Identify Three Major Components Of Medicare And Medic 838086 ✓ Solved

Identify three major components of the Medicare and Medicaid programs and,

This discussion focuses on analyzing the three major components of the Medicare and Medicaid programs, identifying the coverage gaps within each, and providing a stance on the relevance of the Social Security program to the American public. The analysis will be supported by credible primary sources, including government reports and scholarly articles, to ensure accuracy and depth.

Medicare is a federal health insurance program primarily designed to serve Americans over the age of 65 and individuals with certain disabilities. Its core components include Part A, Part B, and Part C. Part A provides inpatient hospital benefits, skilled nursing facility care, hospice, and home health services. It is mostly funded through payroll taxes, and most beneficiaries do not pay a premium for this coverage. Part B covers outpatient medical services, including physician visits, preventive services, and outpatient procedures, which generally require beneficiaries to pay monthly premiums. Part C, or Medicare Advantage, offers alternative means of receiving Medicare benefits through private insurance plans that may include additional services and benefits beyond traditional Part A and B coverage.

Medicaid, on the other hand, is a joint federal and state program that provides health coverage to low-income individuals and families. Its components predominantly include mandatory benefits, such as hospital and physician services, and optional benefits, which states can choose to provide. Eligibility varies but typically includes low-income pregnant women, children, the elderly, and individuals with disabilities. Medicaid programs often cover a range of services, including hospital stays, home health care, and prescription medications, although specific benefits may differ across states.

Coverage Gaps in Medicare

Despite its comprehensive structure, Medicare has notable coverage gaps. One significant gap is the lack of coverage for services such as dental, vision, and hearing aids. Beneficiaries often incur out-of-pocket expenses for these essential health services, which are not included in standard Medicare benefits (Kitchener et al., 2019). Additionally, Medicare Part A generally does not cover long-term custodial care, which constitutes a substantial financial burden for many aging beneficiaries who require assisted living or nursing home care. They often have to purchase additional private insurance or pay out of pocket.

Coverage Gaps in Medicaid

Medicaid also faces limitations in coverage. For example, many states restrict Medicaid coverage for non-disabled adults without dependent children, resulting in a coverage gap for a significant portion of the low-income population (Davis et al., 2018). Furthermore, Medicaid often does not adequately cover long-term care and assistive devices, impacting individuals with disabilities who require ongoing support. The variability across states contributes to unequal access to essential health services, perpetuating disparities among low-income and vulnerable groups.

The Role of the Social Security Program

The Social Security program plays a critical role in providing economic security for retired workers, disabled individuals, and surviving family members. It primarily functions as a retirement income replacement system, funded through payroll taxes paid by workers and employers (Social Security Administration, 2020). Given its influence, the program's relevance to the American public cannot be overstated. It act as a safety net, alleviating poverty among the elderly and disabled populations, and providing financial stability for millions of Americans.

Discussion on the Relevance of Social Security

I believe that the Social Security program remains highly relevant in its current form, but it requires modifications to ensure its sustainability. While the program effectively supports those in need, demographic shifts, such as increasing life expectancy and declining birth rates, threaten its future solvency (Munnell & Sass, 2019). Therefore, proposals such as gradual adjustments to payroll tax rates, raising the retirement age, or increasing the cap on taxable earnings should be considered to strengthen the program. These modifications aim to preserve the social safety net that millions depend on, rather than eliminate or drastically overhaul the system.

Eliminating or drastically changing Social Security could lead to increased poverty rates among the elderly and disabled, exacerbating existing socioeconomic disparities. Conversely, leaving the program unaltered may jeopardize its long-term viability. A balanced approach that maintains its foundational purpose while implementing necessary reforms seems the most prudent path forward, ensuring that future generations continue to benefit from its protections.

References

• Davis, K., Collins, S. R., Doty, M. M., Radley, D. C., Smith, B., & McDaniel, T. (2018). Medicaid and the Health of Low-Income Adults. The New England Journal of Medicine, 379(22), 2101-2104.
• Kitchener, E., Rohr, J. P., & Murphy, S. (2019). Gaps in Medicare Coverage for Dental, Vision, and Hearing Services: Policy Implications. Health Affairs, 38(10), 1748-1754.
• Munnell, A. H., & Sass, S. A. (2019). Reassessing the Sustainability of Social Security: Challenges and Opportunities. Journal of Pension Economics & Finance, 18(2), 173-193.
• Centers for Medicare & Medicaid Services. (2020). Medicare & Medicaid Benefits and Eligibility. Retrieved from https://www.cms.gov
• Blumberg, L. J., Holahan, J., & Buettgens, M. (2018). Medicaid Coverage for Low-Income Adults: Changes in State Policies. Health Affairs, 37(4), 472-479.
• Social Security Administration. (2020). Fast Facts & Figures About Social Security. Retrieved from https://www.ssa.gov
• Börsch-Supan, A., Jürges, H., & Harsányi, Z. (2016). Country Differences in Social Security Systems and Their Impact on Retirement Decisions. Journal of Public Economics, 144, 119-132.
• Davies, P., & Smith, M. (2018). State Variations in Medicaid Coverage and Its Effects on Healthcare Access. Health Policy, 122(12), 1258-1264.
• Centers for Medicare & Medicaid Services. (2020). Medicare Overview. https://www.cms.gov/medicare
• Sass, S., & Munnell, A. H. (2019). The Future of Social Security: Reform Challenges and Strategies. Brookings Institution Press.