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Free «Medicare/Medicaid» Essay Sample

Medicare refers to the "nationwide health insurance program" provided to cater for the aged, who are 65 years and above, and certain individuals who meet a "specific criteria", such as the disabled persons (Colamery, 2003). The program has benefited many over the years since its inception in 1965, by providing the much needed protection for the millions of deserving Americans. The " original Medicare plan provides two parts", "part A" provides for the hospital costs and subsequent medical care, while "part B" the doctor's charges, x-ray and laboratory tests, "home health care" and some of the outpatient services among others. The program has however faced quite a number of major problems in its operation together with criticism from some sections of within the society.

One of the major concerns has been whether the program's "financing mechanisms" will be able to "sustain it in the long run". Another related concern has been raised on whether Medicare's "benefit structure does adequately respond to the health care needs of today's aged and the disabled population" (Colamery, 2003). Many of the aged together with their families have also raised issues concerned on whether the changes made to the original Medicare plan, will may the program weak or lead to decreased benefits.



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In influencing its operations, changes to the Medicare program have been proposed as a result of the many concerns raised by the targeted beneficiaries and their families. The proposed changes have a concerted effort of ensuring that the program serves its intended purpose of providing health cover. Despite the fact that the concerns are caused by diverse but related views on the effectiveness of the program, the primary effect is to improve the running of the program. All these are to assure the concerned persons and ensure the continued provision of health benefits to the deserving population.

Significant and influential changes have been made to ensure improvement on one's benefits and the care accrued from the program. These include having "more affordable prescription drugs", which would reduce cost and result in "saving in the part D coverage gap" (Bihari, 2010). This strategy will be cost effective in the long run ensuring that the extra costs cut, would be channeled elsewhere within the program for the benefit of the public. "New preventive benefits" have been included such as "the free annual physical" and "screening for" cancers, including breast and colon cancer. These have been included to ensure that the beneficiaries stay healthy and at the same time be assured of their health (Bihari, 2010). The changes made will significantly influence the whole program resulting to increase in its efficiency and effectiveness in providing its services; to the advantage of its beneficiaries.

The "choice of doctor" by the beneficiary will be preserved with the program is implementing relevant strategies to ensure the number of the "available primary care physicians" are increased. This is to counter the projected problem of having a shortage in the number of the "primary care physicians" as more and more people acquire "the health insurance". New legislations touching on the program have been made to further assure the affected public that the physicians, their assistants and the nurses will be adequately provided in the provision of the health services. These will ensure the targeted group of beneficiaries gets a better access to the healthcare program. These are expected to also change the negative image the program has received over the years as a result of constant criticism and pessimism from the public. In regard to continue serving the American population in the long run, it has been imperative that Medicare incorporates and implements new and influential strategies in keeping up with the changes that have taken place since its inception (The Henry J. Kaiser Family Foundation, 2010).

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Some other "provisions in the Affordable Care Act" are deemed to have significant effect on the beneficiaries of the program and on the family members taking care for the given beneficiary and the ones dependent on them. The measures are taken to ensure both groups are adequately provided with care and can they can comfortably continue with other pressing duties with the knowledge that the Medicare program would cater for most of the emerging issues in regard to the beneficiary's health.

The "Medicare advantage plans" do cost more for the federal government than the "traditional Medicare plan", with some being concerned about the financing of the entire program as the private insurers are seen to profit from the situation. Financial changes are required on the program as result of legislations made in the "new health reforms" which demand the same. The new laws outlined in the Medicare newsletters, sent out to recipients of the benefits, are expected to widen the benefits and assure security to the seniors enrolled in the "Medicare advantage plan" (Bihari, 2010).

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The laws are also aimed at leveling "the playing field" through gradual elimination of the "Medicare advantage overpayments" made to the insurance companies. It has been shown that the insurance companies covering for "Medicare advantage plan" are overpaid by over a thousand dollars more per person on average by the Medicare program, as compared to the "original Medicare" (Bihari, 2010). The increased premiums on all the Medicare beneficiaries cater for the additional payments. The legislations made are foreseen to influence this situation in due time, in favor of the recipients. The changes made within the program will greatly improve the benefits to the recipients and further place emphasis on the quality of service (The Henry J. Kaiser Family Foundation, 2010).


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