The Importance of Medicaid Expansion among the Elderly

The Importance of Medicaid Expansion in Addressing the Health Issue of Increasing Cost of Pharmaceuticals among the Elderly
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The Importance of Medicaid Expansion in Addressing the Health Issue of Increasing Cost of Pharmaceuticals among the Elderly
Undeniably, there exist various gaps in the medical system in the United States of America (USA). Some of these well-known niches in the USA involves the high rate of uninsured and underinsured people, substandard quality of healthcare services, and the high cost of medicines.
Introduction
One of the primary gaps in the healthcare industry is the increasing costs of drugs, which is a problem that significantly affects older adults. In reality, individuals with chronic diseases spend more money to get the right medications. In other words, the efficiency of healthcare service provision for the elderly with long-term illnesses is highly affected by the high prices of medicines. In particular, efficiency can be perceived as productive or allocative. The productive aspect entails producing specific healthcare services at the lowest price (Goldsteen, Goldsteen, & Goldsteen, 2017). In contrast, allocative means attaining the high quality of medical services. For this reason, efficiency is the best gauge that can be used to evaluate different aspects of healthcare services. The paper focuses on how the rising cost of medicines affects the population of older adults. Aging people are one of the vulnerable populations, and they are the ones who use hospitals the most. These individuals are in the frontline when it comes to those who deserve preventive care and the management of their health.
Historical Background
The primary question that should be asked is: Is the gap of the surging price of medicines a problem of today or has it been there in the past?
For sure, the health problem of the increasing medication costs among the aging population is not new and has been there for several decades. Based on Candy Sagon's article, the chart shown depicts that there was an increase in the average price of brand name medicines from $4,896 to $5,807 between 2015 and 2016. Even though the figure shows annual measurements, it is clear that the cost of medications has been rising steadily from 2006 to 2015 (Sagon, n.d.). Moreover, the price of medicines continues to surge even today. A CNN article by Wayne Drash begins by asserting that “The prices of the 20 most commonly prescribed brand-name drugs for seniors have risen nearly 10 times more than the annual rate of inflation over the past five years, according to a congressional report released Monday” (Drash, 2018).
Socioeconomic Background
The socioeconomic background of a specific population has a significant influence on how people access healthcare services. The majority of individuals find themselves in a position of not affording medications because of socioeconomic factors. Some of these people who are highly affecting by the problem at hand are the elderly, uneducated, and those living in abject poverty. Individuals below the poverty line cannot afford medical insurance and they end rising the percentage of uninsured people in the USA. Older adults without retirement benefits do not have health insurance and they end up rising the percentage of those who cannot obtain proper medications. Moreover, uneducated people who do not understand the importance of health insurance end up being uninsured.
Gap Effect
The healthcare services provided to the elderly are significantly affected by the gap in the increasing cost of medicines. Underinsured or uninsured people cannot access some medications or treatment procedures. As such, the gap in the access to medical services is limited if many individuals cannot afford proper medications.
Implications
If this gap in the healthcare system is not fully addressed, it has potential consequences. Specifically, if many individuals cannot afford medications, it means that they are likely to suffer horribly. Health complications have a likelihood of increasing, which will eventually lead to a rising number of patients admitted to hospitals. Overall, many people visiting health institutions will be unable to pay their medical bills and their debt will keep increasing.
Existing Initiatives
The Present Health Initiative
The two primary existing healthcare initiatives that were introduced to address the issue of increasing the cost of medicines in the USA are the Health Insurance Marketplace and Medicaid Expansion. The latter came into existence on 23rd March 2010, when the Affordable Care Act (ACA) was being implemented. Specifically, Medicaid is a program funded by the state and federal governments, which enable low-income earners and the unemployed people to get health insurance with very low premium rates (Goldsteen, Goldsteen, & Goldsteen, 2017). The reason behind the establishment of the Health Insurance Marketplace was to allow small enterprises and low-income earners to access medical insurance so that they cater to their medical expenses.
Specific Objectives
The primary goals of the Health Insurance Marketplace and Medicaid Expansion are to address the gap of people who are underinsured and uninsured. Approximately 15.5% of the USA’s population does not have health insurance coverage (HealthPayerIntelligence, 2018). For this reason, providing health insurance to many people in the country will reduce the number of individuals hospitalized. Besides, the majority of people will afford preventive care, such as vaccinations and annual physical examinations. A report by the Centers for Disease Control and Prevention (CDC) shows that 174 pediatric deaths were experienced during the influenza season that lasted from 2017-2018. By considering this situation, if many people had health insurance, they should have been able to get a free flu vaccination, which would have reduced the number of deaths. “Medicaid Expansion CHIP programs provide the standard Medicaid benefit package, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, which includes all medically necessary services like mental health and dental services” (Medicaid.gov, n.d.).
Circumstantial Development
This section describes the circumstances that should be considered when developing or improve the existing health initiative. Indeed, the focus will be on when Medicaid was developed and the factors that were put into account.
The primary reason behind the development of Medicaid was due to the rising number of uninsured Americans. Notably, many people were unable to access high-quality healthcare services. In addition, the majority of children did not have health insurance since their parents could not afford it. The percentage of the underinsured and uninsured elderly population has always been high. As a result, many people were unable to settle to the medical bills and visited hospitals when their health issues were in advanced stages, which means they required emergency care. Based on the Census Bureau of 2011, the population of uninsured individuals in 2010 was 49.9 million, which represented 16.3% of the entire American population (U.S. Department of Health and Human Services, 2011). Diverse groups were the ones who lacked health insurance coverage. As such, policymakers cannot come up with an appropriate solution to address the issue of healthcare inaccessibility if they do not know the reason why uninsured people are vulnerable to various health problems.
Resources
Numerous resources are needed to ensure that the existing health initiative is effective. Both the Health Insurance Marketplace and Medicaid Expansion are financed by the state and federal governments. For instance, for every $6 on healthcare services in the USA, $1 comes from Medicaid. In other terms, Medicaid is the primary source of funds that significantly contribute to helping low-income residents in different states to access proper medical services (Synder, 2015). Therefore, without this initiative, many low-income earners would not be able to cater to all their medical expenses since they would no...