MEDICAID AND MEDICARE

Medicaid and Medicare

Medicaid and Medicare

Introduction

The people of America are quite fortunate that they have a government system in place that ensures they receive quality healthcare in a timely manner. The purpose of this paper is to take a look at how Medicaid and Medicare evolved with time to be known as it is today. Medicare is part of a national social insurance program that was initiated by the United States Government in approximately 1965. As per the policies of the programs, Americans that are of the age 65 or older, younger individuals with specific disabilities and individuals who are suffering from end stage renal disease are guaranteed health insurance. The program is a noble effort, effectively helping to remove the financial risk associated with illness. With that being said, one can understand that the purpose of the program is different from conventional insurance schemes where organizations become capable of making money out of the process of rearranging an individual's portfolio based on the tools of risk assessment and recognition.

The social insurance program, Medicare, offers all participants, enrollees, a defined amount in terms of benefit. At the moment, Medicare is divided into four categories, commonly referred to as Part A, Part B, Part C and Part D. Part A is responsible for providing enrollees hospital care while Part B is responsible for outpatient medical services. The Medicare programs offers a choice between open network and singly payer health care plan method or a network plan, referred to as Part C. The federal government is responsible for paying the private health coverage in part C. Statistics show that a vast majority of enrollees prefer the traditional option, the open network single payer health care plan method. Part D deals the outpatient prescription drugs.

A program often confused with Medicare, is Medicaid. Medicaid was initiated to help out those families and individuals who are not so well off financially, who have low income and considerably low resources. The program is funded by state and federal governments, while being managed by the state in which the individual resides. The program was designed to cover individuals from all age group and specifically those with disabilities. Poverty is not the only deciding factor for the program and there is an extensive checking mechanism in place to ensure nobody gets away with cheating the government, primarily because the government hopes to get the money to those who need it most.

The Rise of Health Insurance Coverage

As mentioned earlier, before programs like Medicaid and Medicare were available to the general public, individuals were left to fend for themselves. Before the year 1930, if an individual required medical assistance, they had to seek it on their own from physicians at their own expense. The individuals had to pay for the consultation and the treatment that followed. History shows that there was no fixed pricing mechanism and the fee was subject to the bargaining skills of both the physician and the patient. Because of the fact that there ...