Biggest Problems Facing Medicare and Problems Key Similarities and Differences Essay

Problems liner Medi portion outfulness and MedicaidThe national government has sponsored whole nearness redress programs such(prenominal)(prenominal) as Medic ar as tumefy as the Medicaid. checkup insurance for the time-honored, dis satisfactoryd, as strong as low-income Americans argon covered by these insurance programs. In 1965, these programs took upshot and the wholesomeness C ar Finance Administration or the HCFA, of the Department of Health and Human function administered these programs. Health C atomic number 18 coverage is domiciliated by the US government to a pattern of groups such as federal employees, armament personnel, veterans as intimately as the indigene Americans. However, the largest proportion of wellness trade expenditures is accounted by the Medicare as well as Medicaid programs.The program of Medicaid provides Health work as well as residential care to more than 50 million Americans wherein distributively has crotchety personal needs. Medicaid provides defrayal for prenatal care for about one-third of the children of the nation, long-term care for more than 20 percent of elderly citizens as well as health safety for people with disabilities are provided. In addition to that some(prenominal) States works on similar initiative to cover the uninsur fitted. Medicaid are facing severe crisis of sustainability. It was found that since nineties a typical State was able to see that the medical make ups project double the percentage of their budget and it was in addition communicate that continue disproportionate emergence is evident. In 2006, the combined federal as well as State expenditures take $320 billion and by 2016, they are projected to reach $580 billion (Making Medicaid clear A Practical Guide for Transforming Medicaid, 2007).The one- course of instruction Medicaid Budget Survey Report incur indicated that at the beginning of the distinguish financial family 2008, according to the description of the Medical Directors, State financial situation is mostly improving, the secernate r eveningues are increasing that all toldowed Governors as well as the reconcile legislatures to compensate many a(prenominal) cuts as well as restrictions that wee-wee been watched during the economical downturn, and adopt positive changes in Medicaid such as increase in supplier payment evaluate as well as expansion in benefits and eligibility. The State insurance decisions for 2007 and 2008, includes a clear focus on improving coverage as well as quality of care provider under the program (Smith V.K., Edwards, B.C. & Tolbert, J. (2008).Across the kingdoms, however, signs that the economic climate was changing, emerged just a a few(prenominal) months into advance financial year 2008, in the fall of 2007. Studies have shown that the outlook was no prolonged positive as it had been in the case early in the state monetary year (Smith V.K., Edwards, B.C. & Tolbert, J. (2008).Diffe rent Issues Facing Medicare and Medicaid account Issues of MedicaidA hand out of funda psychological issues, concerns and priorities in mid fiscal year 2008, have been identified by Medicaid Directors. On top of it were the effects of an increase in fiscal stress across states, a lot of federal state issues such as those impacting Medicaid enrollment and entree, as well as their current efforts to orchestrate the uninsured (Smith V.K., Edwards, B.C. & Tolbert, J. (2008).Fiscal Stress across the StatesAs described by the directors of the State Medicaid, in the last half(prenominal) calendar 2007, economic situation in a lot of states leveled off unexpectedly and in some cases deteriorated. Results have shown that early in fiscal year 2008, the revenues came in below projections on which the state constitution makers had based the state budget. Based on the report as the state approached the mid-point in fiscal year 2008, the outlook for the immediate future was slight optimis tic than it had been at the beginning of the year.The directors of Medicaid had excessively described in the budget aspect that at the beginning of state fiscal year 2008, they strongly sense that the state economies were rebounding as compared to the juvenile years, according to late(a) rates of growth in state revenues. Due to Annual changes in each states federal Medicaid duplicate rate, the states budget is affected. It would be difficult to hit significant Medicaid cost savings immediately than it had been during the last economic downturn and Medicaid cost control actions are not often easy and almost always have impacts on the effectiveness of the program (Smith V.K., Edwards, B.C. & Tolbert, J. (2008).Issues of the Federal-StateThe modern federal regulatory changes are unseemly to the states, according to Directors of Medicaid, and it will provide controvert impact on the programs including the proposed changes regarding the Medicaid benefit intent as well as the M edicaid backing arrangements. They also have singled out the Health Information Technology as an recitation of the state-federal relations moving in a positive way (Smith V.K., Edwards, B.C. & Tolbert, J. (2008).Improving entryway in MedicaidIn Medicaid the issue of access had been perennial because of generally lower rates of provider reimbursement in most of the states, periodical budget-driven cuts or freezes, as well as rate increases occurring at sure intervals when sure by state legislatures. Few providers of proper(postnominal) types as well as commercially insured patients encountered access problem for certain specialists such as psychiatrists, pediatric specialists in some states. Directors have also convey concern over access to spoken as well as mental health services. It was observed that in many states there are few alveolar consonant health providers who participate in the Medicaid program. Moreover, union has not been meliorate just by the rate of increas es. In fact, one state reported that despite the rate adjustments, even dental clinic of public university would no longer serve Medicaid patients. In addition to that, succession access to mental health services suffers from lack of providers, the issue gets more compound by the lack of resources and need to align with other agencies in order to provide non-medical services (Smith V.K., Edwards, B.C. & Tolbert, J. (2008).Enrolment in MedicaidThe sum Medicaid enrollment dropped by -0.5% in fiscal year 2007on average across all states, with increase enrollment for almost half of the states and decrease enrollment for over half of the states. Reports indicated that Medicaid caseload was showing flat or continued downward-sloping caseload trend, and in addition to that, several state indicated that their current projections had been revised upward. Where the caseload was instanter increasing, the upward caseload trend was thought to be associated with a more sluggish miserliness (Smith V.K., Edwards, B.C. & Tolbert, J. (2008).The Health Care Reform and masking of the UninsuredThe Governors, as reported by the Medicaid directors are interested in reforming the health care system as well as the strategies to reduce the number of various(prenominal)s who do not have health insurance coverage. A lot of states have proposed initiatives to pass over the problem of the continuous increase of the number of uninsured nationally. In some states their remainder is universal coverage, on the other hand, others center on increasing coverage options for the targeted populations (Smith V.K., Edwards, B.C. & Tolbert, J. (2008).Key Issues of MedicareOne of the major problems of Medicare program is that financial support mechanisms of Medicare will not be able to sustain it in the long run. some other concern is that the structure of the program which in large measure reflects health care delivery and political considerations in effect at the enactment, has failed to k eep pace with the changes in the health care system as a whole. A lot of individual suggest that in order to credit this problems major morphologic reform are required. However, to others the existing system should be improved rather than replaced. As of now, there has been no consensus reached. The major focus in the recent years has been on providing prescription drug coverage for beneficiaries. According to some observers, it would not be appropriate to add freshly costly benefit before structural reforms are enacted, while others verbalize that seniors, oddly low-income seniors, should not be required to require for benefits until resolution of the entire restructuring issue (OSullivan, Chaikind, and Tilson, 2001). weapons platform financing is the major concern to policy makers. Another important issue that they are facing is whether the program has responded to changes in the health care delivery.Another issue is phony in Medicare. Sometimes beneficiaries are not safe, that is why Medicare is working hard in order to protect them from being a victim of fraud (Quick Facts About Medicare prescription Drug Coverage and Protecting Your individual(prenominal) Information).Key similarities of the ProblemBoth Medicare and Medicaid are having problems in sustaining the program.The biggest problem that the Federal Government is facing is fraud in Medicare as well as Medicaid. They wish to address the problem by teaching the beneficiaries of Medicare and Medicaid on how to avoid being the victims of fraud, waste and abuse. Mr. Clarkson stated that everyone is at stake in this since the bullion lost, in these practices has an impact on premiums and deductibles and could issuance in cutbacks to these programs (Medicare Fraud, 2008).