Long-Term Viability of Medicaid and Medicare - Research Paper Example

Long Term viability of Medicaid and Medicare Abstract As per estimates made by the Congressional Budget Office (CBO) in 2009, the USAs expenditure on the health care program would reach about 31% of the GDP by 2035 and 46% by the year 2080. Affordable Health Care Act is one step forward to contain such surmounting long term health care expenses. Many provisions in the Affordable Care Act are tailored to surmount the inequalities in health outcome created by social features linked with culture, language, race and ethnicity. It is alleged that minority population is receiving low quality of health care aid and the passing of Affordable Care Act is one step in the right direction to address the issue. . Affordable Health Care Act is one step forward to contain such surmounting long term health care expenses and this research will analyze in detail the salient features of ACA in an exhaustive manner. Introduction In USA, for elderly people, Medicare is the federal insurance program, covering about 43 million Americans. In 2006 alone, the aggregate of Medicare benefits was about $374 billion or 14% of the federal budget. Medicare comprises of a variety of physician services, hospital services, which include a prescription of drug benefit. Medicare is funded by general tax revenues, wage tax paid by employees and premium paid by recipients. End-stage renal disease patients, citizens of 65 and above and disabled persons who have eligibility are the major beneficiaries of Medicare in USA. (Jimenez, 2009, p.371). Funded by both state and federal, Medicaid is the program offering health insurance to the poor where the federal government defrays about 50 to 75% of the expenses, footing upon the per-capita income of the concerned state. Medicaid is more limited and parsimonious program where Medicare is more generous program that extends almost unrestricted health care access to elderly persons. The lion’s share of Medicaid is being enjoyed by low-income families and kids. (Mmapinc.org, 2012). Obama government in an endeavor to address the long term viability of the Medicare and Medicaid had introduced the Affordable Health Care Act in 2010 with stiff opposition from Republicans and this research essay will attempt to ponder the strategies of American government in providing a successful long term medical benefits scheme to its citizens in detail. Long Term Viability for Medicaid and Medicare –An Analysis About, 50% of Medicare beneficiaries have income which is below 200% of the poverty line; about, 15% of the beneficiaries are permanently disabled and under the age of 65. Medicare is said to be responsible for cost inflation in health care mainly due to elderly employ their benefits to buy fee for service medical care instead of managed care. With deteriorating health and advancing age ,the demand for the health care increases and hence , the costs of Medicare are become exorbitant and are probable to increase radically when there is retirement of baby boomers within the next decade. With a hope to contain the Medicare costs under control, in 1990, the federal government tried to shift the elderly away from the fee for service to managed-care plans, which is called as Medicare Advantage plans, , but many service providers deserted the Medicare market leaving Medicare beneficiaries without coverage. However, to remedy this, in 2003, the Medicare “Drug Improvement and Modernization Act were initiated.” (Jimenez, 2009, p.372). Since two years have passed after the enactment of the Affordable Care Act 2010, there are more fringe benefits offered to millions of Americans under this scheme, which includes the following: Health insurance now extended to more than 2.5 million young adults. When they hit donut hole, in excess of 2.65 million senior citizens in USA received a 50% discount on their medical prescriptions. (I don’t know what this means) Now, insurance companies cannot refuse anyone’s coverage when the beneficiary is sick or can place a lifetime ceiling on the quantum of Medicare that one can receive. Further, from 2014 onwards, in every state, consumer can utilize the services of Affordable Insurance Exchanges, which is state-oriented, a one-stop service provider where the beneficiary can select an insurance plan offered by the private insurers that suits their heath requirements. Thus, tax credits now made available to millions of beneficiaries to make it more convenient to purchase insurance policies from exchanges. Already, about 28 states have started to take steps to establish their own Exchanges in USA. (DeParle, 2012). Significance to Nursing Profession In the process of reforming of healthcare facility , now more attention is given by policy makers, professional colleagues and nursing leaders to nursing profession .(Stokowski ,2011).The enactment of the Affordable Care Act 2010 (ACA) despite strong opposition from Republicans has unlocked new doors to career advancement and education opportunities for nursing profession as the many clauses in the ACA intended at promoting the accountabilities and roles of nurses in the provision of health care services and can be regarded as government’s acknowledgement of the value of the nursing profession. (Wakefield, 2010, p.11). Social and Political Issues Many provisions in the Affordable Care Act are tailored to surmount the inequalities in health outcome created by social features linked with culture, language, race and ethnicity. The Affordable Act now provides the eligibility to more ineligible adults in the past, and now it can offer subsidy care to families up to 400% of the poverty level fixed by federal government. (Daley 2011). On political side, Health Care Act witnessed a lot of turmoil. In the final version of the bill, not a single Republican voted for it and all over USA, Republican rallied under a single banner to oppose the bill and made a vigorous campaign to repeal the bill. As the Republican failed in their attempts to repeal the bill and now the matter is in US Supreme Court. (Barr, 2011, p.121). Economic Issues At a critical period of time, the Affordable Care Act 2011 has been passed in USA. In 2009 alone, about 16% of US’s GDP was spent on health care. Within the next few decades, without any adequate reform, USAs excessive spending on health care at present level would have attained untenable magnitudes in the near few decades. As per estimates made by the Congressional Budget Office (CBO) in 2009, the USAs expenditure on the health care program would reach about 31% of the GDP by 2035 and 46% by the year 2080. As per projection made by the Medicare Trustees in 2009 that the Hospital Insurance (HI) Trust Fund would become insolvent by 2017 if the spending in health care is going to increase at an uncontrollable space. Further, there is not only increasing financial burden on health care not only for American government but also American households, which is suffering from high health costs where nearly 16% of household’s income is being spent on health care. (Jimenez, 2009, p.375). Cultural and ethical issues Long -term viability of Medicaid and Medicare is impacted by the ethical issues that are going to be faced in the future days. For instance, with the limited resources , for giving treatment to a premature baby , will the government ready to spend tens of thousands of dollars to keep the child alive and if so , how long it going to be. Likewise, in case of organ transplant, whether the same is going to be available to everyone or not, what is the criterion for selection of beneficiaries? For AIDS and cancer patients, how much dollars is going to be earmarked for the education, research and treatments and who should bear the expenses. Some states in USA have made law to address serious ethical issues. The state of Oregon had decided to cease employing funds earmarked for Medicaid to pay for heart, bone marrow, heart, liver and pancreas transplant and to employ the funds so saved to offer prenatal care for downtrodden women. Many states have set restrictions on what they will defray for organ plantations. Throughout the United States, citizens groups have been established mainly to address ethical decisions like above. (Ambrosino et al, 2011, p.221). Political strategies that have been or could be used by different groups of stakeholders, including nursing, to move or thwart the issue. As per the Institute of Medicine landmark 2002 report, there prevail health care disparities due to lack of insurance. It is alleged that minority population is receiving low quality of health care aid and the passing of Affordable Care Act is one step in the right direction to address the issue. Thus why, the Democrats vehemently supported the Bill. Stringent opposition came from the Republicans as what they viewed the same as it will make the treasury to drain out due to fraud, false claims and they asserted that the drug and pharmaceutical industry will alone prosper at the cost of public money. As per federal government of USA estimates made in 2007, about 9 million citizens over 65 used some guise of long-term care, either out of home or in home. Further, it estimates that about 12 million aged Americans would require long-term care by 2020. (Jimenez, 2009, p.373). It was estimated that annual federal spending on Medicare to be around $524 billion in the year 2011. The growth in Medicare’s per-capita cost (8.9%) which well less than the private insurance (9.9%) which imply that the Medicare has been comparatively beneficial in containing the medical costs. However, many critiques are more worried about the long-term viability of Medicare as there will be an enormous increase in the demands on the funds in the near future as the baby boomers will soon to retire from the services and start to seek relief under the Medicare. (Jimenez, 2009, p.373). It is alleged that there is a paucity of fund allocation to the nursing programs like advanced education nursing traineeship, nurse anesthetist traineeship, nurse faculty loan program and for nursing doctoral programs. Nursing profession for many years has raised their voice to redress the above issue. The Affordable Care Act has not only strengthened but also reauthorized the nursing programs with earmarking more funds to the above programs through the Health Resources and Services Administration (HRSA) - the chief source of federal funding for nursing education. Hence, we can say, nursing profession’s welfare has been taken care in the Affordable Health Care Act which is going to act as a long term viability of Medicaid and Medicare benefits in USA. (Wakefield, 2010). References Barr, DA. (2011). Policy: The Organization, Financing and ... New York: JHU Press. Daley, B. (2011, October12) .Will the Affordable Care Act Help Eliminate Disparities? Retrieved January 24, 2012, from http://allianceforajustsociety.org/2660/will-the-affordable-care-act-help-eliminate-disparities/#more-2660 DeParle, NA. (2012, January18) Moving Forward and Implementing Health Reform. Retrieved January 24, 2012, from http://www.whitehouse.gov/blog/2012/01/18/moving-forward-and-implementing-health-reform Jimenez, J. (2009). Change: Toward the Creation of Social and Economic. New York; SAGE. Mmapinc.org. (2012). Affordable Care Act Update: Implementing Medicare Cost Savings. Retrieved January 24, 2012, from www.mmapinc.org/.../ACA-Update-Implementing-Medicare-Costs-S... Stokowski, LA. (2011, Feb 17). Your Stock is Going Up .Are you Ready? Retrieved January 24, 2012, from http://www.medscape.com/viewarticle/737413 Wakefield, MK. (2010).Nurses and the Affordable Care Act. Am J Nurs, 110, 11. Read More