Despite the fact that Medicare has increased the number of seniors and other people who were not insured, Medicare various challenges. Some of the challenges include financing. This as a result of the increasing spending by Medicare which is growing over the years. At least 10,000 people qualify for Medicare daily while workers funding the program through tax paying are decreasing (Rice et al, 2014). Most beneficiaries of Medicare are the aged who have either retired or have meagre earnings that cannot sustain the program. This will result in Medicare being forced to get their capital from the federal budget which will probably lead to increased share tab of beneficiaries. Similarly, spending on Medicare by the federal government will greatly impact other programs such as education, national defense, environment protection and health and safety.
Affordability is another challenge facing Medicare. Most beneficiaries of the program are seniors hence they do not have a lot of money and most of their capital is spent on health care (Ginsburg & Rivlin, 2015). It is unfortunate that the program does not cover different services that the beneficiaries need as their counterparts with private insurance plans forcing them to rely on out-of-pocket costs. Medicare has been found to lack programs that can help its beneficiaries cover their health care expenses since their incomes are far much lower than what they spend on their health care.
Medicare is facing the challenge of managing chronic diseases. Most beneficiaries of the program have been found to be suffering from various chronic diseases including diabetes and heart disease (Rice et al, 2014). These illnesses require high medical costs to be managed, therefore by keeping the beneficiaries with the chronic diseases health is likely to reduce the expenditures for Medicare. Also, as the beneficiaries of the program age, most of them prefer to stay at their homes forcing Medicare to come up with strategies to serve them as they face cognitive and physical impairments as well as their need for increased personal care.
Finally, the growth of the Medicare Advantage is another great problem for Medicare,. People enrolling in the private plans that offer alternative insurance is increasing rapidly. Approximately one third of the Medicare beneficiaries have enrolled into the Medicare Advantage Plans. These plans have been found to provide more benefits as compared to those of the traditional Medicare such as dental care and eyeglasses which are among the basic needs of most beneficiaries of Medicare (Ginsburg & Rivlin, 2015). Similarly, these other coverage plans call for lower out-of-pocket costs making most people to prefer the plans to the traditional Medicare. However, due to the constant decreasing support from the federal government, the Advantage Plans are reducing their generosity. This is because the number of insurers accounting for Medicare Advantage Plans are reducing while those enrolling into the plans are twice or more the number of insurers.
Medicaid is a United States program that is jointly run by both United States federal government and the different states independently. It has helped the low income earners in the United States to access high quality medical care at a relatively cheaper cost. It also offers other benefits that are offered by Medicare like personal care services and home nursing services. It is often considered a United States government insurance for persons of all age whose income is below the poverty line. But the program is run by different states independently with slightly different policies that are engineered to favor the needs of such specific state.
Some people considers the program to be a collective of fifty different Medicaid programs across the United States. This different policies in different states makes it seem like the program is a set of different programs that are all interested in subsidizing the health of the American citizen. For instance, the different states use different criteria in determining the people who are eligible to accessing the benefits of the Medicaid program. For instance if you need to use the benefits of the program in Alabama, it is a requirement that you must be a resident of the state of Alabama (Takach, & Buxbaum, 2013). It must be proofed that your income is below the poverty line as per the federal standards and fall in the category of people who are eligible for the benefits.
This trend changes in the different states as every state has its own preset standards and policies they use to determine who is eligible for the funding. On top of that, the different states of America run the different application sites for their citizens. This further shows why the program can be considered to be fifty different programs that are run under the same name. The procedure of application is also different depending on the requirement and laws of every state (Sommers, Blendon, & Orav, 2016).
Finally, the amount of premiums paid by citizens in the different states differ depending on the state a person comes from. For instance, the state of Arkansas requires that a family of 3 that is eligible for the benefits pays $ 27,159 per year while the state of Alabama requires that a family of 3 dependents pay $26,813 per year (Takach, & Buxbaum, 2013). This is evident enough to show how different the program is run in the different states in America.
From the evidence above therefore, we can conclude that the Medicaid program of the United States is a combination of 50 different health programs run by the different states that make up the United States of America. The mode premiums charged by the different states is different, the procedure of application and most importantly the eligibility procedure differs according to the policies set by the different states. Therefore the Medicaid program can in this case be said to be fifty different programs.
Ginsburg, P. B., & Rivlin, A. M. (2015). Challenges for Medicare at 50. New England Journal of Medicine, 373(21), 1993-1995.
Rice, T., Unruh, L. Y., Rosenau, P., Barnes, A. J., Saltman, R. B., & van Ginneken, E. (2014). Challenges facing the United States of America in implementing universal coverage. Bulletin of the world health organization, 92, 894-902.
Sommers, B. D., Blendon, R. J., & Orav, E. J. (2016). Both the ‘private option’and traditional Medicaid expansions improved access to care for low-income adults. Health Affairs, 35(1), 96-105.
Takach, M., & Buxbaum, J. (2013). Care management for Medicaid enrollees through community health teams. Washington, DC: The Commonwealth Fund.