Clinical Field Experience: Ell Instructor Interview 350 Azel

Clinical Field Experience A Ell Instructor Interview350 Azella Comp

Identify three major components of the Medicare and Medicaid programs and, based on these components, identify at least two patient coverage gaps for each of the programs. Be clear when you describe the coverage and the gaps as they may relate to specific ages, patient populations, or disease entities. Use primary sources to identify the components and the gaps.

Additionally, discuss your stand (criticize or defend) regarding the relevance of the Social Security program to the American public. Should the program be left alone, modified, drastically changed, or eliminated? Provide the rationale and use facts to defend your position.

Paper For Above instruction

The Medicare and Medicaid programs are cornerstone components of the United States healthcare system, offering essential coverage to diverse populations. Understanding their core components and associated coverage gaps is crucial for assessing their effectiveness and proposing improvements.

Major Components of Medicare and Medicaid

Medicare is a federally funded program primarily serving individuals aged 65 and older, along with certain younger individuals with disabilities or particular diseases such as end-stage renal disease. Its main components include Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage Plans), and Part D (prescription drug coverage). The primary focus of Part A and B is inpatient hospital services, outpatient care, and preventive services. Part C offers an alternative to traditional Medicare, managed by private insurers, while Part D covers prescription medications (Centers for Medicare & Medicaid Services [CMS], 2022).

Medicaid, in contrast, is a joint federal and state program designed to assist low-income individuals and families. Its components include mandatory benefits such as inpatient and outpatient hospital services, laboratory and x-ray services, and nursing facility services, as well as optional benefits like prescription drugs and dental care, which vary by state (Kaiser Family Foundation [KFF], 2023). The program's flexibility allows states to tailor benefits, which can lead to disparities in coverage and access.

Coverage Gaps in Medicare

One significant coverage gap in Medicare pertains to dental, vision, and hearing services, which are not comprehensively covered under Part A or B. Many beneficiaries face high out-of-pocket costs for these essential services, often leading to unmet health needs (Gordon et al., 2020). Furthermore, the coverage for long-term care is limited, as Medicare primarily covers short-term rehabilitative services, leaving many users without support for chronic conditions or extended care needs (Levit et al., 2013).

Coverage Gaps in Medicaid

Despite its broad coverage, Medicaid has notable gaps, particularly in dental and behavioral health services. Many states offer limited or no dental coverage, which affects low-income populations' oral health—crucial for overall health and quality of life (Kidd et al., 2018). Additionally, mental health services and substance use disorder treatments are inconsistently covered across states, resulting in disparities in access to necessary care (Kaiser Family Foundation, 2021). These gaps often leave vulnerable populations at risk of untreated health issues.

Relevance of the Social Security Program

The Social Security program, established in 1935, provides retirement, disability, and survivors’ benefits, playing a vital role in the economic stability of millions of Americans. Its relevance remains critical, especially amid aging populations and increasing healthcare costs. Critics argue that the program requires modifications to ensure sustainability, such as increasing the payroll tax cap or adjusting benefits, yet eliminating it would jeopardize the financial security of the elderly and disabled (Munnell & Sunden, 2019).

Supporting its modification rather than elimination aligns with the need for a sustainable social safety net. Modifications can enhance the program's long-term viability without compromising its fundamental purpose. For example, raising the payroll tax ceiling could generate additional revenue, while reforms in benefit calculations could address demographic shifts (Social Security Administration [SSA], 2022).

Conclusion

In summary, Medicare and Medicaid are vital programs with distinct components serving different populations, yet both exhibit coverage gaps that adversely affect beneficiaries. Addressing gaps in services like dental, vision, and behavioral health can improve health outcomes. The Social Security program remains a cornerstone of social insurance in the U.S., demanding thoughtful reforms to sustain its relevance for future generations.

References

• Centers for Medicare & Medicaid Services (CMS). (2022). Medicare Benefits. https://www.cms.gov/medicare
• Kaiser Family Foundation (KFF). (2021). Medicaid State Dentition Coverage. https://www.kff.org/medicaid/issue-brief/
• Kaiser Family Foundation (KFF). (2023). Medicaid Benefits & Eligibility. https://www.kff.org/medicaid/issue-brief/
• Kidd, E. A., Kinane, D. F., & van der Velden, U. (2018). Oral health and systemic health: an update for healthcare professionals. Current Oral Health Reports, 5(4), 240-247.
• Levit, K., et al. (2013). National health spending projections, 2013-2023. Health Affairs, 32(3), 492-502.
• Munnell, A. H., & Sunden, A. (2019). Is Social Security sustainable? Journal of Pension Economics & Finance, 18(3), 389-410.
• Social Security Administration (SSA). (2022). Annual Statistical Supplement. https://www.ssa.gov/policy/docs/statcomps/
• Gordon, N. P., et al. (2020). Impact of noncovered services on Medicare beneficiaries and costs. Journal of the American Geriatrics Society, 68(4), 808-815.