The Issue Of The Medicare Part D

Medicare Part D is the portion of Medicare that covers prescription drugs and is separate from

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).

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.

The analysis of positive and negative impacts of Medicare that you made, I believe, were comprehensive and interesting to see with your background in health care. I agree Medicare has increased insurance beneficiaries in the elderly population which is a positive influence. This also includes the coverage of those disabled and with ALS and end stage renal disease. The impact that Medicare has made on the families of these particular populations is the greatest impact of all. Medicare as you stated, has its flaws and one of the primary negative impacts I believe there to be is the services that are not covered such as vision and dental. The major of individuals had a payroll deduction while they were able to work and now that the insurance is

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.

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.

Medicare part D is the prescription drug plan. Each plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different tiers on their formularies. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost less than a drug in a higher tier. In some cases, if the drug is on a higher tier and the patient 's prescriber (the patient 's doctor or other health care provider who is legally allowed to write prescriptions) thinks the patient needs that drug instead of a comparable drug on a lower tier, the prescriber can ask the patients plan for an allowance to get a lower copayment. In the case of Mrs. Zwick Part D will cover the prescription drugs that she needs that are not covered by Medicare Part A and Part B unless those medications are on the unapproved list. What the patient will be responsible for paying

In order to fully evaluate the tradeoffs associated with the Medicare-for-all policy, it is imperative that a source of funding, or a payment model, is identified. Without this information, it is difficult to determine not only who would benefit and who would suffer, but how the system as a whole will respond to the healthcare choices of over 323 million people. Another important detail lies in the potential cost savings and efficiency for middle-class families. The Medicare-for-all plan promises to save the average American family anywhere from $3,800 to $5,100 a year in health care costs (Qiu, 2016). Instead of a traditional monthly premium, consumers would pay a much lower health care tax based on their household income. A household

Medicare Part D was created under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. (Medicare Part D, 2011). It is also known as the prescription Drug Plan. This plan was created to help cover cost of prescription drugs, and people who have the original Medicare or Medicare Advantage are eligible to enroll (Medicare Part D, 2011). Prescription drug coverage is only offered through HMOs, PPOs, and PFFSs and by some private companies who contract with Medicare through individual plans (Medicare Part D, 2011). Private companies are allowed to create their own customized benefit plan as long as the plan is as good as the plan outlined in the 2003 Medicare Act (Medicare Part D, 2011).

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

How Medicare, Medicaid and private insurance benefits affect how the hospital bills and collects revenue. To begin with, a hospital is funded by numerous fairly distinct systems, depending on who is paying. Medicare program for the aging normally pays hospitals a flat payment per hospital case. With the federal-state Medicaid program the poor, sightless and disabled, hospitals obtain either one case-based expenses or a two set amount of dollars per day of inpatient visit (per-diem payments) or (3) fees for single services and supplies . The levels of the payments are set individually by the state managements. In numerous states payments are greatly lower than the full cost of providing the services. Private insurers

Medicare acts a universal health care insurance system by allowing all Australian citizens to have access to basic health needs inside of Australia. Medicare provides Australian with the opportunity of gaining access to the public hospital and free consultation at any bulk billing doctor. All though Medicare doesn't cover everything it covers the basic most important things. These include access to the public Medicare aims to promote the principles of social justice by making health care free for all Australians. This enables all people no matter what background to gain access to medical support even if they cannot pay for it. Health care ensures that all people receive basic treatment, not just the rich. This idea shows equity in Australian

“Medicare-for-all” is piece of legislation proposed by Vermont Senator Bernie Sanders that advocates for a single-payer healthcare system and universal coverage for all in the United States (Keith & Jost, 2017). The bill details a national health insurance plan, funded by a government trust, that would cover all services from hospital stays to primary care visits, thus eliminating high out-of-pocket costs, copayments, and deductibles. Comprehensive coverage under Medicare-for-all would also include treatment for substance abuse, mental health counseling and resources, reproductive and maternity services, and even abortion (Keith & Jost, 2017).