Medicare As Distributive Politics

Health insurance comes as second nature to many of us. We grab that blue and white card and put it in our wallet and forget about it until we are sick or injured. When this happens, there it is, cushioning our fall like the extra padding it provided to cushion our wallets. This is not the case with everyone, however. Many Americans have no cushion to fall back on, no blue and white card to show the emergency room when they have an unexpected health concern. No HMO with a convenient co-pay amount when their son or daughter develops an ear infection.

Since its establishment in 1965 we have seen Medicare change as people’s needs change however being a federal program these changes do have an incredible amount of lag time. One of the first major changes to Medicare occurred in 1972 when President Nixon signed the Social Security Amendments of 1972 which extended coverage to individuals under age 65 with long-term disabilities, expanded benefits to include some chiropractic services and speech and physical therapy. During this time we see the American public growing tired of the Vietnam Conflict and lack of support and care for those returning Marines and soldiers with severe disabilities. As the protests escalate and the peace initiatives fail a key piece of legislation is signed showing government support and a willingness to extend health care benefits to this growing and vocal population of veterans (The Vietnam War, 1999). Also included in this Amendment is the encouragement of the use of Health Maintenance Organizations, President Nixon’s administration caught in the scandal of Watergate and pending hearings appeased the left and proposed the HMO Act, which Congress passed in 1973 (Phillips, 2003).

Health insurance in the United States is a highly politicized issue. In recent years, many strides have been made to extend health insurance coverage to all Americans with the passage of the Patient Protection and Affordable Care Act (PPACA). While the program has been vigorously debated in the public realm, arguments are often centered around political ideology rather than economic theory. This paper seeks to challenge the entire structure of the current health insurance model, since its inception in the 1950s. Through the overuse of a third-party payer model, a magnitude of problems have emerged that severely diminish the efficiency of health care allocation in the United States. This paper proposes a model that seeks to correct issues of cost, access, and market efficiency by adapting the Medicare Part D payment scheme for an all encompassing insurance model.

The biggest issue in America is not just hunger, education, and crime- but health care. Perhaps the cause of these other issues, health care is expensive and hard to access. The high cost is tolerated in the belief that more expensive health care leads to better care. This is not true, as studies show that 20% to 30% of patients are issued the wrong treatment or medicine. These medical errors have caused thousands of lives to be lost- at a higher cost. As more Americans are aware of our low ranking in worldwide health care- Japan, Sweden, and Canada making the top three-the need for a nationwide health care reform is much debated. Even with other great countries to mirror we are still hesitant in reforming health care to make it accessible to every American citizen. Although the United States guarantees it's citizens access to fire and police services, protection by military, national postal service, and education as well as many other free federal- and state-funded services they have yet to commit to ensuring them health care coverage.

Each state has their own policies for Medicaid eligibility, services and payments. Medicaid plans have three eligibility groups such as categorically needy, medically needy and special groups. Children's Health Insurance Program (CHIP) is a program that offers health insurance coverage for uninsured children under Medicaid. If Medicaid does not cover a service, the patient may be billed if the following conditions have been met such as the physician informed the patient before the service was performed that the procedure was not covered by Medicaid and if the patient has signed an Advance beneficiary Notice form. However, there are also conditions where the patient cannot be billed if necessary preauthorization was not obtained or service

Medicaid and Medicare was created and called the Social Security Act of 1965 to provide coverage for medical treatment for qualified individuals and their families. Medicaid is a program that is jointly funded and managed by the federal and state governments that reimburse hospital and physician for providing care to qualified patients who cannot afford medical expense. To qualify for Medicaid he or she must be a United States or resident citizen which, includes low income adults and their children, people with certain disabilities and senior citizens. “Medicaid and Medicare is overlooked by the Center for Medicare and Medicaid,

The U.S. health care system is a scrutinized issue that affects everyone: young, old, rich, and poor. The health care system is comprised of three major components. Since 1973, most Americans have turned to managed-care programs, known as HMOs. The second type of health care offered to Americans is Medicare, health care for the elderly. The third type of health care is Medicaid, a health care program for the poor.

The topic that concerns author Ms. New is the Medicare Savings Program. The Medicare Savings Program covers part A and part B premiums, deductibles, coinsurance, and copayments. There are four kinds of Medicare Savings Programs “Qualified Medicare Beneficiary (QMB), Program

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.

America’s Health Insurance Plans (AHIP). (2011, September 9). Rising Health Care Costs. Ahip.org. Retrieved October 22, 2013, from http://www.ahip.org/Issues/Rising-Health-Care-Costs.aspx

In 1965, President Johnson signed Title XIX of the Social Security Amendments, which enacted Medicare and Medicaid (CMS, n.d.). Originally, Medicare was composed of Part A and Part B. Part A is covers more medical costs associated with hospital stays, while Part B cover medical costs such as durable medical equipment, nebulizers, some vaccinations (Pneumovax ®, Zostavax ®, and Flu), and some nebulized breathing treatments. The original program was designed to cover disabled individuals and every over the age of 65.

In discussion with two families, the pros and cons of Medicare are discussed. Melvin and Barbara Coats are above retirement age and until recently were both still working. Edward and Betty Florence are below retirement age, but Edward is disabled and hasn’t worked since 2007.

Majority of individuals with Medicare get their health coverage from Original Medicare and Medicare Advantage Plan. However, compared to Medicare Original, Medicare Advantage covers all the services under Original Medicare barring hospice care. According to Medicarerights.org, Medicare Advantage Plan must cover same Part A and B Original Medicare benefits, in addition to extra benefits such as dental care and vision in some cases. The plan comes with an out of pocket yearly limit, after which you are expected to pay nothing for the rest of the year.

Due to the upcoming presidential election, the two major political parties, and their candidates, have been focusing on the primary problems that the nation will face. Chief among those problems is the future of Medicare, the national health-insurance plan. Medicare was enacted in 1965, under the administration of Lyndon B. Johnson, in order to provide health insurance for retired citizens and the disabled (Ryan). The Medicare program covers most people aged 65 or older, as well as handicapped people who enroll in the program, and consists of two health plans: a hospital insurance plan (part A) and a medical insurance plan (part B) (Marmor 22). Before Medicare, many Americans didn't have health

“Medicare-for-all” is piece of legislation proposed by Vermont Senator Bernie Sanders that advocates for a single-payer healthcare system and universal coverage for all in the United States (Keith & Jost, 2017). The bill details a national health insurance plan, funded by a government trust, that would cover all services from hospital stays to primary care visits, thus eliminating high out-of-pocket costs, copayments, and deductibles. Comprehensive coverage under Medicare-for-all would also include treatment for substance abuse, mental health counseling and resources, reproductive and maternity services, and even abortion (Keith & Jost, 2017).