share the same instance of being federally run programs. Both Medicaid and Medicare were created in 1965 in response to the fact that older and lower income people could not buy private insurance. Medicaid is dispersed individually by each state in which is primary role is to cover low income people who do not have the financial means to purchase healthcare on their own. On the other hand Medicare is paid into by everyone that works a legal job where taxes are deducted. Medicare was created to address the issues of elderly; typically people 65 years or older; having extremely high healthcare bills but limited personal funding. These people will typically pay part of the cost

Medicare and Medicaid are two types of government insurance assistance that were put into place in order to give those that fall into certain categories receive medical care and have basic insurance. Although they are two separate programs, both managed by the Centers for Medicare and Medicaid Services, which is found under U.S. Department of Health and Human Services.

Medicaid, Medicare, and CHIP’s healthcare coverage is usually used in the typical American household. Though they serve different people they all have the same goal: To provide health coverage for lower costs and better care. They all have many ways they are funded. Medicare is funded through taxes, trust funds, premiums from members of Part A,B, and D, and funds from Congress. Medicaid and CHIP is funded by the government. The federal government pays states for a specific percentage of program expenditures or costs for a specific group. The percentage for Medicaid is 15% higher than CHIP’s. If you want to be a member of medicaid, you have to have a limited income, be 65 or older, a child under 19, be pregnant, be living with a disability,

The issue of healthcare coverage under the federal health reform has been politically debated by many Americans, including the current Democratic presidential candidates Hillary Clinton and Bernie Sanders. The healthcare reform enacted in 2010 under President Obama’s regime intended to support the ongoing healthcare system as a building block to enhance more access to health insurance coverage for millions of uninsured Americans; yet the government’s tireless effort to ensure all individuals are covered remains a major issue across the country.

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.

Medicaid and Medicare are two different government programs. Both programs were created in 1965 to help older and low-income families be able to buy their own private health insurance. These programs were part of President Lyndon Johnson’s “Great Society” plan, a commitment to helping meet the needs of individual health care. They are social insurance programs, which allow the financial load of patient’s illnesses to be shared by other healthy, sick, wealthy, and lower income individuals and families.

During the beginning of this era, reformers had the support of President Theodore Roosevelt who thoroughly believed “that no country could be strong whose people were sick and poor”. In 1915, a bill was proposed by the American Association of Labor Legislation (AALL) that limited coverage to working class individuals whose annual income was less than $1200 a year and included hospital services, sick pay, maternity benefits, and funeral expenses (Palmer, 1999). This system was believed to “relieve poverty caused by sickness” and would “yield a net savings for society” that would benefit not only citizens but businesses as well (Toland, 2014). Opinions on the AALL bill were mixed. The American Medical Association (AMA) was included in the formulation of the bill, leading them to create a committee whose entire aim was to assist the AALL but a disagreement over physician payment led the AMA to redact their support (Palmer, 1999). The American Federation of Labor continuously spoke against universal health care, fearing that it would result in complete state supervision over citizen’s health and would undermine current worker unions and the benefits they provided. Within all of this was also the strong opposition of the private insurance industry which, oddly enough, rested on the inclusion of death benefits in the AALL bill which had

Currently, the issue of health insurance has been a bone of contention for the public regarding whether the United States government should provide this health plan or not. People often possess different perspectives and refer to pros and cons on both sides of the spectrum. While some believes a universal healthcare system will set a foundation for a lower quality of service, increasing governmental finance deficit, and higher taxes, others do not hold the same thought. A universal healthcare system brings enormous advantages rather than disadvantages, such as all-inclusive population coverage, convenient accessibility, low time cost, and affordable medical cost, all of which not only provide minimum insurance to the disadvantaged but also improve the efficiency of medical resources distribution.

The health care industry exist to provide preventative measures, diagnose health conditions, repair, and provide services to improve the quality of life. The cost of health care continues to rise each year. Health care fraud is a factor that continues to plague the health care industry. The affect health care fraud has on hospitals, is the increasing cost of medical services. The following research will examine and evaluate how organizational structure and governance, culture and the lack of focus on social responsibility affects on health care fraud. The following research will also include recommendations for prevention of health care fraud, recommendations for