Term Paper on "Federal Governments Healthcare Programs"

Term Paper 5 pages (1664 words) Sources: 1+

[EXCERPT] . . . .

Federal Government Healthcare Programs

The year 2005 is the 40th anniversary of Medicare and Medicaid, two of the most well-known federal healthcare programs in the United States. Both of the programs were instituted by the Social Security Act, with Medicare administered by Social Security Administration and the federal financing for Medicaid managed by the Social and Rehabilitation Service. Today, after a series of changes in administration, the CMS, the Center for Medicare and Medicaid Services, is the agency that oversees the programs ("40th Anniversary for Medicare and Medicaid" 1).

Medicaid is a program that helps low-income individuals and families pay for their medical expenses. The states and Federal government share the costs of this program. There are eligibility requirements for this program and these vary from state to state. However, there are some eligibility criterions, which can be used as a general rule. The recipients of Medicaid generally fall into one of the following categories, if your income meets the eligibility requirements. The elderly, blind and disabled people who are low income may be eligible for Medicaid services. Pregnant women may also be eligible, as may children under the age of 18 or 21 (depending on the state) and if they are sick or disabled. There are separate requirements for Nursing Home care for people who need this type of care and assets may be considered in order to assist these individuals ("Who is eligible for Medicaid?" 1).

For the most part, Medicaid is only used for used individuals or families who are low income, meeting their state's resource's eligibility requirements and are either aged, blind, disabled or pregnant. There are exceptions to this as some states do have programs through Medicaid, which allow other categories of people to receive the health care benefit, such as the low income working person. These are entirely up to the state and residency requirements apply to eligibility ("Questions and Answers" 1).

Medicare, which supplies health care to approximately 40 million citizens of the United States, is administered and funded solely by the federal government ("Medicare Information Resource" 1). This health insurance is for those individuals who are 65 years of age or older, under 65 years of age but disabled and those persons with End Stage Renal Disease ("Medicare Information Resource" 1).

In order to be eligible for Medicare, a person must have worked and contributed to the Social Security coffers.

Medicare is extremely complex and has many facets to it. There is coverage for medications, hospitalizations, long-term care, disease screening, and well care physicals. This Federal program is extremely complicated and difficult for some seniors to negotiate. The government has a website that has an abundance of information on it and allows the recipient a chance to change addresses, request a new card, supply provider information as well as provide information ("The Official U.S. Government Site for People with Medicare"). This website also allows recipients to compare hospitals, nursing homes, dialysis centers and provides a wealth of information about what services are provided under Medicare.

One health care advocacy group, Families USA, reports that "optional beneficiaries include 6 million working poor adults, 5 million children, 3 million seniors, 2 million people with severe chronic disabilities and 3.5 million additional adults and children with medical bills that take up most or all of their income" (Bush Plans 2). The federal government and states share the expense of this program that serves millions of people. According to Joseph Kay, "The combined federal and states costs for Medicaid have risen to more than $300 billion annually" (1).

Mr. Kay also reports that "the number of Medicaid recipients rose by one-third between 2000 and 2004, largely as a result of employers eliminating or severely curtailing private health insurance programs in order to cut labor costs" (5).

The states and the federal government share the burden of Medicaid expenses, with the wealthier states taking on more of the burden. For example, New York State pays about 50% of the cost (Robinson 2). The total cost nationwide, 300 billion dollars, represents payments for about 50 million people (Robinson 2). New York State has the most expensive Medicaid program in the United States, with a budget of 44 billion dollars; assisting 4 million people (Robinson

3). Fraud, misuse of the money spent, and the rising costs of Medicaid for taxpayers make the program controversial and the opinions about whether the program is helpful or not, vary as much as the recipients do.

For example, Ms. Robinson reports that The Public Policy Institute, which is a research group, has said that Medicaid is not an effective program because even though New York State has spent billions of dollars on health care for the poor, there is still a rate that is higher than the usual rate of women who receive prenatal care (Robinson

3-4). There are many critics of Medicaid, to be sure. The fraud, the misspending of money and the abuse of the system leads many people to resent spending their tax money to support a program that seems to have become an entitlement program.

There is some public sentiment that Medicaid relates directly to welfare, so it must be for those who refuse to work and would rather be "on the rolls." The news expose fraudulent claims and there seems to be no end in sight to the people who need the assistance. This expensive program that is often seen as a legacy that one generation leaves to another, seems to leave out many uninsured people who need medical attention.

Even with that in mind, where would the people who are assisted by Medicaid be without the assistance? Consider that many residents in Nursing Homes have their care paid for by Medicaid. If they have no family who can care for them at home, that would leave them with nowhere to live and no one to care for them. Many of the recipients of Medicaid are the elderly or disabled who do not have Medicare, or any other possibility of health care insurance. These individuals many times do not have the funds to pay for Dr. visits or the money to buy prescription medications. Even with Medicaid, they often choose between services they can afford, or between food and health care, or paying their rent or health care. Without Medicaid, these individuals might not have any services to choose from. Medicaid definitely has a positive effect on their lives.

Recently, there has been a great deal of news about the concern that Social Security will go broke in a few years with so many baby boomers nearing retirement age. Medicare, which costs about 277 billion dollars a year, may go broke before Social Security. The current projections are for Social Security to be funded until 2042, but Medicare to be out of money by 2019 ("Medicare: Overview" 1). Considering the aging population of the Unites States, this could be a significant problem in just a few short years. Currently "there are four workers for every retiree today, a ratio estimated to shrink to 2:1 over the coming decades" ("Medicare: Overview" 1). With less workers paying for more retirees, it is easy to see why this will create problems in the future. Health care costs are rising and with the increase of medical technology, people are living longer. There were approximately 23 million people receiving Medicare in 1967 and in 2003, there were 41 million people who received Medicare. ("Medicare: Overview" 1).

Additionally, there is a trend of companies not receiving health care benefits with their retirement packages, if they even receive those. The health care benefits packages that are available many times are not as comprehensive as they once were and recipients may opt for their Medicare benefits. The addition of the prescription drug program has increased the… READ MORE

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