Medicare Is the Health Insurance Program - Research Paper Example

Medicare Introduction Medicare is the health insurance program in the United s for individuals who are 65 years old and above (Social Security Online, 2010). People with disabilities and those with permanent kidney failure as well as those with amyotrophic lateral sclerosis also qualify under this program. Medicare coverage is not complete as it covers a portion of the cost of health care and the cost of long-term care (Social Security Online, 2010). This program is financially supported by payroll taxes which are paid by workers and employees and also by the monthly payments deducted from Social Security checks (Social Security Online, 2010). It is a program being implemented by the Centers for Medicare & Medicaid Services. Medicare is divided into four parts. The first part is the Hospital insurance (Part A). This helps to pay for inpatient care in a hospital or skilled nursing facility, (after hospital stay), home health care and hospice care (Social Security Online, 2010). Medicare insurance (Part B) covers doctors’ services and other medical services and supplies which are not covered by hospital insurance (Social Security Online, 2010). Medicare Advantage (Part C) can be availed of in many areas. Those under Medicare Parts A and B can opt to receive all their health care services through the provider organizations under Part C (Social Security Online, 2010). Finally, drug coverage (Part D) assists in the payment of medications for which doctors prescribe for the treatment of their ailments (Social Security Online, 2010). Medicare is different from Medicaid. Medicaid is a program which provides aid for those who cannot afford medical services. Different states have different rules on eligibility and coverage; and in some cases, these programs do overlap and some individuals may qualify for coverage under both programs (Social Security Online, 2010). Significance This Medicare program is significant for public health because it helps ensure that all people receive quality health care and are entitled to improved outcomes (DeWalt, Oberlander, Carey, and Roper, 2006). Some studies also point out that Medicare programs help control the cost of health care as it improves health outcomes of the people covered. It also helps prevent illnesses and reduce waiting times with doctors; and through the coordinated efforts of the Medicare programs, many states are able to encourage practices which “improve the timelessness of care and also…reduce the rate of no-shows to clinic appointments” (DeWalt, Oberlander, Carey, and Roper, 2006, p. 86). Most individuals without health insurance or who are cannot afford medical care and services are more likely to avoid seeking consults or follow-up check-ups for their ailments because of their inability to pay for such medical services. Through Medicare, these patients would feel less restricted about seeking medical help because they know they are covered by the Medicare and would not have to bear the entire cost of care. Medicare is also significant to those who have chronic/long-term diseases. The Medicare can help cover their expenses, thereby increasing their chances of survival and minimizing the financial burden of their disease. This is the same for those who are under hospice or palliative care. Medicare can also help cover and defray their medical expenses, ensuring that they will receive assistance and will improve their outcomes even to the last few days or weeks of their life. By sharing the burden of medical expenses with many taxpayers, the cost of medical care and services would not be as heavy on the patient and his family. Medicare is also important for me because I can concentrate on treating the patient and on delivering health services without worrying that the patient may not be able to afford such services. As a medical health professional, I can focus on the care of all patients, not on the cost of equipment, supplies, and services being used on the patient. Application/integration Implications/aspects/dimensions of Medicare for public health The Medicare program implies that public health will have more financial support. Since it would have more financial help, Medicare is able to afford the cost of better quality in medical care and services. With the assistance of Medicare, public health is more able to offer increased and improved services to the elderly population who are also the ones who are likely suffering from chronic or long-term care illnesses (Hutchinson, 2010). It also means that Medicare can provide better medical care and services for those in the rural areas because the services provided by the Medicare program reaches them in the same way as it reaches those living in the urban areas (Hutchinson, 2010). Public health now becomes more equitable in its services because it can provide health services to those who qualify under its program – regardless of their socio-economic status and of their ailment. Public health now becomes a part of social services which does not give any preferential treatment for those who qualify for coverage. Medicare coverage also implies that those who have limited coverage under their private insurers can still use the Medicare coverage to cover the cost of their medical expenses (Edelman & Mandel, 2006). In the current age where the elderly population is swelling, the cost of medical care is bound to increase. The Medicare contributions and other public health options help ensure that the burden is shared by most taxpayers. There is an assurance in the mind of the people that in case they would be afflicted by a debilitating disease in their senior years, Medicare can help them with their expenses and to avoid the pitfall of bankruptcy that many senior citizens often face when battling long-term diseases. Application/utilization in professional work I would apply/utilize this topic in my professional work by encouraging elderly citizens who have chronic or long-term care illnesses to apply for Medicare coverage. I can be an advocate for Medicare coverage by enlightening patients about the benefits of Medicare and their available options under this program. In my professional work, the Medicare can help me in my delivery of services by allowing patients to opt for home-based or community-based care. Since many elderly patients afflicted with chronic illnesses often prefer to be cared for in their own homes, the Medicare can help make this possible (Medpac, 2008). Many of the above patients are more comfortable and have improved outcomes when they are cared for in their own homes; and through Medicare coverage, the choices for patients would not be as restricted. I can also apply/utilize this topic in my professional work by applying and rendering my services for care facilities under the Medicare program. Although, in some cases these facilities may not offer the highest compensation or the most-updated medical supplies and equipment, it is an area of practice which will help provide and ensure care for those who are vulnerable. I can make myself available for facilities that are looking for medical health services in nursing homes and those under community care. I can also apply Medicare in my practice by being a patient advocate for those who qualify under it and for those who are already covered by it. Some patients may not be aware that they can qualify under Medicare and they may think that they have to use their own money or their limited insurance packages in order to pay for their medical needs. In my professional practice, I can educate my patients and inform them that they have better options under the Medicare program. Topic integration with other learning from this course and from other courses This topic integrates with other learning from this course in the sense that it highlights the importance of public health. Many individuals in the United States are uninsured and the cost of medical health services, equipment, and facilities are increasing with each passing year. Although there are now various medical advancements in the treatment of diseases, the state of our medical health coverage has hardly been increased. This topic on Medicare brings attention to the fact that public health is an effective way of ensuring that our medical health is safeguarded and that most people receive quality health care services. There is therefore a need for the government to strengthen the existing policies on public health and to ensure that these policies are updated and are keeping up with the changes in the economy and the government programs (Loyola University New Orleans, n.d). This topic also integrates well with other learning from this course in the sense that it helps establish the different policies available in public health and to establish how such policies affect each other and affect the overall health services available to the public. Medicare also integrates with other learning in other courses in the sense that it helps to solidify the importance of coordinated health care services. Health care services can be ensured and availed of by individuals through private and through public health care services. However, the viability of these options has to be ultimately based on the quality of health care services offered and the minimal cost of such services. Health care is at present one of the most crucial public health care service being discussed in the public and the private sector. However, the quality of such services is not given enough attention. This topic helps highlight the fact that there is a need for cooperation and coordination of health services in order to ensure that most, if not all, receive quality health care services. Works Cited DeWalt, D., Oberlander, J., Carey, T., & Roper, W. (2006) Significance of Medicare and Medicaid Programs for the Practice of Medicine. Healthcare Financing Review, volume 27(2). Retrieved 23 April 2010 from http://www1.cms.gov/HealthCareFinancingReview/downloads/05-06Winpg79.pdf Edelman, C. & Mandle, C. (2006) Health Promotion Throughout the Life Span. Missouri: Elsevier Health Sciences Home health care services payment basics payment system (2008) MedPac. Retrieved 23 April 2010 from http://www.medpac.gov/documents/MedPAC_Payment_Basics_08_HHA.pdf Hutchinson, L. (2010) Access to Quality Health Services in Rural Areas. School of Rural Public Health. Retrieved 23 April 2010 from http://srph.tamhsc.edu/centers/rhp2010/Volume_3/Vol3Ch1OV.htm Medicare (2010) Social Security Online. Retrieved 23 April 2010 from http://www.ssa.gov/pubs/10043.html#part2 Public Health: Medicare and Medicaid (n.d) Loyola University New Orleans. Retrieved 23 April 2010 from http://www.loyno.edu/~quigley/powerpointJ/PublicHealth.ppt Read More