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Impact of PPACA in Healthcare

One of the very recent additions of the United States law is The Patient Protection and Affordable Care Act (PPACA 2010). The law has been taken into action from 23rd March, 2010, and it focuses mainly on different health-care facilities that the Government is trying to implement over the next four years. The Act reforms the health care system in a complete way. There are many ways of improving the health system from the point of view of the Government. Medicaid and Medicare are two of the very important parts of that initiative.

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Medicare: It is one of the most popular social insurance programs, “Single payer health care system” (FHF 2010), available in the United States. The facility provides health insurance coverage for the population who is over 65 years of age or, in special cases, fills the other criteria mentioned in the scheme. Other than that, it also funds a special doctor’s training program in United States.

Medicaid: The other program in United States that promotes public health is known as Medicaid. It is designed for the low income group families. One of the most important aspects of the program is that it is jointly funded by both the state governments and the federal government. People with certain specified disabilities can also avail the facilities.

Comparison: While Medicare is completely funded by the Federal Government and primarily focuses on the older population, Medicaid is sponsored by both the State Government and the Federal Government. Both of the programs have facilities for people with specific disabilities. Medicaid, in many aspects, is a social welfare program that is completely based on the specific needs. The eligibility of the Medicaid is determined by the income of a person. It a broader perspective, we can say that Medicaid generally covers a larger portion of health care than Medicare (FHF 2010).

Medicare A and B

Medicare has four parts in its conditions. Basically Part A and B were the original part of the program and Part D was introduced later. It can be also said that Medicare Part C is there and it is the process to retrieve all the three Medicare facilities.

Part A of Medicare deals with Hospital Insurances. According to the Medicare there are certain policies that the Hospital stay should fulfill in the case. With the Medicare aid one can stay in a skilled nursing facility for treating any aliment is for a period of 100 days. Also the laws state that in this case Medicaid will completely cover the expenses for the first 20 days and part of payment for the remaining 80 days. If the beneficiary could not get “Skilled Nursing and Care” (PPACA 2010) for 60 days for the first 100 days period, than the period of 100 days will be renegotiated.

Part B of Medicare deals with some services and other important things that can be very important in the case of medical emergency. This is an optional service and if the spouse of the patient is still working than one can not avail the service. It generally covers all the physician and nursing charges, along with all the diagnostic reports, ambulance transport, and all other expensive things like chemotherapy and blood transfusion etc for patient.

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Part D is the plan where a person will be benefited by prescribed drug plans. It is not a standardize plan but rather a person may choose to cover some drugs or even no drugs at all.

On the other hand, Medicaid is the policy to help low assisted individuals for getting quality healthcare. The two types of Medicaid like “Community Medicaid”, which helps those with very little medical insurance or do not have any medical insurance at all. All the states have different laws for the program and so eligibility differs from State to State. Poverty is one of the criteria of the facility, but it is not the only one. Other categories include like age, property, assets, and other income based resources. And another very important aspect is HIV, which takes most of the resources of Medicaid. PPACA will additionally pay $400 million to the hospitals that are qualified for Medicaid facilities. The new inpatient prospective payment system payment will have a 2.4 % market basket for inflation. Though CMS will adjust a negative 2.9% adjustment to make amendments, it will effect on the general people as Medicaid is totally focused on people with low income.

In one hand the PPACA reforms the American Health Care system by expanding the options of health insurance coverage it also directly restructured the health care system of the country. One of the most important facts, statistically saying, with the introduction of the Bill, the number of uninsured American will less by a massive 31 million. It will also leave only 6% of the total adult population uninsured in this case. This is a giant step for an economy or as a whole for a country. The Medicaid facility provides insurance facility to low income parents and children, also to lower and middle income households (PPACA 2010).

Insurance is a variable topic, and in a view we can say every person is underinsured in some way or the other. We have to look in a different light. At first let us discuss about the policy of the insurance makers. Insurance is a financial coverage that helps a person financially in a medical emergency. It should be noted that in our life of stress and tension, everyone in modern society has to have the medical insurance.

However, no one knows for certain about the exact scheme that should be taken up. There is hardly any complete medical insurance coverage that is affordable by all. If the disease is moderate, then the insurance will cover all the expanses, but if it is delicate, then the existing insurance may not cover it. Thus, under such conditions, an individual may be termed as underinsured. Sadly, a good number of insured populations fall in this group of underinsured. As a result, the government needs to be more enterprising and create a better and healthier society (Barr 2009).

References

Barr, D. (2009). Introduction to U.S. Health Policy: The Organization, Financing, and Delivery of Health Care in America. New York: Benjamin Cummings.

FHF. (2010). Hospitals face inpatient Medicare payment cuts in FY 2011. Web.

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PPACA. (2010). Patient Protection and Affordable Care Act of 2009. Web.

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