Medicare Case Analysis

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).

Apart from healthcare issue, the country has adopted the fast-moving life style, which has pushed most of our citizens to succumb to obesity as a result of fast foods. In fact, a recent report by the UN has ranked the United States as the most obese country in the world. Parramore (2012) outlines that, “Obesity is currently being considered as a national crisis in the United States and that it contributes 100,000 to 400,000 deaths per year. Statistics at the CDC and Prevention in 2010 indicate that 35.7% of the American adult is obese.” Many input trends exist in the American society, “First and foremost, people are highly used to fried foods, sugary drinks, and processed meats among others. There is also the sedentary lifestyle that has been adopted by many,” (Huffington Post, 2013). In fact, most of us love relaxing without exercise and too much television watching. These are some of the factors that contribute to obesity. The result is health complications problems such as diabetes, stroke, and heart disease just to mention but a few. These affect the longevity of life.

Another reason for the rising cost of healthcare is the cost of physician care, according to the American Hospital Association “the cost of physician care, both to insurance and patients, has risen 1.3% during the past year.” Because of this increase doctors are put in a corner, they are already locked into an agreement with the insurance companies and do not have much ‘wiggle’ room to negotiate fees and rates. So because of this the patients and consumers are forced to pay a much larger sum. Since there are higher costs and the insurers will not cover them, they are distributes to the customers through higher deductibles, co-insurance, and

Medicare is one of the most widely acknowledged sources of health insurance coverage in the United States. It is often complemented by Medicaid, a similar health welfare program that includes children and the poor. Many Medicare beneficiaries are "dual eligibles" who use Medicaid to extend comprehensive inpatient and outpatient health care coverage, especially for prescription drugs, diagnostic and preventive care, and eyeglasses which fall outside of Medicare. Medicaid can also supplement Medicare deductibles, premiums, and up to 20% of uncovered charges (Goodman, 1991).

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

Medicaid is program that provides health insurance coverage for people with low incomes, including pregnant women with little or no income, also children under the age of 19 are eligible for Medicaid (Research Starters). So for example, a person that is financially independent would not qualify for Medicaid. “Medicare benefits can be as early as age 62, or even earlier in the case of serious disability covered by Social Security” (Reuters). Medicare only requires a person to be over the age of 62 or to be dependent on someone else to qualify for their healthcare benefits. To conclude, Medicaid goes more toward younger low-income communities, while Medicare leans more toward older

Medicaid and Medicare are government-sponsored healthcare programs in the U.S. The programs differ in terms of how they are governed and funded, as well as in terms of who they cover. Medicare is an insurance program that primarily covers seniors ages 65 and older and disabled individuals who qualify for Social Security, while Medicaid is an assistance program that covers low- to no-income families and individuals. Some may be eligible for both Medicaid and Medicare, depending on their circumstances. Under the Affordable Care Act (a.k.a., "Obamacare"), 26 states and the District of Columbia have recently expanded Medicaid, thus enabling many more to enroll in the program.

Medicaid is the largest source of health coverage available in the United States that provides health coverage to United States residents including seniors, children, pregnant women, and individuals with disabilities. To participate in Medicaid, federal law requires states to cover mandatory eligibility groups of individuals such as low-income families, qualified pregnant women and children, and individuals who receive Supplemental Security Income; each state may choose to cover residents who receive home and community based services and children who are in foster care (Medicaid, 2017).

As the industry continues to move away from some of the Medicare programs that were created during the Obama presidency,  the Centers for Medicare & Medicaid Services (CMS) is also pulling away from specific value-based initiatives, such as mandatory bundled payments. The CMS officially canceled two of the models that were included in the Bundled Payments for Care Improvement (BPCI) Initiative.

In a study using Medicare administrative data, the cost of services delivered by APRNs and physicians was analyzed and found the cost of delivered by APRNs was 11-29% lower than the same care performed by physicians. Even after adjusting for lower reimbursement rates for APRNs, the study found an 18% cost

Over the years America has become the most overweight country in the world. The times have changed, people used to run around and eat home-cooked meals every night. Now People drive most places and just grab something quick for dinner without thinking about if it is a healthy choice or not. This has affected America in more ways than most people think. The

Obesity has become a growing problem in America. Approximately 2/3 of adults with another 17% of children/teens are obese.(1) That is nearly a 5% increase since 2000.(2) How has this come to be? The problem lies in the diet that the Americans have taken. With fast food chains taking over the food industry, everyone is getting lazier at cooking and eating healthy meals. With the daily lives of most people being busy due to work and the other chores, people are settling for fast food. Fast food has been

Obesity is a major food epidemic that has become so global it is a leading cause of death in America. Many Americans have vouched for a sedentary lifestyle due to their unhealthy eating habits. Americans do not realize that the unhealthy food choices they make now, will affect them in the future. The food industry is a negative contributor to this. The food industry is affecting the health of future generations by surrounding the streets with fast food restaurants, and the overconsumption of processed food.

In the past, everyone ate freshly prepared healthy meals that were made at home with their families. Nowadays, people tend to eat out more and are eating very unhealthy food, like pizza, burgers, fried chicken or ice cream. There are many reasons as to why people eat out more, such as just not having the time or supplies to cook because of work, a busy schedule or not having enough money. This is what causes people to eat out more and now because of that, there are many children out there that are not getting the proper nutrition they need and are eating all types of unhealthy food and that can lead to many problems like obesity. They get so used to eating so much junk and processed food at fast food restaurants that it starts to affect their bodies in many bad ways. Now, everybody that eats fast food could end up with three negative side effects in their daily lives and they are depression, heart disease, or high cholesterol.

The Affordable healthcare act seems as if its answer to the ever increasing healthcare cost in America, but even it has unrevealing complications. Yes, healthcare needs to be reformed, but with the new health care act, it will come with a price. There are several reasons why healthcare needed to be reformed. Some of the main reason why is because their no consistent pricing on healthcare procedures and test, physicians are testing too much on patients, and physicians being scared of lawsuits. There are many reasons why the cost of healthcare rises each and every year. It starts from issues such as compensation for physicians, premiums, deductibles, etc. From earlier years of advance medicine to now, hospitals has been continually using new more advance drugs, technologies, services and procedures each and every day. The cost of healthcare over time just seems to increase with the times. The more and more advance our society becomes, the more and more expensive medical care cost continues to rise. There has to be some level of consistency in order to help reduce the overall cost of healthcare to patients. Health care is still growing at more than double the