How Does Medicare Reduce Health Disparities?

Money plays a huge role in access, therefore it is a vital issue to discuss. Within the current system, lack of money results in lack of health care, which leaves thousands of people without any health care coverage. Between 2001 and 2005, the number of people paying for health insurance increased 30%, however income only raised 3% (Health Care Problems). Adequate income is a necessity and unfortunately that is not present. According to the National Conference of State Legislatures, the average annual premium across the country is $16,000. Currently, the average annual income in the United States is $51,107. Mint Money Management suggests that about 4-6% of one’s total income should be spent on insurance, including life, disability, and health insurance. However, the averages in the United States show that the average person spends about 31% of their income on health insurance, which is not financially beneficial. When this rise in health insurance is not parallel to the inflation of income, innocent people are left without a method to achieve health care. There is a program for those who can’t afford health insurance out of pocket nor have access to it, and that is called Medicaid. Issues still exist with the program. There is only so much funding, which leaves many still uninsured. Additionally, people with Medicaid have difficulty

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).

In 1964 Congress passed the Civil Rights Act in which Title VI specifically forbade the distribution of federal funds to organizations that practiced discrimination. Enforcement of Title VI was a major priority within the Johnson administration as they implemented the Medicare program (Reynolds, 1997). Despite a mandate of equal treatment, significant patterns of segregated health care utilization have remained to the present. In an analysis of Medicare beneficiaries, Bach and colleagues found that their was a small proportion of physicians – 22% - who provided the majority of visits - 80% - by black patients (Bach, Pham, Schrag, Tate, & Hargraves, 2004). This may represent a pattern of racial concordance, patients choosing providers of their own race, but the physicians seeing the majority of black patients did not the same resources available as those seeing the majority of white patients. Compared with physicians seeing the mostly white patients, physicians seeing mostly black patients were 33% less likely to report always having access to high quality specialists, and 40% less likely to report always having access to high quality diagnostic imaging. In short, black patients are using a different health system than white patients on average and the health system black patients are using has fewer resources (Bach, et al., 2004).

With this increased research and effort, Americans would be able to intervene and make positive impacts with the state, tribal, and local levels to best address health disparities and inequalities. In efforts to thwart ethnic and minority disparities, The Department of Health and Human Services (HHS) passed the HHS Disparities Action Plan in order to establish “a nation free of disparities in health and health care, (Cooper 97)” and to implement a series of priorities, strategies, actions, and goals to achieve this vision. States, local communities, private organizations, and providers have additionally engaged in efforts to reduce health disparities. With the HHS Disparities Action Plan, the Department continuously assess policies and programs on racial and ethnic health disparities, watching to see which policies make an impact on the level of health care received by minorities. Similarly, The Affordable Care Act (ACA) health coverage expansions significantly increase coverage options for low and moderate income populations and particularly benefit the “vulnerable populations.” The ACA also includes provisions to strengthen the safety-net delivery system, improve

Medicaid is a social health care program that covers nearly 60 million Americans, including children, pregnant women, seniors, parents and individuals suffering with disabilities. Medicaid is the biggest source of funding for health related services and medical needs for the people with low income in the United States. This program is funded jointly by the state and federal level governments, but it is the state’s responsibility to manage this program. The Medicaid program is not a required program that states have to use, but all 50 states have implemented this program. With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in coverage for adults” because it was only restricted to the low income individuals and other people with needs in their own specific category. In the past, the majority of the states who had adults that did not have children dependent on those parents were not eligible for Medicaid. These low income adults without dependent children would be without medical insurance assistance before the ACA was introduced. Medicaid is now available to all Americans under the age of 65 whose family income is at or below the federal poverty guideline of “133 percent or $14,484 for an individual and $29,726 for a family of four in 2011” (NSCL).

Health Care reform is a major topic of discussion in today’s society, especially with the relatively novel release of the Patient Protection and Affordable Care Act (ACA) by the Obama administration. Historically, the health care system has disproportionally favored those of higher class and income, resulting in diminished health care for those that could not afford it. The Institute of Medicine’s (IOM) 2002 report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, states that a lack of insurance substantially contributes to the proliferation of healthcare disparities. Furthermore, racial and ethnic minorities are most subject to these healthcare disparities because they are significantly more likely to be uninsured. (1) The history of health care reform in the United States, as it pertains to under-insured urban populations, will be discussed, with a specific emphasis on its impact on African-Americans; in addition, the modern resolutions to healthcare disparities will be assessed.

Although the United States is a leader in healthcare innovation and spends more money on health care than any other industrialized nation, not all people in the United State benefit equally from this progress as a health care disparity exists between racial and ethnic minorities and white Americans. Health care disparity is defined as “a particular type of health difference that is closely linked with social or economic disadvantage…adversely affecting groups of people who have systematically experienced greater social and/or economic obstacles to health and/or clean environment based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion” (National Partnership for Action to End Health Disparities [NPAEHD], 2011, p. 3). Overwhelming evidence shows that racial and ethnic minorities receive inferior quality health care compared to white Americans, and multiple factors contribute to these disparities, including geography, lack of access to adequate health coverage, communication difficulties between patients and providers, cultural barriers, and lack of access to providers (American College of Physicians,

The purpose of this paper is to exemplify the healthcare crisis of African Americans within the broader context of American healthcare reform. In order for one to appreciate the depth of necessity for healthcare reform in the African American community, he or she must have a general understanding of the history of healthcare for African Americans. As stated by the institute of medicine in a study assessing the health and mental health disparities of African Americans, “The sources of these disparities are complex, are rooted in historic and contemporary inequities, and involve many participants at several levels, including health systems, their administrative and bureaucratic processes, utilization managers, healthcare professionals, and

The U.S. healthcare has been dealing with disparities for centuries. These disparities can be racial, social, or economical. The disparities are easier to see when compared to other reference points, such as policies, procedure or protocol. Williams & Torrens, 2008 list several disparities when it comes to patient care, such as minorities are less likely to get diagnosed with cancer verses whites, patients with lower socioeconomic statuses are less likely to received diabetic services, and many more. In order to eliminate some there disparities it must first be recognized by others that it is a serious problem. These problems have been around for years; therefore the public must put pressure on the policymakers to promote change. In order

Medicaid initially established that each state is responsible for designing their medical costs to pay medical care for the poor. Also, Medicaid created as a voluntary program for each state; they have to have the choice to participate. For one thing, because of the rising costs of healthcare, it has been difficult to bring Medicaid recipients into the “mainstream” of United States (U.S.) medical care. Donald R. Barr notes, “between 1975 and 1989, the cost of the Medicaid program increased by an average of 11.9 percent per year before adjusting for inflation” (172). The rising costs of healthcare are necessary for each state to determine if it is beneficial for them to participate in the Medicaid program. As the government level of payment is determined by each state economic condition. For instance, a state with lower per capita income will receive more government funding. A state with higher per capita income receives less reimbursement for program costs. Therefore, on December 31, 2010, many states continued to experience budget cuts. As a result on August 2010, Congress increased reimbursement rates through June 2011.

The Affordable Care Act (ACA) is a very controversial topic that I never quite understood until I got to read the supplemental chapter untitled “The Affordable Care Act: A Brief History, Assessment, and Future Challenges.” Throughout this paper, I will be answering five questions about the ACA. The first question has to do with listing and explaining three demographics that contributed to disparities in health insurance coverage prior to the ACA. There were many demographics that contributed to disparities in health insurance coverage in America prior to the adaption of the Affordable Care Act. Some of those demographics had to do with race, age, citizenship, or region of the country. One of them had to do with racial demographics, which

Disparities in health and health care in the United States have been a longstanding challenge resulting in some groups receiving less and lower quality health care than others and experiencing poorer health outcomes. Hispanics, Blacks, American Indians/Alaska Natives, and low-income individuals are more likely to be uninsured relative to Whites and those with higher incomes. Low-income individuals and people of color also face increased barriers to accessing care, receive poorer quality care, and experience worse health outcomes. The Department of Health and Human Services Disparities Action Plan (HHS) sets out a series of priorities, strategies, actions, and goals to achieve a vision of a nation free of disparities in health and health care.

In 1965, President Johnson signed Title XIX of the Social Security Amendments, which enacted Medicare and Medicaid (CMS, n.d.). Now, Medicaid is the single largest publically funded health coverage in the United States. The Medicaid program is federally and state funded. Currently, Medicaid covers 70 million Americans. Over 33 million children, 19 million low-income adults, and 16 million elderly or disabled persons are insured through the program. Medicaid also provides assistance to select Medicare beneficiaries, which is currently about 10 million individuals. Long-term care assistance is also a role of Medicaid, with 1.5 million institutional and 2.9 million community-based residents assisted. As visualized in Figure 1, of the almost 70

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.

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