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Health care: Medicaid and Medicare

Introduction                                                             This paper will concern on comparing and contrasting about Medicaid and Medicare as guided by the various questions outlined. Medicaid is a program that gives managed care health plan to millions of low-income mothers and children, individuals with serious chronic illness and disability, aged persons needing nursing home care that are impoverished at the time or become with their stay. Beyond covering individuals, it provides major subsidies, to safety net hospitals to provide uncompensated care to millions of uninsured people.                Medicare on the other hand is a program that gives health plans care to aged people above the age of 65 that have certain disabilities or people of any age with End Stage Renal Disease (ERSD). Medicare has four parts namely, part A, Hospital Insurance, Part B, Medical Insurance, Part C, Medical Advantage and Part D, Medicare Prescription Drug Coverage. Part A covers, Inpatient care in hospitals, Inpatient care in a skilled nursing facility, Hospice care services, home health care services and inpatient care in religious non medical health care institution. Strengths and weaknesses               Medicaid can be said to have the following strengths. The increased access to use an health care to uninsured adults who benefit by outpatient care of 35%, prescribed drugs of 15% and 30 % of hospital care. Secondly it leas to increased financial security to the uninsured person by helping to settle medical bills that would have otherwise gone unsettled. Improved health and well being as the people in the program report felling of good health and reduced chances of feeling depressed especially for the uninsured person (Davidson and Somers, 1998).               The fact that it does not reduce the chances of private health insurance cover makes a benefit to those enrolled. Others strengths in that many youths and families are eligible in Medicaid after the review of the old provision of the program. Medicaid receives funds the federal and the state provisions and also every state has the allowance to deliberate on which rule to follow and what to incorporate hence flexibility. The various types of waivers available allow for flexibility in the structure of the program and at the same tine serve a benefit to the people hence a very good incentive.                On the other side, Medicare care program strengths include containment of cost and access which allows the open dialogue between patient and provider in decision making. The consumer of Medicare is better informed and is given the active role of making decisions. Its emphasizes on quality which serves as a catalyst and an incentive to other payers and hospitals to give quality assurance and assessment. It promotes the need for development performance standards among professionals. This has allowed private sectors to fund research and assurance assessment researches.                There is improved quality of services due to presence of the checks and balances put on place hence a national commitment to the care of the elderly. Again due to the use of data bases and computer technology, it provides a platform to advance technology and also assessment as well as research among professionals and the whole system. However, it has the following weaknesses. Medicare provides inadequate reimbursement and also creates disincentives to physicians to care for Medicare beneficiaries and places marginal procedures and services. Sometimes it does not promote quality and its cost containment emphasis has changed focus to employers and businesses that would care about quality (Lohr, et al, 1990).               Commitment to Access               The commitment to access for both Medicare and Medicaid are related in terms states. For the provision of these services, every state has been left alone to decide and design the program appropriately. The Medicare and Medicaid programs are located in strategic areas for every state. This allows easier access to members of the state. However, incase of emergency and travel there is an allowance, of any visit to the service providers that are available notwithstanding them are part of managed care or not. People can at the same time belong to the two programs at time if they qualify under the given set of conditions or rules. The commitment to access is well established by the placement of emergency centers and hotline numbers that one can seek for information or clarification. This is backed up by computerized data and websites that are all geared towards greater access and efficiency (Kongstvedt, 2007).The similarities and differences                In terms of formation, both were formed under the US government scheme for health concerns in 1965. The similarities of these programs, is that they are primarily federally funded. Medicare is funded through federal taxes on employers and Medicaid is funded through a joint state program. Both are low cost programs generally focusing on elderly, children, women each with a particular focus as defined in this paper. The other similarity is the fact that, they both have a medical element (Hurley et al 1993).               These programs on the other end have differences although they seem very similar obviously confusing very many people. Medicaid observes strict eligibility criteria despite the fact that it is concerned with the plight of poor persons. It is not every poor person who is eligible in the program as it is for Medicare. Eligibility is pegged on income levels with Medicaid and usually it becomes a render of last resort which is the opposite of Medicare. In addition, Medicaid is concerned with long term care funding as opposed to Medicare.                 Risks Associated                The risks associated to each plan may be varied. For the Medicare program the risk is connected to one of its advantages, connection to social security. This connection may prove a weak point for account fraud and abuse by persons involved with the services or with the elderly person. For Medicaid the risk involves participation problems of service providers when there is a downturn in the economy. This means that the people enrolled in the program may be forced to keep on changing their doctors or health providers due to large turn over.Recommendations               Recommendations, on Medicaid would involve streamlining the program to offer a service that makes things easy for the consumer. This observation emanates from the fact that, Medicaid has been found to have various plans each surrounded by rules and policies that end up confusing the consumer thus impending effective efficiency in the overall performance. Medicaid also should be redesigned to cut the costs that arise from unnecessary services offered to patients who increase the doctor visitations without necessarily improving health. This is also happens with the case of Medicare and therefore these costs should be brought down to commensurate with the performance outcomes (Cuomo, 2010).               For Medicare the recommendations should revolve around lowering the age level of eligibility to include persons who have almost the same characteristics especially from age 60. The other one should be centered on the combination of Part A and Part B in order to harmonize the amount of deductibles   and help in efficient performance. There should be an assurance of parity in mental health services and expansion of home health coverage to cater for elderly at home. This should reduce expenses and let the physician focus keenly in providing better services.                There should be an increase in accessibility in the form of home cares and community health cares to reduce inefficiency and redundancy at the health provider’s premises for both Medicaid and Medicare.

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