BHS 450 Medicare and Medicaid Case

Medicare and Medicaid Case Student name: Student number: School name: Introduction Medicare and Medicaid are both government funded programs designed to cover healthcare costs. These programs were established by the government in 1965 and are funded by taxpayers’ money. Medicare is a long term program for the elderly whereas Medicaid cover covers healthcare costs for the poor Americans. The two terms however, confuses most people because of their similarities but in a real sense, they are different in terms of eligibility and coverage. Distinguish between Medicare and Medicaid Medicare This federal program is attached to social security and is available to all senior citizens of USA (aged sixty five years) and above regardless of their income level. The program also covers medical costs of people with certain disabilities. The program is divided into four parts which include: Hospitalization coverage Medical insurance Privately purchased supplemental insurance Prescription drug coverage Prescribed drug coverage was added to this program in 2006. Part A and B are paid for by payroll taxes and social security income deductions. Part C and D are paid by program participants, (Centers for Medicare & Medicaid Services, 2007). Medicaid This is a joint program by the state and federal governments that cover medical costs for the low income individuals and families. The more affluent states receive less funding from the government compared to less affluent states which receive more funding. There are 50 programs, one for each state with the federal government funding up to half of the cost in their respective jurisdictions. In contrast to Medicare, these programs have strict eligibility requirements which vary across the states. While the program is geared towards helping the poor population, being poor alone may not qualify one to benefit from these programs because they have other requirements as well. These other requirements are meant to ensure that the program serves specific groups such as families, pregnant women, children, caretaker and disabled groups of people, (Centers for Medicare & Medicaid Services, 2007). Evolution of Medicare in the society Medicare evolution in the country can be traced back to 1930s when healthcare took a dramatic change. Before this period, individuals used to pay for medical treatments and consultations on their own. The first private medical insurance companies were initiated at Baylor university medical center to cover medical costs. Blue cross and blue shield were the first private insurance companies. Baylor hospital started selling insurance to community and soon after, blue cross and blue shield spread all over the country, (Corning, n, d). Private health insurance was followed by public health insurance in July 1965 when President Johnson signed Medicare bill into law. Medicare bill brought forth a federal insurance program for senior citizens, disabled workers and certain individuals with renal diseases. Medicare program was divided into parts; currently it has four parts of insurance cover for the targeted groups in the society. Medigap policies were instituted by congress to address the weaknesses and gaps within the Medicare programs. Weinberg variation of 1980 impacted heavily on Medicare payments. It brought about the shift from fee for service payment to payment for services rendered to decrease health care spending under the DRG system (diagnostic related group). The consolidated omnibus budget reconciliation act of 1985 (COBRA) gave some employees the ability to continue health insurance coverage even after leaving employment. Children in poor families were offered health insurance cover under the state children health Insurance Program established by the federal government in 1997. Patient protection and affordable care act of the year 2010 was enacted by President Obama to introduce a comprehensive health insurance reforms. The...