...momentum for social reform during the 1960’s, the strongly Democratic Congress decided to enact the Medicare program as a way to provide much needed health care insurance for the large population of elderly Americans. In “Introduction to US Health Policy”, Donald Barr highlights that when Medicare was passed in 1965, only about 56 percent of elderly citizens in the United States had any form of hospital insurance. Since aging is an inescapable fate of every person, there was an American consensus that no one should face financial ruin due to the rising costs of receiving health care during their elderly years which served as a catalyst for this program’s formation. The passage of the Affordable Care Act in 2010 has further...
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...One of the things we will be talking about in the medical section is elderly women and Medicare. The passage of Medicare did not occur until 1966, which marked a key milestone in women’s economic security. It was also a huge influence to decreasing income equality between genders. Alina Salganicoff’s journal article “Women and Medicare: An Unfinished Agenda” written by mentions that “Today, Medicare serves 24 million women ages 65 and older, representing 56 percent of older adults enrolled in the program, and provides them with financial protection at a time in their lives when they have the greatest need for medical care and often the fewest family and economic resources” (43). This shows that almost 60% of women are covered by Medicare....
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...DeVry University Managed Care & Health Insur Professor: Keri Bahar Week 7 – Webliography Contribution Reforming Medicare in the age of Deficit Reduction Date: 04/16/2014 Webliography Contribution Entry / Reference 1: Urban Institute (2013). Can Medicare Be Preserved While Reducing the Deficit? Timely Analysis of Immediate Health Policy Issues. Retrieved from: http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf404766/subassets/rwjf404766_1 This reference help the current healthcare insurance and managed healthcare issues to reach the right set of policy to make changes that could correct long-standing gaps in financial protections that Medicare beneficiaries face, promote greater efficiency within payment systems, and generate the additional revenues necessary to pay for the impending surge in the number of beneficiaries. Entry / Reference 2: Steckenride, Janie, Parrott, Tonya (1998). New Directions in Old-Age Policies. The Health Care Policies and Older Americans. Retrieved from: http://books.google.ae/books?id=rwR4rpIrvW0C&pg=PA19&lpg=PA19&dq=Reforming+Medicare+in+the+age+of+Deficit+Reduction&source=bl&ots=ZtGKc36-o3&sig=00b8wDb48nxaR4uqWAHTms1slBU&hl=en&sa=X&ei=SKgJU77mK8eb0QW-44C4AQ&ved=0CDUQ6AEwAjgU#v=onepage&q=Reforming%20Med&f=false This reference help the current healthcare insurance and managed healthcare issues to explores the changed political environment in the United States and what...
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...Policy Interview Analysis For this essay I chose to interview Carla, a Registered Nurse, with twenty years of experience, from the Operating Room. She has seen many changes occur in healthcare during his career. This paper will discuss some of the values he finds most important for creating an equal healthcare system. In order to establish an equal healthcare system, coverage needs to be affordable, with equal opportunities for everyone, and American’s need to feel they have the freedom of choice for the type of coverage they want. Healthcare coverage first of all, needs to be affordable. Employers should pay all or most of the healthcare premiums to cover their employees. The coverage should be competitive and at the same time the employee should have the right to choose if they want to be covered or seek private insurance. Mandatory physical exams and blood work should be discussed in detail at employee forums and human resources should not just assume all employees know their coverage rights. Physician’s office staff should be well educated in insurance literacy to let their patients know what their coverage rights are. This will keep the patient from getting a surprisingly high statement in the mail. Those who are eligible for Medicare should not have deductibles. If they are on Medicare then they obviously fall below some standard and therefore do not have the money to pay for medical coverage. Carla states, “Medicare should not be eliminated unless...
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...This is one service that I believe would help the Krona Community Hospitals for their financial forecasting for their organization, which is National Health Service (NHS). This is a Healthcare System that is publicly funded for England. This is the largest system and the oldest single payer healthcare system in the world. This system has been funded through a general taxation system, this system will provide healthcare to every legal resident in the United Kingdom, which is with most services free at the point of use. This healthcare is at the point of use, which comes from the core principles at the funding of the National Health Service which is by the United Kingdom of labor Government in 1948. The free of point of use would mean that anyone that is legitimately has been fully registered with this system. Core Principles: · Will meet the needs of everyone · Will be free at the point of delivery · This will be based only on clinical needs not ability to pay From my research these three principles has been guided the development of the National Health Services over more than a century and it does remain. Now the main aims of these principles are that the National Health Services, which would provide is. · Will provide a comprehensive range of services · Will respond to the different needs of the different population · Will work continuously to improve the quality of their service · Will use...
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...GOVERNMENT MANDATED BENEFITS Benefits May 18, 2015 Table of Contents Introduction…………………………………………………………………………………………………………………………3 Article Summary…………………………………………………………………………………………………………………3 Analysis……………………………………………………………………………………………………………………………….4 Conclusion…………………………………………………………………………………………………………………………..6 References…………………………………………………………………………………………………………………………..7 Introduction In this article, we will be summarizing and analyzing an article on “Mandated Insurance Benefit Laws: Important Health Protections for Women and Their Families”. The federal and state governments in the United States have mandated certain benefits, mostly related to health insurance. Employee benefits can consist of a variety of benefits that could become a great addition to an employee package. The article analyses the economic impact of these benefits. Article Summary There are certain benefits which have been mandated by the government which an employer must provide to its employees. Businesses use benefits to attract new employees and give current employees a greater sense of job satisfaction. The United States government has mandated certain benefits for employers to provide to their employees. Employers mostly and in some cases employees need to pay for these benefits. This article analyses the reasons behind the choices the government has made. Employee benefits are much more than health insurance, vacation time, and 401 (k) plans. Companies with 50 or more employees must also...
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...Budgetary Analysis Heather Horning HCS/550 August 18, 2014 Elaine Bobo Budgetary Analysis The Medicaid program is one of the largest sources of health insurance in this country in addition to employer-based health insurance and Medicare. Medicaid delivers crucial medical related services to the most at risk populations in society. The importance of Medicaid's part in providing health insurance cannot be exaggerated; “the Medicaid program covers millions of low-income women, children, elderly people and individuals with disabilities” (U.S Department of Health and Human Services, 2000). Funding for Medicaid is limited through various federal policies, leaving much of the program’s budget burdened on the individual states to make necessary spending cuts in order to provide the funds needed for the demand of the program. Budgetary decisions need to be thoroughly reviewed before any immediate action is taken as these decisions can create a domino effect on other programs and their participants as sections of this paper will describe. Medicaid Overview Medicaid is a cooperative federal and state program with a common goal to provide a vital service for the general public. “Medicaid is the largest source of federal revenue for states. Medicaid funds support health care providers, jobs and state economies overall” (Kaiser Family Foundation, 2013). Every state institutes its own eligibility criteria, benefits platform, payment rates and program organization under the broad federal recommendations...
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...a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes enacted in 2010: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010 , which amended the PPACA and became law on March 30, 2010. Future reforms and ideas continue to be proposed, with notable arguments including a single-payer system and a reduction in fee-for-service medical care. The PPACA includes a new agency, the Center for Medicare and Medicaid Innovation, which is intended to research reform ideas through pilot projects. ------------------------------------------------- History of national reform efforts Here is a summary of reform achievements at the national level in the United States. * 1965 President Lyndon Johnson enacted legislation that introduced Medicare, covering both hospital and general medical insurance for senior citizens paid for by a Federal employment tax over the working life of the retiree, and Medicaid permitted the Federal government to partially fund a program for the poor, with the program managed and co-financed by the individual states. * 1985 The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) amended the Employee Retirement Income Security Act of 1974 (ERISA) to give some employees the ability to continue health insurance coverage after leaving employment. * 1996 The Health...
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...that a person is paying for and there could be high out of pocket expenses. In the US healthcare isn’t guaranteed by the government like in other industrialized nations. In the US the government doesn’t control most insurance systems or how they operate. People in the US who do have healthcare coverage are covered either by private insurance or a public health care system. A lot of unemployed individuals don’t have any coverage at all. Medicare, Medicaid, Children’s Health Insurance Program and the Veteran Affairs program are considered public health care systems. For some of these government programs, individuals may still be responsible for a premium depending on income. The US system also offers the Affordable Care Act. This act offers insurance to those who have been unable to obtain coverage due to not qualifying for other public insurance and not being able to obtain private insurance for various reasons. The Affordable Care act also allows for children to be covered under their parents plan until they are 26 years old. Medicare is the program in the US that...
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...need for Healthcare and the importance it plays in their lives. My Museum Hall of Fame will focus on the changes in Health Insurance and its many different policies. The depression in the 1930’s changes Healthcare with Employer-Based Health Insurance, which made health insurance much more accessible to working, middle-class Americans. By the mid 1950’s 45 percent of the population had health insurance coverage. Coverage then skyrocketed and by 1963 about 77 percent of people were covered by some form of Health Insurance. It seems Commercial-Based Insurance companies may have put an end to Employer-Based Insurance, but may have opened the door for insurance to improve and grow in other ways. Development Description Analysis (How does the development affect the current U.S. health care system?) 1. Employer-Sponsored Health Insurance During World War II the federal government controlled employer’s wages, forcing employers to search for another way to attract and hold onto workers. The labor market was suffering because of the increased need for goods and the decreased number of workers during the war. Employers decided on offering workers benefits, such as health insurance as an incentive. Employer-Sponsored Health Insurance is often called Group Health Insurance. Employers are responsible for a large portion of the employee’s Healthcare expenses. The Health Insurance carrier that the employer chases must cover all applicants as long as their employment qualifies...
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...jstor.org This content downloaded from 130.63.180.147 on Sat, 12 Oct 2013 14:05:01 PM All use subject to JSTOR Terms and Conditions Parting at the Crossroads The Development of Health Insurance in Canada and the United States, 1940-1965 AntoniaMaioni Frequentlyraised in recent discussions abouthealth care reformin the United States has been the model of the Canadianhealth insurancesystem.' While debates about health insurance often turn into polemical battles over which country offers the "best" health care for its citizens, the issues at stake raise a fundamentalquestion. Why did these two neighbors develop different forms of health insurance, a health care in Canada and a dual-tiered universal system of government-financed of Medicare and Medicaid targeted at the elderly and poor in the United system States? The contrast...
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...Critical Analysis of a U.S. Healthcare Challenge - Fraud and Abuse HSM 420 - Managed Care and Health Insurance April 19, 2015 Professor Bob Vega Critical Analysis of a U.S. Healthcare Challenge - Fraud and Abuse Introduction 2 What is Fraud and Abuse 2 Cost of Fraud 2-3 How can fraud be detected in Medicare 3 What are the implications for fraud and abuse 3-4 How can it be prevented? 5 Summary 6 Conclusion 7 References 8 Increasing costs of healthcare is a fear for many families in America. An issue in the rate of healthcare insurance is deception. Fraud is frequently very problematic to identify. The scale of healthcare fraud is indefinite. Preliminary compensation and expense and billing timeframe of 90 days permits for quick reimbursement of services, however, many times before there is a warning of deceitful billing the company has shut down and moved on. Fraud in American healthcare will cost American’s millions, possibly even billions of dollars each year. Without hesitation, behind every action of fraud, is an interval in ethics. Fraud is the deliberate dishonesty or falsification that a person knows to be untrue or that they consider to be factual is not, and sorts, if they know that the dishonesty might cause in an unsanctioned advantage to themselves or someone else. The most common kind of fraud rises from an untrue...
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...belief that it is the forty-plus million uninsured Americans who are the problem with our present system. It is our insurance itself that forms the biggest problem, an erratic problem that fails to provide needed health. Cohn methodically discusses each piece of the book one by one, using case histories to illustrate his points. He meet a few people with no insurance at all, a few with Medicare or Medicaid, and a few with good private policies. All are hard-working, well-intentioned, and startled that they have been punished, financially, emotionally, medically, or all three, for getting sick. What sets Cohn’s book apart from other compilations of sad stories is the comprehensive, dispassionate analysis he offers of the policy behind the tragedies. He provides a history of U.S. health insurance from the beginning up through the politicking behind Medicare and Medicaid in the 1960s, the rise and fall of health maintenance organizations (HMOs) in the 1990s, and the confused debut of last year’s Medicare Part D (for prescription drugs). I suspect that committed policy wonks might find his analysis fairly basic, but for those of us without formal background in the area, it is a pleasure to have the whole drama laid out, act by act. Cohn seeks to tie together all of these troubling stories and histories in order to make a case for publicly funded, universal health care. His proposed solution resembles the French system, which (unlike, for instance, Britain’s entirely...
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...workers and their family members when they change jobs. It also provides privacy to children ages 12-18 in that a provider must have written consent before disclosing any health information to anyone, including their parents. JCAHO: the Joint Commission on Accreditation of Healthcare Organizations is now known as The Joint Commission (TJC) and is a nonprofit organization that accredits health care organizations across the US. They review standards of care through surveyor visits and performance measures. Their mission is centered around providing safe, quality care. Organizations are surveyed every 3 years and are scored on compliance and non-compliance. Hospitals are required to meet TJC standards to receive reimbursements from Medicare and Medicaid and all information collected is visible to the public. Total Quality Management: TQM is one of the philosophies in continued process improvement. It’s a customer-focused tool that uses team members of an organization to collaborate using data and strategy to build process improvement into the everyday culture. TQM, very similar to lean manufacturing, drove an effort to focus on processes and problem solve from beginning to end for more streamlined, efficient and effective processes. Malcolm Baldridge award: The Baldridge award is an annual award given by the US Government for organizations that exemplify quality excellence. More than half of the organization is evaluated on leadership and the other half is evaluated...
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...observation rooms, four surgical operating rooms, a 24-hour emergency center, a maternity department including one C-section room and an intensive care unit. It will also have extensive support services such as physical therapy and cardiac rehabilitation. In order for the new facility to be a success, we must prepare next year’s financial plan and operational budget. This can be accomplished through careful planning, forecasting, and finance management. First, we need to expand the budget and take into consideration any new services being offered. We have $3 million we can use for additional staff, maintenance and other services. Funding sources The primary source of funding is through government health insurance programs. Medicare is the largest source of funding and makes up approximately 40% of the total funding for health care facilities. A second government funding opportunity is Medicaid, which is a joint responsibility of the Federal and State governments. Because of their quick reimbursement turnaround time, many hospitals rely on those reimbursements to fund the overhead costs of the facility and pay the salaries...
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