The Part A deductible cost went from $40 back in 1965 to $1,484 as of today. Now, the park B Part B deductible cost from $3 back in 1965 to $148.50 per month or higher, depending on your income. In 1972, Richard Nixon President Richard Nixon expanded it to actually include certain people under the age of 65 with long-term disabilities or end-stage renal disease, which was a game changer for Medicare. But it didn’t stop there. Additions to what Medicare covers expanded in the 1980s and included home health care, and hospice services, which providers desperately needed. And in 1980, Medicare supplement insurance, known as Medigap, which we’ll go over a little bit later in another video, was born under federal oversight. See in the 1990s. The new legislation also required that Medicare cover premiums for those with incomes between 100 to 120% of the national poverty level. In addition to Part A and B, Part C of Medicare was added in 1997; it was called Medicare plus choice. In 2003, what we now call it which is Medicare Advantage. It used to be called Medicare plus choice, but now it’s called Medicare Advantage. It was created as actually an alternative to Original Medicare Part A and B to give someone more choices under a private health insurer. Then, in 2003, another part of Medicare came into effect, which is known as Part D. C; up until the new millennium, about 25% of Medicare beneficiaries had no sort of coverage for prescription drugs.
Medicare Spending
President George W. Bush changed that in 2003 when he signed the Medicare prescription drug improvement and modernization Act, enabling people to add an optional drug plan to their policies. Prior to 2003. There was no coverage that was nationalized for prescription drug coverage. Today three are over 60 million Americans that are on Medicare, which represents a significant part of the population. It’s then estimated that there are going to be over 80 million beneficiaries of Medicare as of 2030. “Medicare plays a major role in the health care system, accounting for 20 per cent of total national health spending in 2017, 30 per cent of spending on retail sales of prescription drugs, 25 percent of spending on hospital care, and 23 percent of spending on physician services. In 2018, Medicare spending’ net of income from premiums and other offsetting receipts’ totaled $605 billion, accounting for 15 percent of the federal budget”. (Cuban ski, J. F. 2019, August 20).
Examine Medicare as a healthcare policy.
Medicare is the largest federal health insurance program in the United States as far as cost, second to Medicaid for the number of people covered. Medicare is made up of two parts Part A and Part B. Each part covers certain healthcare services. The two main parts are often called Original Medicare. There’s also Part C and Part D and Medicare supplement insurance.
Medicare is a federal entitlement program first created in 1965 to provide national health insurance coverage for those that were 65 and older, regardless of their income and medical history. It first started when President Harry Truman sent a message to Congress in 1945 that called for a national health insurance fund that all Americans would have access to that will be paid for through a payroll tax. Unfortunately, as stated above in the democratic contribution to healthcare, many saw this plan as universal health care and it looked a lot like the beginning of socialism. Next, President John F. Kennedy made the exact same attempt during his presidency in the early 1960s after learning that over half of Americans over the age of 65 had no health insurance coverage at all. Seeing the average life expectancy around 69 years old during that time, the idea of providing universal health care overseen by the federal government for those who are 65 and older became much, much more popular. Unfortunately, John F. Kennedy was not able to go ahead and get that done. On July 30, 1965, President Lyndon Johnson signed Medicare into law, providing hospital medical coverage to those 65 and older.
Medicare Timeline
When Medicare first began, there were only two parts that existed, part A for hospital services. It was free, and it carried a small annual deductible. “In 2018, Medicare benefit payments totaled $731 billion, up from $462 billion in 2008; these amounts do not net out premiums and other offsetting receipts. While benefit payments for each part of Medicare’ A’, ‘B’, and ‘D’ increased in dollar terms over these years, the share of total benefit payments represented by each part changed. Spending on Part A benefits’ mainly hospital inpatient services’ decreased from 50 percent to 41 percent, spending on Part B benefits ‘mainly physician services and hospital outpatient services’ increased from 39 percent to 46 percent, and spending on Part D prescription drug benefits increased from 11 percent to 13 per cent.” (Cubanski, J. F. 2019, August 20).
Cost of Coverage for Medicaid
Everyone who is affected by Medicare is a stakeholder. To break it down into main categories, first, the public at large, represented by the patient’s family and friends. The next group are Health insurance companies, followed by Hospitals and other healthcare providers and pharmaceutical companies. Government officials – Republicans and Democrats have different views on Medicare. On the other hand, the Democratic party wants to expand healthcare for all. The Biden Administration proposes a law to expand Medicare for all. On the other hand, the Republican party feels that Medicare is socialism and takes too much of the National budget. Other stakeholders who opposed Medicare in the past are Insurance companies who feel the government is overreaching. An example of a specific stakeholder who is against Medicare and reinforces the republican argument. As Health insurance industry executives gathered, CMS administrator Seema Verma made her point on various Democratic coverage proposals writing them off as ‘socialized medicine’ Verma continued with the administration’s ‘socialized medicine’ focus in September at a gathering of America’s Health Insurance Plans, offering the following criticism of the Medicare expansion proposals:
“Converting voters Lauren Crawford Shaver, executive director of the Partnership for America’s Health Care Future, a coalition of physician, hospital, insurance and drug company advocates, said its polling indicates building the current system garners greater voter support,” (Daly, R. 2019). Criticizers believe that this will do nothing but increase taxes and minimize innovation, as US healthcare executives do not want to follow a cookie-cutter model they believe other countries have tried without considering all unintended consequences.
References
Callaghan, T. & Jacobs, L. R. (2016). Interest Group Conflict Over Medicaid Expansion: The Surprising Impact of Public Advocates. American journal of public health. https://doi.org/10.2105/AJPH.2015.302943
Cubanski, J. F. (2019, August 20). The facts on Medicare spending and financing. KFF https://www.kff.org/medicare/issue-brief/the-facts-on-medicare-spending-and-financing/
Dalen, J. E. (2015). Why do so many Americans oppose the Affordable Care Act?. The American journal of medicine, https://doi.org/10.1016/j.amjmed.2015.01.032
Daly, R. (2019). Opponents of Medicare expansion should focus on pitfalls of proposals. Healthcare Financial Management. https://www.proquest.com/trade-journals/opponents-medicare-expansion-should-focus-on/docview/2310221032/se-2
George, E. (2022, July 5). Cost of HIPAA compliance: HIPAA certification cost. Sybrid MD. https://sybridmd.com/blogs/hipaa/what-are-the-costs-of-hipaa-compliance-and-implementation/
Hoffman, ED Jr. (2000). Overview of the Medicare and Medicaid Programs. Health Care Financ Rev. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194683/
Jost, T. S. (2018, August 30). The Affordable Care Act under the Trump administration. Commonwealth Fund. https://www.commonwealthfund.org/blog/2018/affordable-care-act-under-trump-administration
Davis, K. (2009, December 21). The costs of failure: Economic consequences of failure to enact Nixon, Carter, and Clinton Health Reforms. Commonwealth Fund. Retrieved from https://www.commonwealthfund.org/blog/2009/costs-failure-economic-consequences-failure-enact-nixon-carter-and-clinton-health-reforms
Khan, S. (2016, July 14). History of the Republican Party | American Civics | US Government and Civics | Khan Academy. https://www.youtube.com/watch?v=7T7PxQMLTt8
Macy, J. (1900). Political Parties in the United States, 1846-1861. United Kingdom: Macmillan.
Patel, K. & Rushefsky, M. E. (2020). Healthcare Politics and Policy in America, 5th Edition. Amazon Books. https://www.amazon.com/Healthcare-Politics-Policy-America-Patel/dp/0367027747
Raths, D. (2019). Stakeholders divided over ideas to update Hipaa Privacy Rule. https://www.hcinnovationgroup.com/cybersecurity/hipaa/article/21068348/stakeholders-divided-over-ideas-to-update-hipaa-privacy-rule