Provide an overview on the organization, delivery and financing health care services through government programmes.
Explain the function of entitlement programs and how they affect health care demand.
What does it mean?
Discuss the question of dual eligibility between Medicare/Medicaid and cost implications.
Discuss the implications of Medicare/Medicaid/other gov’t.
Your current practice may be covered by sponsored insurance.
Answer to Question: NURS 4234 Issues In Professional Practice
Overview of The Government Programs
Delivery and Organization
Six major government programs are involved in providing healthcare services to nearly a third of Americans.
Medicare, Medicaid, SCHIP are designed for people with severe healthcare needs and poor socioeconomic standing, including elderly people, low income mothers and children, as well as those with disabilities.
Tri-Care, Veterans Health Administration program (VHA), Indian Health Service program program (HIS), serve specific populations, including military personnel and their families as well veterans and Native Americans.Financing
To finance government sponsored health care programs, the government uses tax payers’ money. This includes funding through the budgets for federal, state and local governments.
Medicare and Medicaid were funded respectively by 14% of the federal budget and 8% in 2013.
It also makes it easier to provide healthcare services by offering tax subsidies for health care providers. This allows health services to be more affordable (Barr (2016)).
Their impact on healthcare demand, delivery and eligibility:
These programs serve the purpose of providing healthcare services to all citizens in America who are eligible.
These government-sponsored programs are designed to help reduce the impact of diseases and injuries, as well provide healthcare services to around 100million beneficiaries.
They aid in maintaining and improving the health and functioning the entire population.
This ensures that both patients and healthcare providers benefit from the consistent implementation of quality enhancement strategies and processes in these government-funded insurance policies (Shi, Singh, 2014).
What does it mean?
This means the federal government needs to be a strong leader and help drive the healthcare industry to improve safety and quality.
These programs are a significant expenditure of taxpayer money. There must be accountability for improved healthcare.
Therefore, improvements will be made in the delivery and quality of healthcare for all Americans (Barr 2016).
Issue of Dual Eligibility.
Dual eligible beneficiaries can be people who receive both Medicare, and Medicaid.
For instance, in 2011, 9.2 Americans had been eligible for dual enrollment. This would have required the spending of $319.5 trillion.
Duals represent 14% in the Medicaid enrollment, yet they account for 36%.
Duals are 20% of Medicare enrollees, but they only spend 36%.
They have often poorer health and require greater care than other Medicare and Medicaid beneficiaries.
Because duals are complex individuals with multiple needs, their long-term costs can be high (Austin&Wetle (2016)).
My Current Practice and the Impact of Government Sponsored Insurance
Medicare, Medicaid, as well as other government-supported insurance, have had a positive impact upon my current practice.
They enable me to provide healthcare services for many health consumers who can’t afford it because of their socioeconomic disadvantages.
The government assures that I will receive the best quality and safest care possible.References:Austin, A., &Wetle, V. (2016).
The United States Health Care System. Pearson.Barr, D. A. (2016).
Introduction to US Health Policy – The organization, financing, delivery and management of health care in America.
JHU Press.Shi, L., Singh, D. A. (2014).
Delivering health services in America. Jones &Barlett Learning.