Suggestions on Medicare and Medicaid

Discussion 1

There are multiple health care lobbyist groups that operate within the nation. To a large extent, the said groups seek to engage in advocacy efforts so as to collectively or individually influence decision-making or policy. Some of the health care lobbyist groups that will be taken into consideration in this text are; Pharmaceutical Research & Manufacturers of America, American Medical Association, and the American Physical Therapy Association. It would be prudent to note that to a large extent, the lobbyists selected above are both good and bad for healthcare. To begin with, they are good for healthcare in the sense that they support the professional advancement of their members. For instance, the American Medical Association is actively involved in the advancement of public health via directed efforts to do away with obstacles that impede the delivery of competent patient care (American Medical Association, 2021). However, in some instances – as will be highlighted elsewhere in this discussion, in seeking to advance the interests of members, some healthcare lobbyist groups could get in the way of the general health and wellbeing of patients.

When it comes to Pharmaceutical Research & Manufacturers of America (PhRMA), this particular lobby group concerns itself with the advancement of the interests of enterprises operating in the U.S. pharmaceutical industry. Through the lobbying efforts of PhRMA, I am likely to continue paying more for drugs that would have perhaps been cheaper. Indeed, as Anderson (2020) points out, in the year 2019, failure by Congress to pass any legislation having a beneficial impact on the prices of drugs could be attributed to the lobbying activities of PhRMA. On the other hand, when it comes to the American Medical Association I, and fellow citizens, are likely to continue lacking access to universal coverage due to dedicated efforts by AMA to block progress in this realm – as Michels, Cox, Siddula, and Tai (2019) observe. I am, however, likely to access better quality of care due to the lobbying efforts of the American Physical Therapy Association, which has been at the forefront in lobbying Federal agencies and Congress to put in place measures to improve access to physical therapist services.

Discussion 2

The health of a population has a huge impact on the economy. As a matter of fact, studies conducted in the past have demonstrated that “improvements in health can lead to an increase in Gross Domestic Product (GDP) and vice versa” (Rughupathi and Rughupathi, 2020, p. 37). It therefore follows that to a large extent, health of a population has a positive impact on GDP. This could be attributed to decreased absenteeism rates, decreased production as a consequence of worker illness, etc. It also means that a nation deploys more on developmental undertakings, as opposed to healthcare costs. It therefore follows that to ensure that the economy is not impacted negatively, there is need for the government to ensure that policies are put in place to secure the health and wellbeing of its citizens. This could be accomplished via public education on strategies for improved health/wellbeing, as well as embrace of universal coverage.

In basic terms, Medicare and Medicaid are instrumental in efforts to cover most of the healthcare costs of citizens. For instance, thanks to Medicaid, enrollees whose income happens to be low can gain access to rates that are more or less like the ones that those with private coverage access. It would, however, be prudent to note that Medicare and Medicaid have been criticized in some quarters. For instance, when it comes to Medicare, Rasmussen (2021) is categorical that Medicare Advantage plans could limit not only the choice, but also the location of providers.

When it comes to Medicaid, the U.S. Department of Health and Human Services (2021) points out that “in all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities.” It is also important to note that from a general perspective, those wishing to receive Medicaid in a certain state ought to be the said state’s residents. In addition, they should also be U.S. citizens or be in possession of a permanent resident status. With regard to Medicare, the U.S. Department of Health and Human Services (2021) observes that this happens to target persons aged “65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).”

Discussion 3

It would be prudent to note, from the onset, that the U.S. spends significantly more dollars on health than other developed countries like Germany, Great Britain, and Canada. However, in terms of performance, the country does not achieve results comparable to those of the countries mentioned. This is more so the case given that of the 11 OECD countries, the U.S. happens to have not only the highest rates of suicide, but also the lowest life expectancy (Tikkanen and Abrams, 2020). As a matter of fact, in the words of Tikkanen and Abrams (2020), the “U.S. has the highest chronic disease burden and an obesity rate that is two times higher than the OECD average.” All these are indicators of inherent lack, or poor implementation of the relevant health promotion programs.

In my own opinion, the present Medicare plan is not solvent, comprehensive, or responsive enough to be able to adequately address the demands of the country’s aging population. This is more so the case owing to the burgeoning costs of the program, which could in the near future end up compromising the nation’s fiscal wellbeing. I would, thus, propose changes that are meant to cut costs on this front. This would likely call for adjustments in the payment as well as benefit structures. These suggestions have been made on the strength of the declaration by Feyman (2017) that failure to reign in cost growth will likely ground the program in the near future, or compromise other equally meaningful government undertakings by eating into their share of the tax revenue.