Public+Policy+-+Medicare

 Medicare is a public policy originally enacted in 1966 designed to address the healthcare needs of the elderly, people aged 65 or older. In 1973, Medicare policy was reformed to include benefits for the disabled and also those individuals who suffer lifelong complication with end stage renal disease requiring dialysis and ,or transplantation. Medicare is a Federal program run by U.S. Department of Health and Human Services it is administered by the The Centers for Medicare and Medicaid (CMMS). Inorder to secure and maintain benefits under this public policy Medicare is not a free health insurance policy beneficiaries must pay monthly premiums inorder to continue to receive the healthcare benefits. Medicare is divided into two parts. Medicare Part A and B. Medicare Part A is hospital insurance it is used in times of hospitalization, hospice, nursing rehab facilities and home health care. Medicare B covers out patient services for physician visits, physician charges, physician assistants, advanced practice nurse and clinical laboratory charges. Medicare Part D(prescription drug benefit) was enacted in 2004, however it is not government funded program. Each individual insurance carrier that is a participating provider of the plan allows beneficiary to purchase common drug prescription whether generic or name brands at discounted rate. Beneficiary must pay premium to the participating provider. Funding for Medicare com es from payroll taxes FICA(includes social security tax and medicare tax). This accounts for a 2.9% tax that is shared among the employee who is taxed on his/her payroll check at 1.45% and the employer pays 1.45% which accounts for the total of 2.9%. Medicare was instituted as a single payor system in which the Federal government was the only administer and distributor of a tax payor health insurance. Currently, private insurance have been able to take part in and manage Medicare benefits now called, Medicare Advantage plans which are health maintenance organization (HMO), this is also known as Medicare Part C. During the early years of administration there was little or no management in the disbursement of claims. This was a major downfall because it was not monitored. Because there was flexibility in the regulation it gave way to frivolously inflated claims. This meant excess government spending and rising health care cost which put a severe strain on the Medicare trust fund. As a result of these mistakes early on, in 1993 Medicare went to fixed rate program, this means that no matter what the billed charges of physician or hospital charges, Medicare will only pay a fixed or set dollar amount for the speicified service and payment is accepted as “paid in full” as long as it is a Medicare participating provider. For non participating facilities of Medicare they are not allowed to charge more the 15% on the approved Medicare allowable charge. This is a benefit for the patient as well, because is still allowed to recieves services and with just a small mark up of the allowable charge with Medicare benefit.without having to choose a different provider. Over the years there has been much debate about the Medicare program and the many cries for reform. Although ,it is still serving its purpose to provide a healthcare coverage to the elderly and some disable and people with end stage renal disease that is substantial quality care.. With the growing number of the elderly and rising health care cost no one can predict the real future of Medicare, however we all agree as American citizen there must. be some type of healthcare benefit in place structured for the elderly the baby boomers begin to meet their age of Medicare eligibility and due to simple fact that people are living longer. Medicare provides an access to affordable, quality healthcare to many elders and disable Americans that otherwise would not be able to afford increasing cost and demands of healthcare.. The trustees estimate that Medicare's long-term unfunded obligation, the benefits promised but unpaid for..totals $37.8 trillion, or more than two and half times entire U.S. economy.( The Washington Post). These claims are just some of which are discussed with our Washington beurocrats. I would hope to believe that with every step and decision that is made to reform Medicare the Congress takes into account not only that people are living longer but also because of the cost of healthcare most elders may tend to suffer more chronic illness which over a period of time can be costly. In closing, Medicare is federally funded program that serves to provide a means of descent, affordable and quality healthcare for the elderly, end stage renal disease suffers and those individuals who qualify because of disability. However, this program is not a free program one must qualify and meet certain guideline as well as maintain obligation of monthly premiums. Future plans for Medicare encompasses reform that would make it much more solid and stable regardless of government deficits and economical challenges. The challenges will always be a part of Medicare legislation because it is dealing with monetary issues and it affects peoples health and how they will be able to manage their healthcare concerns. Overall, it has served its major purpose to provide a healthcare access for the ederly and as time goes on there may be changes in who eligible to benefit from the program, coverage criteria, and what benefits would be covered as a participating provider, but we can all find common ground relating to some of the benefits of having Medicare access as we become elders in the society it is a privilege to be able to benefit from such a program and would hope that it is sustained for generations to come. **
 * Medicare**
 * Some of the pundents in Washington say that Medicare reform should wait and take a back seat until Congress somehow fixes the overall health care system, truth is that Medicare itself is a major driver of increasing health care costs. Within three years, the the gigantic baby boom generation will start to retire and impose a demand on medical services unprecedented in the nation's history. The traditional Medicare program is not capable of absorbing such a shock without some fundamental changes.