It is generally accepted standard when each house is filled by happiness, love, and calmness. Poverty, lack of money even for food, clothes - this is sometimes the other side of real life. For such families American government has created a Medicaid program, which is aimed to cover some medical costs of low-income elderly and disabled people. It serves to nearly 60 million of individuals, and is considered to be the largest social health program. But people have to prove that their financial situation is really bad, if they want to use services of Medicaid. According to this program, a patient has the right for the following services: in-patient care and out-patient treatment, medical consultations, nursing home, laboratory diagnostics and roentgenological methods of investigation. As it is widely known, Medicaid is financed by federal government and by States with the help of special formula, which is called federal medical assistance percentage (FMAP). By means of FMAP it is calculated the share of payments from each side.
“The FMAP formula is criticized for not adequately reflecting the excess burdens placed on states with high concentrations of poor persons, and for not being sufficiently responsive to current state economic conditions. As a result, many argue that the FMAP formula leaves states vulnerable to funding shortfalls at exactly the wrong time — when economic conditions create the greatest need for public services like Medicaid.” (National Health Policy Forum, 2)
Budget of the country sometimes is not able to cover all expenses because nowadays costs on this program are growing. The quantity of elderly people who are really in need of this program is increasing. Eventually costs are growing and government even has an intension to cancel it, not taking into account citizens’ opinion. But qualified medical treatment is rather expensive. To remain without money and have no ability to cure oneself or beloved people, - for any person such situation would be unacceptable and, with various restrictions, it becomes practically impossible to get out of this financial collapse. If one of the relatives seriously gets ill sometimes, family members have no ability to cover all expenses.
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The fact that government takes part in cure and medical services payments from financial point of view is rather costly, because with each passing year, the amount of necessities grows, but in the same time, the health of the whole nation depends on the health of each citizen. There is a way to increase taxation, it will help, but not for long, because everybody will suffer even those, who have high annual income.
Both state and federal governments are interested in Medicaid and in the way of coverage and costs will be managed. Medicaid program is not strictly controlled, even when economy is performing badly.
In times of budget shortfalls FMAP gives an opportunity to plan expenses. Some limitations in formula can make the share of states larger. But will it help?
“Here are for example, some ideas that have been discussed during the Commission’s public meetings, including proposals to split Medicaid into different programs for acute care, chronic conditions, and prevention; to convert the program into a block grant; to create a tax to raise revenue for subsidies to help purchase long-term care; to mandate all people to purchase private long-term care insurance; and to devise ways to enroll young men in the program.” (Covering health issues, 80)
The first proposition may sound reasonable, but people need help permanently and if attention is focused only on hot situations, it will not be effective method. For the second it may be said that block grant is not a bad idea and it is not expensive, but if treatment costs more, there will be lack of money. For the third, I disagree totally, because the taxes are already rather high and to raise them will be unacceptable for common people. To purchase private long-term care insurance is a good idea, but only for people who earn enough money; of course, this kind of alternative may economize federal costs, but will not reduce the quantity of people who depend on this program. Moreover, Medicaid is considered to be a social program for poor population of country, but it won’t be social, if people will buy insurance by themselves.
As Medicaid is rather expensive for federal budget, authorities search for ways to make the program as effective as possible. It is also important to remember that costs for Medicaid will grow permanently because of big amount of elderly people under this program and they of course need a long-term treatment.
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The most obvious decision for government is to make Medicaid costs more reasonable, it concerns to services, or payments to service providers. Each of these options has its drawbacks.
- Cutting of payments for service providers can make an opposite effect and shift prices for services.
- Higher costs to sicker patients can be a result of created tight restrictions on services such as prescription drugs including expensive hospital or nursing home care.
- Freezing or reducing provider payments could result in fewer providers participating in the program, making it difficult to ensure that patients receive needed care. (Martha King, 10)
To remain without money and have no ability to cure oneself or beloved people, for any person such situation would be unacceptable and, with various restrictions, it becomes practically impossible to get out of this financial collapse. And if one of the relatives seriously gets ill, sometimes, one have no ability to cover all expenses.
The fact that government takes part in cure and medical services payments from financial point of view is rather costly, because with each passing year the amount of necessities grows. Of course government can apply some methods to reduce costs, they are the following:
- Economize on long-term care and use it only for infirms.
- Another way is to cut the period of treatment if person got well quicker, than it was planned by doctors.
- Reduce prescription drug costs and choose cheaper drugs.
- Investigate fraud and abuse, because many hospitals rise prices to get more money.
- Electronic billing and payments usage will help to control all the expenses.
Overall, all these methods will not protect people from illness or decrease it. Therefore, government has to do all the best to preserve the health of citizens. The number of people without health coverage in the U.S. grows very fast. That is why government struggles for balance in social health care programs and improving the quality of treatment. People’s health is the biggest value that has to be preserved in any way. That is why I think that government has to increase percentage of payments to the Medicaid program. In any way, nobody is able to predict what will be tomorrow. Medicaid is not only a program,- it is a way to rescue beloved people. Sometimes the government does not think about poor population of the country, but it has to, because the issues of poverty and bad health are widespread not only in the USA, but all over the world. The expenses on the program sometimes can seem enormous, but they are so necessary for people. Thus, it is out of the question to eliminate Medicaid from the social programs. As Medicaid is rather expensive for federal budget, politicians try to seek ways to make the program as effective as possible. If those ways are useful, budget will be rescued and people will be saved and satisfied.
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