2nd week response. Response to Jill. Management Essay

Respond to both post



Jill post #1 w/130 words & at-least 1 source:



When reviewing the information pertaining to the affordability of Medicare for its beneficiaries one might find evidence to support the claim that Medicare is not currently all that affordable for all.  This is evident in that those who are covered by this type of insurance are required to pay extremely high premiums and have tremendously large out of pocket costs.  It is not uncommon for a Medicare Beneficiary to have a second insurance so as to makeup for being under-insured.  One could argue that the program as it is would not be sustainable for many in the future.  A major contributing factor to this lies in the fact that the president's proposed new budget is scheduled to shave off eight hundred billion dollars or more from the current allotment for Medicare.  The benefit gaps and cost sharing requirements are at present quite large and leave its patrons at risk of being unable to afford necessary care as a result (Cubanski & Bocuti, 2015).  There is also not currently a ceiling on the out of pockets costs.  This means that patrons with this insurance could be charged extreme excess amounts thereby creating financial challenges and trouble. 

     There are several suggestions for changes to be made that could potentially allow for the future of the program to not only be solidified but to be assured as well.  Although unpopular, raising taxes would create an inevitable chain of events that might preserve the program for the forseeable future.  Another suggestion was to place a ceiling on the out of pockets costs as there currently isn't one.  The expansion of Medicare could not only save the program but allow for more people to be covered.  It would be a Medicare for all type situation.  Defensive medicine has often been noted as a problem standing in the way of preservation and success of Medicare.  It is a form of care that is not helpful for neither the patient nor the physician.  It has caused increases in healthcare costs as well as the quality of healthcare to go down.  Medicare can only be preserved if changes are made.  If left as it is, only a portion of those it was intended for will be able to afford it.





Frank post #2 w/130 words & at-least 1 source:







The Centers for Medicare and Medicaid Services (CMS) states that people at or above the age of

65, people with disabilities under 65 and people with all stages of end-stage renal disease are

covered under Medicare (CMS, 2019).  According to the 2018 Government Census report,

people at or above the age of 65 are 16%.

 

The Yale Center on Aging predicts that by the year 2027, that percentage will increase by 9%. 

“That shift may not sound significant, but it represents about 40 million additional Medicare-age

patients flooding the already beleaguered U.S. healthcare system”(RXFilm.Org., 2015).

 

Medicare coverage has many pros and cons.  The out-of-pocket costs currently have no ceiling

which can impact a patient significantly and more often than not cause the patient to seek out

additional medical coverage.  But a pro is that a patient would more likely be covered by most

health care facilities and services, just so long as they are Medicare/Medicaid licensed. 

 

However, due to the high reimbursement that Medicare provides for provider and facility

services, medical fraud became too common.  The only way to combat this was to beef up

security protocols, audit reviews and surveys/inspections nationwide.  This just helped with the

high cost of CMS and the ability to provide coverage.  It also didn’t stop providers and facilities

adding on extra ancillary medical studies, questionable preventive medicine and sometimes

outrageous facilities cost just for sitting in a waiting area or provider office for more than 15

minutes.  In 2017, 688 billion dollars was spent for Medicare patients alone and due to the

elderly statistics provided above times inflation by 2027, that number is expected to triple. 

 

But Medicare coverage is not broken and can be repaired to work for the aging population. 

To address the health care financing challenges posed by the aging of the population, a number

of changes to Medicare have been proposed, including restructuring Medicare benefits and cost

sharing; raising the Medicare eligibility age; shifting Medicare from a defined benefit structure

to a “premium support” system; and allowing people under age 65 to buy in to Medicare (Kaiser

Family Foundation, 2017).  Allowing younger people the ability to buy in simply lowers the

overall cost for all beneficiaries.  The “Medicare for all”  idea is not possible at this time but

discussing what would happen with prescription drug costs, facility fees, elective and non-

elective surgical procedures and having the ability to negotiate with a stronger narrative of a

higher pool of patients can work.  In short, continuing to analyze the cocst sharing, increase in

beneficiaries and attaining the ability to negotiate with health services can end up lowering the

cost of Medicare as a whole strategically, even with the significant increase in the aging

population.