Proper health care can be achieved when there are enough finances to support the costly diagnostic tests and processes, and lengthy stays for inpatients. Insurance is one of the healthcare system service components that protect individuals against dangerous risks when needing costly health care services. Insurance covers in this context determine the extent to which the insured person can receive health services, it also outlines how and where the health services will be received. Consequently, the insurance company is entitled to manage the payment of funds to the institutions that provide health care. Health insurance can be categorized as Medicare or Medicaid. Medicare is a centralized health insurance program for older people and some young people who are disabled. This is a module of Social Security program that enrolls anybody eligible for the benefits realized through the program. On the other hand, Medicaid is an insurance program that covers low-income people, and sometimes seriously sick or disabled individuals (Williams, 2007).
Medicare is the diagnosis and prevention of ailments and is normally done by medical practitioners. Medicare systems are intended to meet the medical needs of the population. The objectives of Medicare systems according to Centers for Medicare & Medicaid Services (2007), they include promoting good health, responding to the hopes of the society, and monetary donations.
Medicare services have evolved in regards to the changing needs of the society and the need for healthcare reform. Political parties have influenced the structure of Medicare services by providing policies that are deemed to cater for the uninsured citizens. The government ensures that people are catered for by medical providers in the health care systems. Medicare providers are individuals who have the expertise in Medicare and they work for government agencies and non governmental organizations and private practitioners. They are namely dentists, paramedics, nurses, doctors, laboratory technicians, professional therapists, psychologists and pharmacists. There are five methods of supporting Medicare systems and they include: social Medicare insurance; taxations to the state, county, and municipality; direct expenditure; voluntary or private Medicare insurance; and contributions or community medical insurance.
Health care reforms have been implemented to ensure that there is proper health care for both the insured and the uninsured people. Reforms constituted by the legislative bodies, the judiciary, interest groups, health providers, and the media have changed how Medicare and Medicaid are viewed. Medicare insurance is considered as a type of insurance that pays for medical operating costs. It entails the premiums that are paid to insure against disability and long term Medicare. They are normally facilitated by privately owned insurance agencies or by community cover programs. The insurance products are bought by corporate organizations or by individuals to shield them from expensive medical costs. After all the Medicare costs have been calculated, a regular model of funding is established to ensure there are sufficient funds to cater for Medicare settlement as indicated in the accord.
The benefits are manned by a government agency or by a non governmental organization or by a private entity that is doing so to make proceeds. In most cases social cover programs regulate their costs by employing the negotiating influence of their community programs to regulate the cost of Medicare delivery system. For instance buying drugs and medical equipments directly from manufacturers reduces the cost of these prices by a great margin.
There are several ways of paying for services offered by Medicare agencies. They include money for service basis which are commonly used by professionals who provide ambulance services and capitation payment systems where the Medicare professionals are paid for every patient they attend. Capitation systems make it possible for donors to regulate the initial cost of Medicare by ensuring that monetary donations are distributed to Medicare practitioners according to the number of patients they have enrolled into their system. This can be dangerous as it may cause Medicare practitioners to enroll patients beyond their capacities and therefore fail to deliver satisfactory services.
In some countries Medicare practitioners are normally paid by the state. This system can be very problematic because the experts lack motivation which is brought by the proceeds if they were to be paid on per-patient basis. This has led to the increase in the number of patients that are referred to private Medicare providers to avoid congestion and short of concentration to the needs of the patients.
Public health deals with combating issues that might put the lives of the general public in danger. In some states the government awards contract to Medicare experts to run public health programs. For instance vaccination programs in some states are offered free of charge and are a must for all citizens and foreigners who reside in those states. Two diseases have gone beyond the knowledge of public health experts and they are namely HIV/AIDs and diabetes. These two have led to deaths of over 171 million people in the whole world (Williams, 2007).
References
Centers for Medicare & Medicaid Services (2007). Overview. Web.
Williams, J. S. (2007). Introduction to Health Services. 7th Ed. Clinton Park, NY: Delmar Thomson Learning.