Ordinary insurance companies were not willing to extend insurance services to older citizens since it was considered a losing proposition.
With the enactment of Medicare, 99% of older people in the country have health insurance and poverty among this group has dropped significantly. With this program, people now have access to better healthcare services which has resulted in increased life expectancy. The reason we can say with some degree of certainty that Medicare has met its goals is grounded in the fact that it has provided elderly with greater access and more choices of healthcare facilities. Medicare gives them the opportunity to choose the best physician, good inpatient services and also pays their bills right on time to avoid problems with hospital and medical care authorities. "Medicare provides health benefits to 41.7 million elderly and disabled Americans. Most (88%) have their health bills paid by the traditional fee-for-service program, while…...

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References

MEDICARE at a GLANCE, fact sheet, March 2004: Accessed 12th March 2005:

http://www.sppsr.ucla.edu/classnet/students/sub.cfm?courseid=517&page=weblinks&department=sw

MEDICARE Advantage, fact sheet, March 2004: Accessed 12th March 2005:

http://www.sppsr.ucla.edu/classnet/students/sub.cfm?courseid=517&page=weblinks&department=sw

Medicaid offers service regardless of age (aidmann 1998). The author asserts that raising the age eligibility will simply increase the responsibilities of the Medicaid system (aidmann 1998).. On the other hand, the article also asserts that an increase in the eligibility age to 67 will only make a small difference in Medicare savings. The article explains that it would only add one year to the life of hospital insurance trust fund (aidmann 1998)..
Analysis of these reforms using Priester's framework

Priester has some definite opinions about the values that the healthcare in America should have. Priester explains that any type of healthcare reform that is put into place should incorporate the successes of healthcare systems in Canada and the Netherlands (Priester 1992). Priester also contends that new healthcare reform values should include Fair access, Quality Care, Efficiency, Respect for patients, Patient advocacy, and Personal responsibility (Priester 1992).

According to Priester, under the…...

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Works Cited

Building Better Medicare for today and tomorrow (1999) Retrieved on October 23, 2004 from; http://medicare.commission.gov/medicare/bbmtt31599.html

Kogan R., Park E. (2003). Retrieved on October 23, 2004 from;  http://www.cbpp.org/11-3-03health.htm 

Priester R. (1992) A values Framework for health system reform. Health Affairs,

Waidmann, T, (1998) "Potential Effects of raising Medicare eligibility age," Health Affairs. Retrieved on October 23, 2004 from;  http://64.233.161.104/search?q=cache:hoNzhNjyAvMJ:content.healthaffairs.org/cgi/reprint/17/2/156.pdf+Raising+Eligibility+age+for+medicare&hl=en

Yet, the working class poor elderly person (officially defined as such by the U.S. Bureau of Labor statistics (2011) who, despite working 27 weeks or more -- tedious heard labor- and around the clock still show income that are at, or below, the official poverty threshold) in particular have the most difficult situation since they do not reach Poverty Guidelines that are defined by the U.S. Department of Health and Human services (HHS) for classifying poor individuals and for determining federal program eligibility (U.S. Department of Health and Human services, 2011), but, on the other hand, they are too poor to afford that insurance. These individuals may not qualify for assistance. In other words, it is the very elderly who are no longer able to work who receive Medicare, whilst those who may need it as much, or even more, (since they lack the resources), are by a crippled…...

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References

Brooking Institute (2008). Meeting the Dilemma of Health Care Access. Opportunity 08: A Project of the Brookings Institution. Retrieved on 9/4/2011from:

http://www.opportunity08.org/Files/FD.ashx?guid=98a417e5-5972-4031-b361-e11e00981f55

Bhattacharya, Jay, & Lakdawalla, D. (2006). Does Medicare Benefit the Poor. Retrieved from Journal of Public Economics 90(1-2): 277-292.  http://healthpolicy.usc.edu/docs/lakdawalla/does%20medicare.pdf 

Chaikind, H. (July, 2008). Medicare Secondary Payer- Coordination of Benefits. Retrieved from:  http://aging.senate.gov/crs/medicare11.pdf

In 2003, President Bush expanded Medicare, by subsidizing prescription drug costs under Part D.
There are further changes to Medicare and Medicaid in the Affordable Care Act. There were expansions in the number of preventative health care services offered for free (such as colorectal screening), and by closing gaps in prior coverage (HHS, 2012). Berenson (2010) notes that the ACA pays for this expanded coverage by decreasing Medicare spending by reducing payments to private plans under Medicare Advantage and reduced payments for many providers. There are fears that this will cause many providers to either refuse Medicare patients or that the quality of care will be lowered. There are also changes to the structure of Medicare, the end result being more government intervention on the cost side of the program, in an attempt to use the program's bargaining power with health care providers to lower its costs. It is possible…...

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Works Cited:

Berenson, R. (2010). Implementing health care reform -- why Medicare matters. New England Journal of Medicine. Retrieved October 31, 2012 from  http://comedsoc.org/images/Implement%20HCR%20Why%20Medicare%20Matters%20NEJM%207-8-10.pdf 

Ford, G. (1976). Statements on signing the Health Maintenance Organization Amendments of 1976. The American Presidency Project. Retrieved October 31, 2012 from  http://www.presidency.ucsb.edu/ws/index.php?pid=6435 

Golinker, L. (2001). Medicare vs. Medicaid: Program comparison. NLS.org. Retrieved October 31, 2012 from  http://www.nls.org/conf/medicare-medicaid.htm 

HHS. (2012). Through the Affordable Care Act, Americans with Medicare will save $5,000 through 2022. Department of Health and Human Services. Retrieved October 31, 2012 from  http://www.hhs.gov/news/press/2012pres/09/20120921a.html

Medicare, SCHIP, and PPACA
Who is Eligible for Medicare?

Medicare is essentially an insurance program available to individuals when they reach retirement age. It is however important to note that to be eligible for Medicare, individuals must first satisfy a few requirements. To begin with, in addition to being a U.S. resident, one has to be of age 65 and above to be eligible for Medicare (Medicare, 2012). As Medicare (2012) further points out, the individual seeking to join the program (or their spouse) must have "worked for at least 10 years in Medicare-covered employment…" It is however important to note that those who have a disability do not necessarily have to be aged 65 years or older to be eligible for Medicare (Medicare, 2012). This also applies to individuals suffering from End-Stage enal disease. Those who meet the age requirement above but do not have the prerequisite work history can opt…...

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References

Cordes, J.J., & Ebel, R.D. & Gravelle, J.G. (Eds.). (2005). The Encyclopedia of Taxation and Tax Policy (2nd ed.). Washington, DC: The Urban Institute Press.

Faust, H.S. & Menzel, P.T. (2011). Prevention Vs. Treatment: What's the Right Balance? New York: Oxford University Press.

Medicare (2102, August 3). Medicare Eligibility Tool. Retrieved from:  http://www.medicare.gov/MedicareEligibility/Home.asp?dest=NAV|Home|GeneralEnrollment#TabTop 

State Children's Health Insurance Program -- SCHIP (2013). SCHIP Information Center. Retrieved from: http://www.schip-info.org/

This means that the program will need to support many more people than it currently does, and there will be fewer (proportionally) workers paying into the system (Johnson 2006). The particular problem cited and explored by this author is prescription drug coverage, with the researcher predicting ongoing volatility in coverage laws and particulars, but truly this trend has many far-reaching implications.
The aging of the U.S. population and the increased burden this places on the Medicare program is alarming for another reason, as well: despite ongoing efforts to correct the situation, over a quarter of Medicare payments go to beneficiaries and their providers in the last year of the beneficiary's life (iley & Lubitz 2010). This is a problem for several reasons, not the least of which is that is represents a fairly inefficient use of Medicare dollars -- payments and benefits that improve the quality of life in earlier…...

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References

Johnson, P. (2006). Changes in reimbursement rates and rules associated with the Medicare Prescription Drug Improvement and Modernization Act. American Journal of Health System Pharmacy 63(7):2-6.

Riley, G. & Lubitz, J. (2010). Long-Term Trends in Medicare Payments in the Last Year of Life. Health Services Research 45(2): 565-76.

Saleh, S. & Callan, M. (2006). Trends in Medicare Disproportionate Share (DSH) Distribution in U.S. Hospitals: 1996 -- 2003 Journal of Health Care Finance 33(2):70-83.

(2003) that examined the access that black and Hispanic Medicare beneficiaries have to prescribe drugs for chronic conditions. Not much has changed in the times since then and taking the findings of the study it can be established that the Black and Hispanic Medicare beneficiaries are subject to medication under use for economic reasons. This is also true for the chronically-ill black and Hispanic beneficiaries, who require constant medication but have no resources and have very meager drug coverage. The three common diseases that cause the depravity foremost are heart ailments, diabetes and HIV / AIDS. Though the federal initiatives have given importance to the three diseases in removing disparities, yet the benefits are to reach the target. (Briesacher; et al., 2003)
The general access to prescription drugs is not available for black and Hispanic Medicare beneficiaries. Thus these groups of people may need a different amendment in the policy…...

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References

Bagchi, Ann D.; et al. (2007) "Prescription Drug Use and Expenditures among Dually Eligible

Beneficiaries." Health Care Financing Review, vol. 28, no. 4, pp: 43-45.

Blevins, Sue A. (2001) "Medicare's Midlife Crisis"

Cato Institute: Washington, DC.

Medicare
2012 Election: The Great Medicare Debate

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…...

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Works Cited

Alonso-Zaldivar, Ricardo. "Mitt Romney Medicare Plain Raises Cost Questions." Huffington Post. 5.10.2012. Web. Retrieved from  http://www.huffingtonpost.com/2012/10/05/mitt-romney-medicare_n_1942052.html 

Pugh, Tony. "Obama, Romney Offer Different Paths on Medicare, Social security." Herald Online. 8. 10. 2012. Web. Retrieved from http://www.heraldonline.com/2012/10/08/4321880/obama-romney-offer-different-paths.html

Medicare, Wealth and Equality of Healthcare
The premise of this position paper is that wealth, not regulation, determines the quality of healthcare available in the United States, citing the inequality of the Medicare Program as a case in point. A rich man in a poor country is more likely to live longer than is a poor man in a poor country; moreover, a rich man in a rich country is more likely to live longer than a poor man in a rich country (Smith, 1999, p.16). The first part of the preceding statement is self-evident. A rich man, no matter where he lives, is able to procure the means by which to stay healthy.

The second part of the statement raises serious questions about the quality of life a rich country provides to all of its citizens.

Increases in life expectancy are mainly due to improvements in three basic social conditions: better nutrition,…...

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References

Difficult Path Is Seen for Private H.M.O. Competitors Under Medicare Bill. 28, November 2003. The New York Times.

Clark, Richard C. President and CEO. Healthcare Financial Management Association, Westchester, Ill. Health Care Complexities Work Against Us All. 28, November 2003. The Wall Street Journal.

Fuhrmans, Vanessa and Rhonda L. Rundle. For HMO's, Medicare May Regain Some Allure. 28, November 2003. The Wall Street Journal.

Holding Down Drug Prices. 28, November 2003. The New York Times.

Medicare was initiated in 1966 to provide healthcare coverage to senior citizens who were otherwise uninsured. It has often been said that the costs of providing Medicare coverage has far exceeded the funding available to support this program and thus the whole system is in crisis. However this may not actually be true. Even though it is true that Medicare costs have exceeded government's initial estimates but so have the income level of Americans over the years which helps in raising the funding sources significantly. We must understand that Americans need to contribute to Medicare payments during their working years and with higher income, more money goes into Medicare funds which, helps in meeting the rising costs of this program.
Medicare is primarily funded by the payments made by citizens during their working years. While still working, Americans need to pay a certain percentage of their income to Medicare so they…...

CASE STUDY 6.3: SINGLE-PAYER SYSTEM 1AbstractCase 6.3 seeks to assess the cost-effectiveness of the Medicare for All system. It discusses the cost savings to be realized by insurers, providers, and patients in implementing the Medicare for All system. For insurers, the plan would reduce costs by reducing redundancies and streamlining administrative procedures as well as granting Medicare significant power to bargain over pharmaceuticals prices. For patients under private insurance, the plan will reduce spending on care by $455 billion. At the same time, it would increase spending for those under Medicaid by approximately $160 billion. This text responds to questions one to four in the case study. More specifically, it seeks to determine the extent to which moving to a single-payer system would reduce administrative costs, how much provider revenues would fall if Medicare replaced private insurance, how much provide revenues would rise if Medicare replaced Medicaid, and the effect…...

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References

Cai, C. (2022). How Would Medicare for All Affect Physician Revenue? Journal of General Internal Medicine, 37, 671-72.

Daly, R. (2019). Medicare for All to Cost Hospitals $200 Billion Annually: Analysis Found. Healthcare Financial Management Association. Retrieved from  https://www.hfma.org/topics/news/2019/07/medicare-for-all-cost-hospitals-200-billion-annually.html 

Galvani, A. P., Parpia, A., Foster, E., Singer, B., & Fitzpatrick, M. (2020). Improving the Prognosis of Healthcare in the United States. Lancet, 395(10), 524-33.

Reply to Carina Regarding Health Issues to Resolve Reply to Carina Regarding Health Issues to ResolveWhen I retire, the first issue is how much I should plan to rely on Medicare to cover my healthcare costs as I continue to age. Many are still confused and do not have the proper knowledge of how Medicare works and what it covers. Despite Medicare's assistance to pay medical spending, there are a few gaps that many people are unaware of, such as oral treatment.1 How much of one's retirement income to set aside for healthcare is determined mainly by age and general health.1 Since insurance is modified, implying services are offered and removed, this scenario is challenging to overcome by legislative health policy.1 It can be challenging to determine how often one can depend on Medicare using new plans.1Yes, in several instances, it comes as a surprise to older people that Medicare…...

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References

Ghilarducci, T., & James, T. (2018). Rescuing retirement. In Rescuing Retirement. Columbia University Press.

Lake, R., (2021). How To Plan for Medical Expenses In Retirement. [online] Investopedia. (Links to an external site.) Accessed 11 May 2022.https://www.investopedia.com/retirement/how-plan-medical-expenses

The CDC has provided almost $7 million in funding to establish DPPs for research purposes, which means the number of pre-diabetes individuals helped by these programs will be very limited (CDC, 2012). While these programs will probably provide free or nearly-free diabetes preventive services to a large number of individuals, most underserved patients will not benefit from these programs.
S. 452 is worded in such a way that establishing DPPs under Medicaid will be optional for states (Sebelius, 2010). As of 2010, 43 states covered the expense of screening Medicaid patients for diabetes, but only 13 states provided reimbursement for obesity preventive services. This suggests that states are willing to pay for screening, but not preventive services like lifestyle interventions; however, if only a few states implement DPPs for Medicaid recipients, this will provide a proof-of-principle experiment in a real-world setting and establish the overall healthcare savings such programs can…...

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References

CDC (Centers for Disease Control and Prevention). (2012). National Diabetes Prevention Program. Funded Organizations. CDC.gov. Retrieved 17 Apr. 2013 from  http://www.cdc.gov/diabetes/prevention/foa/index.htm .

Civic Impulse, LLC. (2013). S. 452: Medicare Diabetes Prevention Act of 2013. GovTrack.U.S.. Retrieved 17 Apr. 2013 from  http://www.govtrack.us/congress/bills/113/s452 .

DPPRG (Diabetes Prevention Program Research Group). (2003). Costs associated with the primary prevention of type 2 diabetes mellitus in the diabetes prevention program. Diabetes Care, 26, 36-47.

Green, Lawrence W., Brancati, Frederick L., Albright, Ann, and PPDWG (Primary Prevention of Diabetes Working Group). (2012). Primary prevention of type 2 diabetes: Integrative public health and primary care opportunities, challenges and strategies. Family Practice, 29, i13-i23.

On April 16, 2015 an Act called the Medicare Access and CHIP Reauthorization Act (MACRA) was passed, which is a piece of history of bipartisan legislation. Eventually, on October 14, 2016 the Centers for Medicare & Medicaid Services, the department of Health and Human Services, and the regulatory agency which takes care implementing and putting into practice MACRA, gave out an ultimate rule with a comment duration putting into practice the provisions of MACRA. MACRA revokes the highly denounced Sustainable Growth Rate Formula together with its schedule for Medicare Physician Fee (MPF) cuts, substituting it with the Quality Payment Program, which is a new model that focuses on cost measurement and quality, as well as payment and reporting adjustments. Physicians and their assistants, clinical nurse specialists, nurse practitioners, and certified registered nurse anesthetics are all part of the eligible clinicians indicated in Medicare Part B and their QPP includes the…...

It notes that these nine new categories only apply to "MDS assessments that meet the criteria for the rehabilitation category and the Extensive Services category" (Field and Kazmer, 2006). These cases must also have an ADL rating of 7 or higher to qualify, and it talks about grouper software that facilities can use to assess whether these criteria are met or not. The article notes that a good case mix of patients can help a facility become a "winner" with UG-53. Finally, it lists several processes facilities should utilize to make sure cases have the right qualifications. These include timing the Assessment eference Date, obtaining all medical records, and following AI guidelines in coding. All of these things should help assure UG-53 works for all facilities.

eferences

Field, C and Kazmer, J. Be a winner in Medicare UG-53. Nursing…...

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References

Field, C and Kazmer, J. Be a winner in Medicare RUG-53. Nursing Homes. Cleveland: Jun 2006 Vol.55, Iss. 6-page 58 4 pages.

1. The impact of poverty on education: exploring government assistance programs and private initiatives aimed at breaking the cycle of poverty through education.

2. The prevalence of mental health issues in society: analyzing the benefits of government-funded mental health programs and the role of private organizations in providing support and resources to individuals in need.

3. The challenges faced by homeless individuals: examining the assistance offered by government agencies and non-profit organizations in providing shelter, food, and healthcare to homeless populations.

4. The issue of food insecurity: investigating government assistance programs such as SNAP and WIC, as well as the role of food....

1. The impact of the Affordable Care Act (Obamacare) on access to healthcare in the United States
2. The effectiveness of Medicare and Medicaid in providing affordable healthcare to low-income and elderly populations
3. The future of universal healthcare in the United States
4. The role of pharmaceutical companies in rising healthcare costs
5. The importance of mental health coverage in healthcare policies
6. The debate over the privatization of healthcare services
7. The impact of electronic health records on patient care and privacy
8. The implications of genetic testing and personalized medicine on healthcare policy
9. The role of preventative care and public health initiatives in reducing....

1. The Role of Technology in Transforming Health Care Delivery

Discuss the latest technological advancements in health care, such as telemedicine, AI-powered diagnostics, and wearable health trackers.
Explore how technology can improve access to care, reduce costs, and personalize treatments.
Analyze the ethical implications of using technology in health care and the potential for data privacy and algorithmic bias.

2. Addressing Health Disparities through Policy Interventions

Identify the root causes of health disparities based on race, ethnicity, socioeconomic status, and geographic location.
Evaluate the effectiveness of existing policy interventions aimed at reducing disparities, such as Medicaid expansion and community health centers.
....

Universal Healthcare and the Well-being of Canadians

Canada's universal healthcare system, commonly known as Medicare, provides comprehensive medical services to all citizens and permanent residents, regardless of their income or employment status. This equitable healthcare availability significantly influences the overall well-being of the Canadian population.

Improved Health Outcomes:

Universal healthcare ensures that all Canadians have access to necessary preventive, diagnostic, and treatment services. This broad coverage has led to improved health outcomes across the country. For instance, Canada has a lower infant mortality rate and higher life expectancy compared to many other developed nations.

Reduced Health Disparities:

Medicare eliminates financial barriers to healthcare, reducing disparities....