What is Medicare Part D? Medicare Part D, which is also known as the Medicare prescription drug benefit, is a United States federal government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries (medicareinteractive.org, 2016). In this paper I will synthesize my understanding of why Medicare Part D passed and the influence of the various interest groups and governmental entities during the process, as well as discuss how various stakeholder groups influence the final outcome of Medicare Part D legislation, what the specific strategies and tools that were used most effectively as well as advise if the Medicare Part D passed corresponds with my understanding of policy and …show more content…
It also provides drug coverage to Medicare participants, who are 65 and older or 65 and younger with a permanent disability, who are unable to afford other drug coverage. It was also the first part of Medicare to be made available solely through competing private health plans, rather than being offered as part of traditional, fee-for-service Medicare. The Medicare prescription Plan also offered assistance to low-income beneficiaries directly through Medicare and not though supplemental coverage otherwise provided through Medicaid.
This prescription plan was attempted for many years to put in to play but never made it through. Although the Prescription Plan was intended to help struggling seniors citizens pay for prescriptions, members of Congress contended that some senior citizens maybe end up far worse off than they already were, which caused senior citizens to vote against the Medicare Part D prescription plan. Although the seniors where voting against the prescription plan there where various interest groups and governmental entities that influenced the process to go
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This approach was very important because it helps to reach individuals who are uncomfortable or have a hard time with written material, and/or who do not know how to use or do not have access to the Internet
The last outreach strategy is the use of the Internet. The Internet may prove to be a useful tool in making accurate information available and accessible to a wide range of individuals and organizations that are disabled and can’t leave home to attend outreach clinics and are more comfortable researching the material on their own.
The Medicare part D policy was not a surprise to me, mainly because I work in the health insurance industry and I had first-hand knowledge as well as dealings with the Medicare Part D plan. I also took calls and answered questions about the different plans and their cost as well as advised Medicare beneficiaries which plan would be best for them. I also assisted with enrolling beneficiaries in plans. What did surprise me was the amount time that it took to get the plan passed. While some may see it as helping the pharmaceutical companies’ profit, instead of helping the consumers, having seen firsthand some of the medication that some individuals were taking and the amount of money that they were spending each month on medication, it is clear that it has
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).
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
Medicare Part D is prescription drug coverage. It’s the newest part in Medicare. It adds prescription drug coverage to original Medicare, some Medicare cost plans, some Medicare PPS plans, and Medicare Medical Savings plans. Beneficiaries choose the drug plan and pay a monthly premium.
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.
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;
Medicare Part D Drug Plan was created by Congress in 2003 to aid the elderly, disabled, and sick persons in affording their medication. Coverage for the drug plan went into affect January 1, 2006. This plan was called the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) (Cassel, 2005). The final bill that passed, was influenced by drug-company and health insurance lobbyists and focused mainly on the needs of those industries instead of the seniors it was meant to serve (Slaughter, 2006). These plans are operated by insurance companies and some private companies that have been approved by Medicare. Part D is optional only if a person carries health insurance that includes prescription coverage. If at retirement
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.
The eligibility requirements for Medicare is to be disabled and age 65 and older, regardless of their income. You have to be a U.S citizen and must be
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
The Pharmaceutical lobbyist has a very powerful impact on the outcome of Medicare Part D. They were the ones that wrote the bill and presented it to the House and ultimately, it was passed. However, the tactics that were used were extremely questionable and unethical. A Democratic Representative from Michigan stated: “I can tell you when the bill passed, there were better than 1,000 pharmaceutical lobbyists working on this” (Singer, 2007). The
One person who worked with the interest groups that were involved with the interest included John McManus, a former government worker turned lobbyist. During the time of the initial drafting of this legislation, he was put in place as one who succeeded with others in reference to the policy development and negotiations that were associated with the bill (Pierce, 2009). It is these instances where aides and government workers boast their talents after the bill has passed. The significance of the Medicare Part D passing brought about a great flight of the same workers intending on moving to health care firms or establishing their own lobbying practices as McManus did after his departure.
The purpose of this essay is to discuss Medicare Part D, as well as the influence of the various interest groups and governmental entities during this process. This essay will discuss both the policy process and the policy environment (the key players involved and other circumstances that shaped this policy-making effort), how stakeholder groups influenced the final outcome of Medicare Part D legislation, the specific strategies and tools that were used most effectively, and if the fact that Medicare Part D passed corresponds with my understanding of policy and politics.
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 major purpose of this work is to completely discuss about the Medicare Part D which will set an influence on the different interest groups and all the entities of government which have been set under the policy changing process. There has been a complete set environment which involved and shape the policy to make efforts as to how all the groups of the stakeholders are influences with the Medical Part D. All the legislation and the specific strategies are made in correspondence to the politics. (Powell et al., 2015). The Medicare Part D is also said to be Medicare prescription drug benefit which directs to setting the United States Federal government programs to work on the subsidizing costs of all the drugs of prescription which insure premiums for the Medicare in US. There is a great enactment which has been based on Medicare Modernization Act of 2003. In December 2003, there are major Medicare Prescriptions which have become into the Improvement and Modernisation Act to become a proper law. There has been a great benefit from the drugs which provides an entire coverage to all the disables and the elderly people who could not have the ability to manage it.