How Medicare Is An Efficient Program Offering Guaranteed Treatment And Features Administrative Cost

Hoenisch, Steve. "Health Care." The ENCYCLOPEDIA of the REPUBLICAN PARTY, edited by George T. Kurian and Jeffrey D. Schultz, vol. 1, Sharpe Reference, 1997, p. 128-133.

In my role with Liberty Mutual, I drove adoption of Medicare reimbursement models through public affairs involvement with multiple state workers' compensation committees seeking to update their reimbursement schedules in response to the implementation of ICD-10 coding requirements in October of 2015. With the state workers’ compensation authorities seeking to adopt CMS reimbursement type models, my involvement was directed at securing the inclusion of specific CMS rules governing correct coding and reimbursement practices including National Correct Coding Initiative Guidelines (NCCI), Medical Unlikely Edits (MUE), along with the Resource Based Relative Value System (RBRVS) for reimbursement rate setting.

The current election between Barrack Obama and challenger Mitt Romney is about America's future based upon different visions. To fully understand these contrasting views requires examining the stance of each individual in areas such as: the candidate's vision of America, how they differ, the way they are similar and their beliefs on health care / job creation. Together, these elements will highlight the approach they will be utilizing to address a host of problems.

Although division is seen between the political parties of the Republicans and Democrats, points exist to where lawmakers agree on the reform of healthcare. Lawmakers do, however, have three major points they agree. These points are the banning of underwriting by private insurance companies, providing federal funding to assistance low income families with securing insurance, and by accessing Medicare’s funding to its full advantage to reduce patients billing (Times Topics, 2009). While lawmakers have managed to agree on some points, by drafting a complete healthcare reform that is ethical. This will call for Congress to agree on a bill that fits President Obama’s views, requiring substantial research and planning.

Since the late 1980s, Medicare has reimbursed physician services using the Medicare Physician Fee Schedule (MPFS), which encompasses 10,000 procedure codes. Each code is assigned resource-based relative value units (RVUs), which are designed to reflect physician work, practice expense, and malpractice expense. To adjust for local differences in cost of living, each RVU is modified using geographic practice cost indexes (GPCIs) and then converted to dollars using a “conversion factor.” This system rewards physicians who produce a high volume of services; not surprisingly, Medicare Part B expenditures have grown rapidly.

President Obama’s pledge to pay for the program by taxing the rich, who is anyone that makes more than $1 million a year (which would include President Obama) and will make for “a marketplace that provides choice and competition” (Conniff, 2009). He also proposes that reform is about every American who has ever feared losing their coverage if they become too sick, lose their jobs or even change their jobs. It’s realizing that the biggest force behind our deficit is the growing costs for Medicare and Medicaid programs.”

Universal health care coverage is a dream that the majority of Americans have had for many decades. It seemed that the dream could become a reality with a major effort under the Clinton administration in the mid 1990’s. This effort was spearheaded by the First Lady, Hillary Clinton, and would have established a universal health care system for the entire nation. Unfortunately, after years of work, the effort ended in failure due to trying to modernize and finance universal health care at the same time (Rodwin, 2003). When the current President, Barack Obama, campaigned in 2008, one of his cornerstone promises was to develop a healthcare system that would assure affordable healthcare for all Americans through the Affordable Care Act, also known as Obama Care. With only a slight majority of democrats in the Senate and a large majority of Republicans in the House, this would prove to be an uphill battle (Moore, 2014).

The latest health care reform has done what few policies manage to do – sicken both republicans and progressive democrats. While we can all agree that a reform of the health care system is sorely needed, we must also acknowledge that “Obamacare” is not the cure-all we so desperately require. Rather, President Obama, like a medieval barber, prescribed a health care reform that treated the symptoms of our flawed system rather than the actual disease. The subsidization of health insurance providers has proven ineffective at providing affordable coverage for all. Certainly one is likely to hear the various incendiary talking points of both the proponents and opponents. Whether it’s the republican candidates blaspheming Obamacare as socialism, or the administration praising the success of health care for all, it is difficult to actually find constructive dialogue. We are purview to many sound bites, but few actual solutions. We have witnessed heated debates, but rarely do we witness intelligent discourse. If beneficial reform is to be crafted and implemented, we must first acknowledge the issues and inconsistencies of the current system and begin to explore alternate methods of providing health care to the American people.

Long before the 1990s when Ms. Clinton fought for a Universal Healthcare system in America, the issue of America’s healthcare had been a political quandary. The enactment of the Republican administration’s Health Management Organization Act of 1973 was a weapon meant to address that crisis, yet, it did little to fix the problem. While the liberal Democrats are fighting for Universal Healthcare coverage for all Americans, the conservative Republicans are fighting to maintain the current private health insurance, however, with some revamping of the system, which preserves the capitalistic element of the status quo. The reason for the two opposing views stems from their differences in political ideologies, which theoretically is like pitting socialism against capitalism. While the liberal Democrats’ endorsement of Universal Healthcare system is socialistic in practice, the conservative Republicans’ fight to retain the private or market based plan is unarguably in support of their pro-capitalism stance. The truth, however, is that, though almost every American believes in capitalism, yet, almost none would vote to disband the Medicare and the Medicaid programs, both of which are socialistic. In that light, the argument of a pro-capitalist nation is negated, as we do already have a socialized healthcare program for the seniors and the poor. Extending that concept to include

To attract Medicare patients, hospital must be contracted with Medicare. Hospital must also be contracted with private health insurance companies that provide Medicare Part A or Part B benefits. As per Kaiser Family Foundation, there are more than 55.5 million Medicare beneficiaries in the U.S. and Texas has more than 3 million. Hospital should have regular contact with senior citizens and can be made attractive to Medicare patients by offering sessions about healthy life style choices. Also offer regular disease management sessions, exercise group and organize social activities such as trips to mall, museums. Seniors should also be encouraged to take tour of the hospital.

The article illustrates that how republican candidate, Donald Trump, wants to change the aspects of health care. As mentioned in the article, Trump wants to make vast decisions on health care and wants to repeal the Affordable Care Act (ACA) (Wilensky, 2016). The Affordable Care Act was created in order to help individuals obtain insurance. The Affordable Care Act was created during Obama’s presidency and is a part of Obamacare. If Trump is elected, he wants to repeal the Affordable Care Act, which can cause a variety of issues for those individuals who depend on it. There has also been a discussion about raising the Medicare eligibility age of 67, which would make it difficult for individuals who need the help before the age of 67. Individuals rely on the Affordable Care Act and Medicare because it allows them to have access to the

On February 16th, Speaker Paul Ryan, several House committee members, and Secretary Tom Price presented their outline for the plan set to replace the Affordable Care Act that would rely heavily on tax credits, yet according to The New York Times, would also drastically change the future of state Medicaid programs. According to Five Thirty Eight, Obamacare strived to expand Medicaid to all adults with incomes below 138 percent of the poverty level. This meant adding more than seventy million people to a program that already accounts for more than a quarter of all state budgets combined and half of all federal money that is routed to states. Republicans hope to cap and lower these costs by entirely changing the purpose of Medicaid, a Great Society

The proposed health care reform bill attempts to change issues of public policy and health care management for the poor and uninsured. Many leaders from the Democratic Party are actively engaging in policy-making to fix what Rep. Henry Waxman (D-California) calls a “‘dysfunctional’ health care system” (2009). Currently, the U.S. health care system denies people with pre-existing conditions from receiving care. Another problem with the system is that the health insurance that some employers offer may be so expensive that their employees cannot afford it. Any cuts in Medicaid may mean that physicians have fewer incentives to provide adequate care for the poor. These are some of the many problems that the Affordable Health Choices Act attempts to address. Fiscally conservative political and business groups oppose this measure because they believe that any changes in public policy and health care management might affect them negatively.

“We will pass reform that lowers cost, promotes choice, and provides coverage that every American can count on. And we will do it this year.” The preceding is a powerful statement from the newly elected President Barak Obama. One of the main aspects of both political campaigns was health care reform. The above quote shows passion and encouragement, but the quotes about health care do not end there. Georgian republican gubernatorial candidate and health care policy maker John Oxendine expressed: “Their proposal would virtually devastate the private healthcare sector in this country along with competition and patient choice, by replacing it with bureaucratic planning and government control. The result of this plan and its one trillion

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