A brief history of Medicare and Medicaid

Medicare Medicaid
A brief history of Medicaid and Medicare
The idea of a national health insurance plan gained political momentum in the first part of the 20th C. President T. Roosevelt was among the pioneers in making the health insurance issue a campaign matter. The Second New Deal crafted by President Roosevelt involved including the Social Security program in the laws (Piatak, 2015). The act tried to reduce the extent to which such factors as poverty, old age, widowhood and children without known fathers were seen as dangers. The New Deal had a chunk of its content expunged by the Supreme Court because they were either seen as unconstitutional or simply not within the jurisdiction of the federal government. Some of the acts such as the National Industrial Recovery Act and the Agricultural Adjustment Act were ordered removed, by the Supreme Court.
The medical insurance scheme that had been drawn by President Roosevelt and his team was also expunged by the Supreme Court. Later, President Truman made attempts to incorporate such a social health scheme in his government programs but also failed. Other efforts include the one in 1915 when the American Association for Labor Administration presented a health insurance bill before the legislatures at state level. The latter effort also failed miserably (Piatak, 2015). Nevertheless, in 1965, The Social Security Amendment Bill was passed under President Lyndon Johnson. The bill was passed in both the House and the Senate with 307 and 70 votes respectively. The Act of 1965 had two parts: which were later named Medicaid and Medicare (Piatak, 2015). Johnson was modest at the signing of the Act by crediting former President Truman for initiating the process.
Populations that they are intended to serve
President Lyndon Johnson finally signed into law the Medicaid and Medicare implementation bill on 30th July 1965. Early in the day, the Medicare segment constituted Part A for hospital insurance and Part B for medical care insurance. Both parts came to be what is called the Original Medicare. They are used to assist Americans with footing healthcare costs. Over the years, the Congress has been reviewing and changing the plan so as to make it accessible to more Americans. Medicare extended its coverage in 1972 to include disabled people, the terminally ill renal disease patients and all elderly people at 65 years and above (Piatak, 2015).

Medicaid has made many significant steps over the time in helping American citizens in need of healthcare. At first, the program only focused on people with financial help. It has evolved to; now, include people with disability, low income, pregnant women, and those that require long term care. In 1997, the Children’s Health Insurance Plan was instituted. The program offered preventive health care about to 11 million children who were uninsured. All the 50 states plus the District of Columbia and its territories provide CHIP health plans.
The MMA Act of 2003 was the most revolutionary change in the Medicare program in almost four decades. Health plans in the private sector approved by Medicare were referred to as the Medicare Advantage, or Part C Medicare. Medicare part D was added to the MMA. It was an optional benefit for prescription drugs. The ACA came into place in 2010(Salmond & Echevarria, 2017). The plan enacted the Health Insurance Marketplace. It was a one stop shop for all consumers apply and enroll in private insurance plans across spectrum.

States that have expanded Medicaid
I hail from the state of Virginia which continues to expand Medicaid so that more people can access it. Terry McAuliffe (D), the former governor, was instrumental in the expansion of Medicaid in Virginia. However, in 2014, June, the legislature failed to include the expansion program in its budget (Advisory Board, 2018). Nevertheless, some law makers later stopped opposing the expansion of the Medicaid plan in the state following a huge influx of Democrats in the mid-term elections of 2017. They won the mansion of the governor and accepted to include a Medicaid work provision for work requirement. A state budget bill was passed by the state legislature on May 31st. It expanded the plan to include up to 400, 000 residents with low income. The act instructs the officials to apply for a waiver by the federal government to volunteer or impose work on some beneficiaries who do not have disabilities and also impose premiums on some beneficiaries (Advisory Board, 2018). On 7th June, the bill was signed to become law. The Medicaid expansion of the state is set to start on 1st of 2019.
Reasons why states Opt not to take part in expansion of Medicaid
The prevailing Medicare plans limit or even deny patients to quality care.
Some physicians decline patients on Medicaid because the compensation is too low. Consequently, surveys have indicated that many patients on Medicaid have shown unsatisfactory outcomes after undergoing major surgeries. They have also shown a higher mortality rate for children, and are often into emergency rooms more than uninsured people do. The Medicaid program plays truant to the fact that accessing a government health care insurance is not a guarantee to quality health care (Salmond & Echevarria, 2017).
Embracing Medicaid without reforming it is also embracing the same conditions that have let down tax payers and patients
It is argued that expansion of Medicaid while ignoring reforms is encouraging a failed system. It is also argued that even President Obama admitted in 2009 that Medicaid is broken, when he was signing the Obama care program (Turner & Roy, 2013).
The White House’s approach of using one criterion for solving problems for everybody is an insult to the program integrity adjustments and common sense design tweaks that most state leaders advocate for. For example, the health issues facing people living in a big city like Washington DC would not be similar to the ones that face people residing in sparsely populated locations in rural locations. According to Turner & Roy (2013), the lawmakers at state level should be allowed to make their own custom-made solutions that serve the needs of their unique populations.
Expanding Medicaid could lead to an increase in the cost health care
Many healthcare providers and hospitals change their cost of handling Medicaid patients to the ones holding private health insurance. The reason for such a move is that Medicaid pays healthcare facilities less money per patient compared to what private health insurance companies pay. The long and short is that many facilities make losses handling Medicaid patients. In order to survive, healthcare facilities charge private insurance plans higher rates. Consequently, expanding Medicaid as it is, is likely to compromise healthcare service by making it more expensive.
Role as an Advanced Practice Registered Nurse when interfacing with Medicare and/or Medicaid recipients
Working as an Advanced Practice nurse, I would practice following the full mandate that my education as a healthcare professional allows me. Indeed, patients are innocents that deserve equal treatment in healthcare facilities. Their treatment should not be anchored on the convenience of healthcare professionals. It is important to push for reform in the healthcare sector if we are to achieve quality healthcare across the board. Healthcare transformation means that the role of healthcare professionals will have to be reprogrammed (Kershaw, 2011). I will start new programs and incorporate initiatives that are already in place, aiming at enhancing quality healthcare, value and access. Nurses are key players that must actively engage and embrace positive change, if transformation of the healthcare sector is to be achieved. They are central in the provision of high quality and healthy patient environment.
References
Advisory Board. (2018). Where the states stand on Medicaid expansion. Retrieved from https://www.advisory.com/daily-briefing/resources/primers/medicaidmap
Kershaw, B. (2011). The Future of Nursing – Leading Change, Advancing HealthThe Future of Nursing – Leading Change, Advancing Health. Nursing Standard, 26(7), 31-31.
Piatak, J. S. (2015). Understanding the Implementation of Medicaid and Medicare: Social Construction and Historical Context. Administration & Society, 49(8), 1165-1190.
Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing. Orthopaedic Nursing, 36(1), 12-25.
Turner, G., & Roy, A. (2013). Why States Should Not Expand Medicaid. Retrieved from https://galen.org/2013/why-states-should-not-expand-medicaid/