Health Insurance Vs Medicare Essay

Healthcare insurance have developed over years since it started since 1920 and that was a route for HMO. Healthcare insurance may be private like blue cross and public like Medicare, Medicaid. Most far reaching private health insurance programs take care of the expense of standard, preventive, and crisis human services techniques, furthermore most professionally prescribed medications, yet this was not generally the situation. The ascent of private protection was joined by the slow extension of open protection programs for the individuals who couldn 't secure scope through the business sector. For example, When an injured person goes to the emergency room and receives treatment, he has to pay for the treatment even if he has an insurance the hospital bills goes to the insurance or to the center of Medicare and Medicaid services and if he does not have any insurance he has pay from his pocket and if he is not able to pay it hospitals may write off the payment or payment is paid by some charity.

At some point in everyone’s life they or a family member will have to visit a physician regardless of whether it’s for a sinus infection, a necessary surgery, if they’re insured or not. Everyone will at some point need medical attention, thus utilizing the money taken out of the publics’ paycheck being put towards healthcare spending. According to Fleming, “By 2020, healthcare spending is projected to be 19.8 percent of GDP, nearly one-fifth of economic output, increasing from 17.6 percent in 2010.” Since, Medicaid and Medicare are funded by Federal and State taxes (Medicare, 2015) with a fee-for-service system; the public will continue to pay for services provided. However, with a pay-for-performance system, providers will be required to make changes within their area of care to ensure that quality is administered and at a lower cost (Better Care, 2015).

Depending on your health insurance, you will receive a card similar to a debit card allowing you to pay for medical expenses. Other plans require you to submit documentation or receipts so your insurance company can reimburse you for your expense. You can use flexible spending accounts for any dependents that you claim on your taxes or any adult children in your home under the age of 26. Flexible spending accounts also allow you to use the funds for any approved medical expenses incurred by your spouse. At the end of the plan year, you will forfeit any money left in the account, although some employers provide you with a short grace period.

Why do LTCF/nursing homes play an important role in the continuum of care? Goldberg, T., (2014), explained how Medicare and Medicaid supports nursing homes in the continuum of care for the elderly. He stated that from their establishment in 1965 as a part of the Social Security Act both Medicare (Health Insurance for the Aged and Disabled) and Medicaid (Medical Assistance for the Poor) cover aspects of long-term care (LTC) but in different ways. He added, that Medicaid covers long-term nursing home care for those who qualify financially and medically, but generally does not cover residential care/assisted living. The coverage provided under Medicare is more complicated because of its four different parts: • Medicare Part B covers physician services and therapies, generally regardless of location (i.e. physicians bill Medicare Part B for patients seen in hospitals, outpatient or LTC settings, but using different billing codes based on setting).

Dear healthcare staff: The hospital is currently under financial difficulty and as a hospital administrator, I would like to explain to you how the Medicare (DRG) works. First, Medicare is a federal-sponsored health insurance program for individuals who are older than 65 years. Medicare also covers people with major debilitating conditions, such as End Stage Renal disease without any limit to household income. In order to qualify for Medicare, a person has to be a US citizen or with at least 5 years of permanent residence in the United States. Medicare is divided into four parts, namely: Medicare part A, B, C and D. The Medicare part A covers the inpatient cost of the hospital and skilled nursing facilities; Medicare part B focuses on outpatient

Managers should identify these patients and plan a follow-up treatment plan for them. Fourth, information transparency has become more important than before, and those who pay for the medical services want to know about the medical cost and the quality of care. Also

So because you get to stop paying for insurance you don’t get to stop paying taxes used for the medicines needed. The second problem is, “In the United Kingdom, which has a right to health care, a 2002 study by the British National Health Service found that it was ‘critically short of doctors and nurses’”states procon.org. They say possible doctors will not want to be doctors, because many doctors’ pay will drop a lot with the universal healthcare system. Procon.org states that, “A right to health care could lower the quality and availability of disease screening and treatment.” This would be because with free healthcare hospitals and other medical facilities income would be cut short and they may not be able to afford the most helpful or the newest technology or research.

The United States currently abides by the Affordable Health Care Act’s legislation to provide millions of Americans affordable health care plans. Unfortunately, some individuals have struggled to pay for either the premiums that are offered by insurance companies or the penalty fee that is issued for not having any form of insurance. However, if changes are made to increase tax rates, free universal health care can be provided to all citizens. Under the Affordable Health Care Act, a marketplace consisting of many insurance providers is made available to the public.

There are four main components to Medicare. Part A of Medicare deals with the reimbursement of institutional providers for hospital stats or services, post hospital stays, home health, and hospice benefits (Esdin 5). Part B is an elective portion that the majority of those qualified for Medicare elect to have. This portion is not free and requires 20 percent reimbursement. Those selecting part B need to pay a monthly premium for service.

How much each party pays is different each year the most that the Federal government pays is 60%. States get the funds needed from taxes such as sales tax, personal or cooperate income taxes.

The United States should provide health care for all citizens. This would be beneficial because diseases and disorders would be caught earlier, the cost of medicine would decrease, and people would go to doctors for annual checkups. For instance many people die from diseases and disorders they are not aware of. High blood pressure is often

A major issue in America today is poverty. However not much is being done to help those in need. Many who struggle in poverty are those who struggle getting the basic necessities we need in the everyday life such as food, clothes, water, and shelter. Different factors that can contribute to poverty are lack of education, unemployment, poor economy, race/origin, non-effective policies, and illness/disease; therefore more help should be made towards helping those in need. One of the factors that contributes to poverty is lack of education.

In the King v. Burwell case, the challengers had a point. Subsidies should be decided by the each state. But, in my opinion, I think the government will always be right. I believe the subsidies for health insurance was an act of kindness, and even though it is costly, it is helping out our country a lot.