Prescription Assistance For The Elderly Population

With an aging population and various sicknesses or disease, such as diabetes and cancer, there is a demand for medical treatment for many who don’t have the wherewithal to access medical care. For example, there is a growing demand for non-emergency medical transportation (or NEMT). An estimated 3.6 million Americans miss or delay medical care because they lack transportation to their appointments (Wallace and Hughes, 2005) Access to Medicaid is another method by which the Human Services worker can assist a client in meeting their medical needs.

The purpose of this paper is to give an overview of two federally and/or state funded programs. The programs that will be discussed are Medicare and Medicaid. In this paper will be information about who receives Medicaid/Medicare, the services offered by these programs, and those long term services that are not.

Statistically, the majority of older adults require continual health care for at least one chronic condition, half of this group for multiple chronic conditions, and more than half are managing multiple prescription medications. In older adult groups without chronic illness, there is still a high demand for health care access for “acute conditions as well as for extensive preventative care services recommended by evidence-based guidelines, such as medical screenings and vaccinations” (Thorpe et al., 2011, p. 2). Education from research is necessary to address the efficacy of health care delivery within the communities nationwide, and to mitigate the disparities within a flawed system. “As this vulnerable population is expected to double by the year 2030, efforts to identify and eliminate disparities in access for older adults are among the most pressing health care issues for the 21st century” (Thorpe et al., 2011, p. 2). Ultimately, through exploration of predictive risk factors in the older adult population, along with implementation of various approaches for intervention and policy, health care accessibility for this vulnerable population can be greatly improved.

Patients with long-term, chronic illnesses like Mr. Davis’s, care can be very costly, especially when the patient is unable to maintain routine medical care or visits and medications. Without routine medical care and maintenance medications, patients like Mr. Davis tend to have more frequent emergency room visits and hospitalizations; increasing costs for state and local government as well as tax payers. Though Mr. Davis is able to receive care during an emergency room visit, the providers are not fully aware of his health history and are only able to provide a temporary fix of his symptoms and not address his health care needs.

Immigrants are faced with a lot of barriers when it comes to taking full advantage of basic preventive care services available to them. Of the diverse population of immigrants coming to the United States, over half (53%) of them are older Hispanics from Latin America (Strunk, Townsend-Rocchiccioli, & Sanford, 2013). This paper focuses on US-dwelling Hispanics, aged 65 years old and above. This paper will depict how failing to acculturate, lacking financial resources, and having limited ability to communicate in English pose a challenge for the older Hispanic population to obtain high quality and cost-effective patient care.

One dominant economic feature of the healthcare industry is the growing need for both basic and specialized healthcare due to the continued aging of the “Baby Boomer” generation. This generation consists of over 79,000,000 individuals born in the US between 1946 and 1964. As this generation has aged, the need for healthcare has increased dramatically. Let us take a look at some statistics:

Long-term care is vital in the United States health care system. As the population ages, more people will need assistance to recover from illness or injury, and others will need end of life care to ease their passing. People who use long-term care are all ages. From young to old, people can receive it if they cannot care for themselves because of a condition, an illness, or an injury that requires assistance for a period of 90 days or more. The concern people face when looking at long-term care is the funding. Medicaid will likely be drained of funds long before the country’s aging population is past its peak and while there are some options of insurance coverage, not everyone may afford them.

Within the United States some populations groups face greater challenges then the general public with being able to access needed health care services in a timely fashion. These populations are at a greater risk for poor physical, psychological, and social health. The correct term would be underserved populations or medically disadvantaged. They are at a disadvantaged for many reason such as socioeconomic status, health, and geographic conditions. Within these groups are the racial and ethnic minorities, uninsured children, women, rural area residents, mentally ill, chronic illness and the disabled. These groups experience greater barriers in access to care, financing of care, and cultural acceptance. Addressing these

Health care in the United States is currently facing a looming crisis that requires an urgent response of intervention. With the baby boomers population on the rise, there will ultimately be an increased need for long-term care (LTC) services. Pratt (2015) defines baby boomers as “the name given to the large number of people born in the period following World War II, between 1946 and 1964” (p. 17). According to Mikulaschek (2013), “Beginning in 2010, the roughly seventy-eight million baby boomers began turning sixty-five at a rate of three to four million per year leading to growing concerns over meeting their healthcare demands” (p. 86). This brings the number from about forty million in 2010 to seventy-two million in 2030 causing them to account for almost twenty percent of the total U.S. population (Mikulaschek, 2013, p. 96; Pratt, 2015, p. 17). This alarming rate will correspond to the increasing number of elderly individuals with chronic conditions who depend on LTC services for daily functioning (Pratt, 2015, p. 17). This influx of baby boomers presents the health care industry with a plethora of issues related to costs, quality, and access to the LTC services that this population so desperately needs.

Every individual in the world deserves to enjoy health and wellness. Maintaining or achieving proper health needs enables individuals to be productive at work and leisure. Traditionally, many people have had barriers obtaining adequate healthcare due to economic constraints or personal inconveniences. Despite impressive technological advances in medicine, the challenge of delivering quality healthcare to the Americans continues to be debated amongst the nation’s political and healthcare leaders. The aging baby-boomers and the increased number of uninsured people add to the equation of population growth which results in limited access to primary healthcare for the entire public. On the

Medicare, which was first enacted by Congress in 1965, is a popular, yet failing, program because of a rapidly increasing population of retirees and their increasing costs; despite program’s flaws, Medicare is difficult to change because of the political influence of the elderly, who approve of the benefits they receive from the program. Medicare provides health benefits to citizens who are eligible for social security benefits(Fiorina, Peterson, Johnson & Mayer 2009). The program is embraced by the public, but Medicare’s increasing cost makes it difficult to sustain. Due to its popularity, the program is also very difficult to change, but without limitations the program will continue to decline in the future.

This exercise point out some very important factors with regard to health care cost.  nursing homes and other health care delivery systems are faced with significant shortfalls in reimbursement for various reasons.  Medicare reimbursement often does not cover the full extent of treatment of individuals.  McPike (2008) notes that, “The insurance and hospital industries released a study today showing that underpayment by Medicare and Medicaid costs consumers and employers $88 billion more a year for health care as providers attempt to make up the difference.” Today with continue cutbacks in medicare reimbursement this number is significantly higher.  In an attempt to reclaim these losses, both self pay and privately insured patients are charge

Medicare is America’s largest health insurance program for the men and women over the age of 65 or with certain disabilities. For many Americans, this a huge part of how they can afford medications, doctor visits and other medical expenses. In recent years the number of Medicare enrollees has doubled (NASI, 2015). The “Baby Boomers”, people born from 1946-1965, is the largest generation within America with roughly 75 million Americans. This generation of Americans are all turning 65 around the same time and enrolling into this medical program. With the amount of new enrollees the total spending for Medicare will rise from 3.6% of the nations GDP to 5.1% by 2030, when the youngest of the baby boomer generation will be 65 (NASI, 2015). Even

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.

After four decades of failure to enact a universal healthcare program, advocates decided to refine their approach in the 1950s, and the strategy that ultimately led to the passage of Medicare and Medicaid was formulated. Wilbur Cohen and I.S. Falk recognized that a health insurance plan focused on Social Security beneficiaries would be much easier to sell than a plan for all Americans. By limiting its benefits to the elderly, Medicare could be portrayed as a program for people who met two important criteria: they had greater need for healthcare coverage and they were especially deserving of public assistance. Because of their age, seniors have relatively high medical costs--when Medicare was passed, average healthcare expenses for people sixty-five or older were twice the average expenses for younger persons. (Orentlicher, D. (2012).