Medicare Modernization Essay

Over the last 8 years especially, the national spotlight has been focused on government programs, specifically Medicare and Medicaid, whether these opinions be positive or negative. Although many people believe that these governmental acts only include negative aspects, this is in fact wrong, as there are many positives. Medicare, the commonly known health insurance program for people 65 and older, has positively contributed to the American society for the past 50 years. Medicare has helped elders financially , increased the quality of care we give to elders, and provided more jobs throughout its existence.

The first piece of legislation (one legislation I discussion 2 pieces of that) discuss is section 101 part of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), a bipartisan legislation signed into law on April 16, 2015. This law was created to replace the current law in that time Medicare reimbursement schedule with, the revolutionary idea of new program supposed directed focus on the quality, value and accountability of the national health care program. The CMS describe MACRA as a modern system new payment framework, supposed rewarded the national health care providers to obtain the better care instead of more service, looking for value over volume. The information’s observed in the interview provides consistent points

Therefore supporting this bill without making major changes to the bill will inevitably affect seniors negatively. A lot of seniors are on prescription medication to keep some chronic conditions under control. The medications play a fundamental role in keeping themselves healthy. Given the scope of wellbeing conditions that numerous elderly patients confront, from elevated cholesterol and hypertension to joint inflammation, diabetes, and the sky is the limit from there, it's not unordinary for a few people to take at least five distinctive professionally prescribed medications every day. A few people admitted to the doctor's healthcare facilities sometimes have at least ten unique drugs prescribed for their chronic diseases. Regardless of the possibility that they could bear the cost of the medications and adhere to the treatment plan. The official Medicare website offers suggestions for seniors to utilize to assist with their costs of prescription medication such as opting to fill for generic versions of their drugs and many do but some drugs do boot have that option. Mail ordered prescription services can

The essential target of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) was to furnish seniors in the United States with moderate scope for their physician endorsed solutions through the new Medicare Part D professionally prescribed medication advantage. After the MMA was implemented—however before Part D was actualized—there was a disagreement about the cost of the program. In March 2004, the Medicare Chief Actuary affirmed before the House Ways and Means Committee of United States Congress that he was requested by the (Centers for Medicare and Medicaid Services) CMS Administrator to smother his assessments of the ten-year cost of the program, which were considerably more noteworthy than unique Congressional Budget

It was a defining moment just over a decade ago that Medicare Part D, or the Medicare prescription drug benefit, became effective. A group of officials and assistants crafted this legislation to aide those seniors that had troubles getting their prescriptions every month. The program also made millions upon millions for pharmaceutical companies. The various stakeholder groups influenced the final outcome of this legislation to the point that if they were not involved, the country may not have ever been introduced to Medicare Part D.

Another provision that the ACA provided was creating the Center for Medicare & Medicaid Innovations within the Centers for Medicare & Medicaid Services (CMS) in order to test new payment and service delivery models designed to reduce costs and increase quality of care to those that receive these benefits.² In this briefing, information about this organization, including financing and delivery, and the impact of the ACA on the Medicaid Program and the

Medicare Part D was created under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. (Medicare Part D, 2011). It is also known as the prescription Drug Plan. This plan was created to help cover cost of prescription drugs, and people who have the original Medicare or Medicare Advantage are eligible to enroll (Medicare Part D, 2011). Prescription drug coverage is only offered through HMOs, PPOs, and PFFSs and by some private companies who contract with Medicare through individual plans (Medicare Part D, 2011). Private companies are allowed to create their own customized benefit plan as long as the plan is as good as the plan outlined in the 2003 Medicare Act (Medicare Part D, 2011).

On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173).  This landmark legislation provides seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. One month later, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the figure presented by the Bush administration

The program was created due to a collaboration of multiple unconnected governmental obligations. The first obligation was that the Medicare prescription program was in need of a reasonably lower yearly deductible to make sure the majority of participants saw individual benefits for being enrolled in the plan. The reason for this was due to a failure of a 1988 regulation made to the Medicare drug program. As a result an enrollee would have to volunteer for any new legislated Medicare prescription program which meant that if the enrollee had to volunteer for the program it was important for the majority of the recipients to be given some form of substantial assistance for participating in the program. (Kaplan 2011)

The Patient Protection and Affordable Care Act (Obamacare) had mame dramatic changes in the field of the health care system, especially in Medicare, that will seriously take effect in American seniors. Indeed, much of the health law’s new spending is financed by spending reductions in the Medicare program. In addition to the provider payment reductions, Obamacare significantly reduces payments to Medicare Advantage (MA) plans by an estimated $156 billion from 2013 to 2022.( Elmendorf, letter to Speaker Boehner). About 27 percent of all Medicare beneficiaries are enrolled in MA plans, a system of regulated and private plans competing against each other as an alternative to traditional Medicare. MA plans are attractive to beneficiaries because they offer more generous and comprehensive coverage than traditional Medicare by capping out-of-pocket costs and offering drug coverage to a rasonable

Since its establishment in 1965 we have seen Medicare change as people’s needs change however being a federal program these changes do have an incredible amount of lag time. One of the first major changes to Medicare occurred in 1972 when President Nixon signed the Social Security Amendments of 1972 which extended coverage to individuals under age 65 with long-term disabilities, expanded benefits to include some chiropractic services and speech and physical therapy. During this time we see the American public growing tired of the Vietnam Conflict and lack of support and care for those returning Marines and soldiers with severe disabilities. As the protests escalate and the peace initiatives fail a key piece of legislation is signed showing government support and a willingness to extend health care benefits to this growing and vocal population of veterans (The Vietnam War, 1999). Also included in this Amendment is the encouragement of the use of Health Maintenance Organizations, President Nixon’s administration caught in the scandal of Watergate and pending hearings appeased the left and proposed the HMO Act, which Congress passed in 1973 (Phillips, 2003).

The largest changes that have occurred to Medicare to date spawned from the Medicare Modernization Act of 2003. This act expanded Medicare to include Part C and Part D. Part C plans are known as “Medicare Advantage Plans”, these

Due to the upcoming presidential election, the two major political parties, and their candidates, have been focusing on the primary problems that the nation will face. Chief among those problems is the future of Medicare, the national health-insurance plan. Medicare was enacted in 1965, under the administration of Lyndon B. Johnson, in order to provide health insurance for retired citizens and the disabled (Ryan). The Medicare program covers most people aged 65 or older, as well as handicapped people who enroll in the program, and consists of two health plans: a hospital insurance plan (part A) and a medical insurance plan (part B) (Marmor 22). Before Medicare, many Americans didn't have health

The proposed health care reform bill attempts to change issues of public policy and health care management for the poor and uninsured. Many leaders from the Democratic Party are actively engaging in policy-making to fix what Rep. Henry Waxman (D-California) calls a “‘dysfunctional’ health care system” (2009). Currently, the U.S. health care system denies people with pre-existing conditions from receiving care. Another problem with the system is that the health insurance that some employers offer may be so expensive that their employees cannot afford it. Any cuts in Medicaid may mean that physicians have fewer incentives to provide adequate care for the poor. These are some of the many problems that the Affordable Health Choices Act attempts to address. Fiscally conservative political and business groups oppose this measure because they believe that any changes in public policy and health care management might affect them negatively.

The growing concern regarding the financial security of Medicare is one of particular interest to the nearly 72 million baby boomers that become eligible for this government-assisted, and tax-payer bolstered, program over the next two decades. According to the U.S. Census Bureau (2010), there will be a rapid increase in baby-boomers between 2010 and 2030, as the entire baby boomer population move into the 65 years and over category (p.3). Political and financial revisions must be made to ensure the security of Medicare as the numbers of individuals paying into this program are soon to be surpassed by the number of individuals drawing-off this program (U.S. Census Bureau, 2010). The elderly are also at a disadvantage with transportation to health care visits, picking up prescriptions, and rehabilitation services. There needs to be an establishment of access not only to primary care providers, hospitals, and rehabilitation services, but access to other aspects of the health care system for the elderly population.