Medicare Funding Crisis

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).

Medicare has had many legislative changes to modernize the program since it was first signed into law. Medicare has assisted many retirees from a financial disaster by providing benefits during a healthcare crisis. The prescription drug program has ensured seniors have access to the medications they require. Medicare has also provided care to the disabled that are under age 65. This national social healthcare program has also come under fire politically because of the extremely high cost of the program.

The Social Security Act of 1965 established Medicare and Medicaid which are health insurance programs for the poor and elderly people of the United States. It is funded by a tax on the earnings of employees and contributions by the employers. “It is now broadly apparent that those who opposed Social Security in 1935 and Medicare in 1965 were wrong in their fears…” (Nicholas Kristof  “The Wrong Side of History”).

The Patient Protection and Affordable Care Act (Obamacare) had mame dramatic changes in the field of the health care system, especially in Medicare, that will seriously take effect in American seniors. Indeed, much of the health law’s new spending is financed by spending reductions in the Medicare program. In addition to the provider payment reductions, Obamacare significantly reduces payments to Medicare Advantage (MA) plans by an estimated $156 billion from 2013 to 2022.( Elmendorf, letter to Speaker Boehner). About 27 percent of all Medicare beneficiaries are enrolled in MA plans, a system of regulated and private plans competing against each other as an alternative to traditional Medicare. MA plans are attractive to beneficiaries because they offer more generous and comprehensive coverage than traditional Medicare by capping out-of-pocket costs and offering drug coverage to a rasonable

As we become older, issues with our health begin to take affect and finding ways to fund for that care is becoming even more difficult. In the article “Some Elders Must Take Drastic Measures to Obtain Long-term Care”, national magazine journalist Mary A. Fischer (2011) states that many Americans must face demeaning and disempowering choices in order to qualify for Medicaid or Medicare—federal funded health insurance programs— such as refusing to pay for a spouses institutionalization, divorce, and spending down assets. The author argues that these choices leave the healthy spouse with decreased funds to plan for their own retirement expense (Fisher, 2011). Working in the health care field for 4 years, along with my family’s own personal experiences I can relate to this article, since I have seen a variety of ways that federal funded health insurances have been unable to meet the expectations and demands of its beneficiaries.

Many proposals to reorganize Medicare could increase the financial and health risks faced by the vulnerable elderly. Turning Medicare into a premium-support system a voucher set randomly at the value of the second-least-expensive insurance plan could shift costs to elderly households. Increasing the Medicare eligibility age from 65 to 67 will leave many Americans ages 65 and 66 without insurance. The basic idea of part A Medicare payment is simple. The patient pays a deductible that approximately equal to the cost of the first day in the hospital;

Medicaid, which is a separate federal funded insurance was intended to cover low-income, aged, blind, disabled individuals, parents, and their dependent children on welfare. However, the senior citizens are the population group most likely to be living in poverty, and only about half of these individuals have insurance coverage. The difference between 1965 and now, of course, is costs. Years ago spending more on health care in result covering more people were the whole point. The administration wants to broaden coverage, but cut spending.

So why isn’t insurance for those sixty-five and older the biggest payer of long-term care? This contradiction to what you would think is a result of the restrictions put on long-term care by both types of insurance. Medicaid only sets the restriction that the person must be over twenty-one, have a medical need (verified by a doctor) for help with their daily living, and the care be given in a Medicaid certified facility. If these requirements are met Medicaid will cover nursing facilities, home health, and some day care facilities. However, each state set their own services so the Medicaid eligible services may be different from state to state (Meedicaid.gov, n.d). Medicare on the other hand does not cover long-term care that helps with the functioning of everyday life. Medicare only covers subacute care weather in your home or a facility. With the requirements being that the facility must be at a Medicare licensed facility, the patient has to be transferred from an acute hospital, the transfer must be prescribed by a doctor, and or the patient must have been released from a hospital stay within the last sixty days (CMS, 2014). Medicaid pays for long-term care users who have difficulty living everyday life, performing everyday activities, and have a lifelong medical disorder needing assistance to function at just about any age. While, Medicare pays for

Medicare and Medicaid assist 111 million individuals of which 10 million individuals are qualified for both programs. By 2025, that number will increase to 139 million individuals. Medicare beneficiaries receive $23,500 for a medium income and Medicaid beneficiaries receive $15,000 (Altman & Frist, 2015). Both programs combined comprise of “39% of national health spending, account for 23% of the federal budget, and generate 43% of hospital revenues” (Altman & Frist, 2015). These programs are predicted to increase by 3.7% each year. Since the two programs affect many individuals, any changes to the programs can shake election turn-out votes. The toughest health policy surrounding Medicare and Medicaid today is whether the programs should remain entitlements.

Medicare provides federal health insurance coverage to millions of elderly, and disabled Americans. As of 2015 data by the Kaiser Family Foundation, Medicare covers 55 million people. Medicare covers people age 65 and older, people younger than 65 with certain disabilities, and people of all ages with End-Stage Renal Disease, or amyotrophic lateral sclerosis (Medicare, 2015). Medicare consists of several different components, including: Part A, Part B, Part C, and Part D. This Federal health insurance program, Medicare, is financed by several sources, including taxes, revenue, and premiums. Each part of Medicare has different eligibility requirements and provides different benefits, and covered services.

Since 1965, Medicare has been attempting to provide low cost, guaranteed access to much needed healthcare for senior citizens over the age of 65 and other age groups that suffer from disabilities and terminal diseases. These people represent some of the most vulnerable population groups in the United States. Most do not work, and rely on Medicare to provide them the access to healthcare they need. Unlike privatized health insurance companies, Medicare is a social insurance program that is paid for through federal mandates and tax payer funds. Billions of dollars are spent annually on over 50 million Americans in need (Alonso-Zaldivar 1). The care structure itself is broken into several main parts: Medicare Part A covers hospital costs, Part B cover most outpatient care costs, and Part C and D cover prescription drug costs through dealing with other private insurance. Yet, the upcoming election in November is threatening to change and alter the structure. Each candidate has his own plan to deal with Medicare; both are trying to reign in the costs of operating Medicare, but with some elements being obviously more beneficial for Medicare recipients than others.

Variability: First, Medicare is more or less the same in every state, but Medicaid rules vary widely state

Ron is very happy as an enrolled participant of Medicare and specifically Medicare Part D. His eligibility for Medicare and the affordability of health insurance at the spry age of 74 was a blessing for Ron and his wife. Like Ron and his wife, many of the elderly depend on payments from government sources for their health care, and there is concern that this part of the system is also in decay. Medicare is a federal health insurance

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

The growing concern regarding the financial security of Medicare is one of particular interest to the nearly 72 million baby boomers that become eligible for this government-assisted, and tax-payer bolstered, program over the next two decades. According to the U.S. Census Bureau (2010), there will be a rapid increase in baby-boomers between 2010 and 2030, as the entire baby boomer population move into the 65 years and over category (p.3). Political and financial revisions must be made to ensure the security of Medicare as the numbers of individuals paying into this program are soon to be surpassed by the number of individuals drawing-off this program (U.S. Census Bureau, 2010). The elderly are also at a disadvantage with transportation to health care visits, picking up prescriptions, and rehabilitation services. There needs to be an establishment of access not only to primary care providers, hospitals, and rehabilitation services, but access to other aspects of the health care system for the elderly population.