Access to healthcare is one of the pillars of social justice. Although governments recognize its importance, a good number of them are still unable to ensure equitable access to healthcare for all their citizens. Sometimes it is a matter of resources being unavailable, but more often than not, it is a matter of policy shortcomings.
A good illustration of this is a comparison of the US system to that of Sweden. The US spends 16% of its Gross Domestic Product (GDP) on healthcare while the Swedes spend 9% (VE, 2010). A basic interpretation of the figures implies that the US citizens spend almost twice as much as their Swedish counterparts on healthcare. Logically then, it is expected that the US healthcare would be superior compared to that of Sweden.
That is not the case however, because on many healthcare indicators such as mortality rate, life expectancy and Magnetic resonance Imaging (MRI) machines per million people, the Swedes are ahead of Americans (VE, 2010).
These figures are an indication of the inadequacies of the current healthcare system. United States of America remains one of the few developed countries in the world that is without a universal healthcare system. Healthcare coverage in the country can be classified as follows
Medicare: – This is coverage provided by the government for those members of the population over the age of 65 and the disabled.
Employer-funded: – This is a contributory scheme for those in employment. The insurance is funded by premiums contributed by the employer although at times the employee may be required to make some payments as well.
Medicaid: – This is a government sponsored program that covers low income individuals and families that are eligible.
Military veterans: – Military veterans, subject to meeting certain conditions are eligible to healthcare coverage that is paid for proportionately by the government.
Children’s insurance program: – This Program covers children from families whose incomes do not qualify for the Medicaid program.
Uninsured: – This is the group that has no access to any medical insurance cover. They are however entitled to emergency medical care. Sometimes referred to as indigents.
The groupings above are a summary of how medical care is accessed in the US, but there may be variants within them. There are reforms that are now being spearheaded and one group that has been target by the fear mongers is the group covering the elderly citizens.
Indeed, the consensus is that healthcare needs reforms, and Medicare is one of them. It will undergo reforms with some of its components’ expenditures being reduced. However, this should not worry the older members of the population. Ultimately, the reforms will bring more advantages to them. Accordingly, this paper contends that implementing the new healthcare reform law will help the elderly people in the United States in the long run from a legal perspective.
Structure of the Medicare
This program is administered by Centers for Medicare and Medicaid Services (CMS), which is a federal agency created within the United States Department of human and health services. In administering the program, the agency enlists the services of private insurance companies also referred to as fiscal intermediaries.
Private insurance companies act as the intermediaries because they contract with the individuals and in turn get their funds from the agency. The scheme is divided in to three components.
Part A covers the necessary costs related to hospice, psychiatric hospital, nursing or home care. A second part under the plan is part B. This part covers costs related to physician-related care, necessary diagnostics and many other services that are out of part A’s scope (Findlaw, 2009).
There is a third section also known as part C or Medicare advantage. Under this plan, the program’s beneficiaries are allowed to use private insurance companies to receive their medical benefits. It is so designed so as to have extra benefits in comparison with the plan A or B. Of course, Medicare operation is much more complex than it has been described so far, but it nevertheless offers one a clue of how the schemes operates.
With the passage of the healthcare bill, the Medicare program is bound to undergo considerable reforms. Funding to some sections will be reduced or eliminated altogether, while some new areas will introduced or merged.
It is worth noting that the plan has undergone continuous changes since its introduction in the mid 1960s and the changes visited upon it by the healthcare reform bill, although radical, can be considered to be part of the long running changes on it. Of importance is that each of the changes must take in to consideration equity and prevailing economic modalities.
This is one of the hotspots that have been used to convince the elderly that their benefits are being reduced by the government by way of cutting funding to their healthcare plan. To be sure, there will be an aggregate reduction in the cost of benefits available under the Medicare scheme.
The reduction is not particular to the Medicare program. Skewed apportioning of resources has led to the country having one of the least desirable healthcare systems in the developed world. For a correction to be realized there has to be a redistribution of the resources so that at the end of the day more people can be brought on board and the scope of basic health services redefined to increase the general wellness of the population.
That way, more people will have access to healthcare thus improving indicators such as infant mortality and life expectancy. In that regard, some of the services available under the Medicare plan will be reduced while others will receive more funding.
The changes have been spread over ten years to give the stakeholders in the sector time to readjust to the changes. According to (Berenson, 2010), there was a suggestion that over 30% of Medicare spending went to waste due to inefficiencies found in the operations of some of the providers. This figure may not be authoritative, but it nevertheless provides a justification for wide ranging reforms.
The underlying contention on inefficiencies is the difference in costs that patients incur when they visit different providers. Although allowable, some of the differences suggest inefficiency.