NURS 4234 Issues In Professional Practice
Question:
Answer:
Government Supported Healthcare
Overview of the government programs.
Organization and Delivery
There are six major government programs that invest in the provision of healthcare services to approximately one third of Americans. Medicare, Medicaid and SCHIP are intended for people who have major healthcare needs and poor socioeconomic status including elderly persons, low-income mothers and children as well as people with disabilities. The other three including Tri-Care, the Veterans Health Administration program (VHA) and the Indian Health Service program (HIS) serve specific populations with a particular relationship with the government such as military personnel and their families, veterans as well as Native Americans respectively (Barr,2016).
Financing
The government uses tax payers’ money to finance government sponsored health programs through the federal, state and local governments’ budgets. In 2013 for instance, Medicare and Medicaid was financed by 14% and 8% respectively of the federal budget. It also facilitates provision of healthcare services by offering tax subsidies to health care providers so that health services can be more affordable (Barr, 2016).
Their role as entitlement programs and effect on healthcare demand and delivery
The role of these programs is to deliver health care services to all American citizens who are eligible. These government-sponsored programs help to reduce the burden of diseases, injuries and providing healthcare services to about 100million beneficiaries. They assist in improving and maintaining the health and functioning of the general population. As a result, both healthcare providers and patients benefit from the high consistency of quality enhancement requirements, strategies and processes across these government-supported insurance programs (Shi and Singh, 2014).
What does this mean?
This means that the federal government ought to take a strong leadership position and drive the healthcare sector in order to improve the quality and safety of healthcare services. A lot of taxpayers’ money is spent on these programs and there needs to be accountability seen in improved healthcare. Consequently, there will be improvements in delivery of safe and quality healthcare to not only the estimated 100million beneficiaries, but to all Americans (Barr, 2016).
Issue of dual eligibility and cost implications.
Dual eligible beneficiaries are persons who benefit from both Medicare and Medicaid. In 2011 for instance, 9.2 Americans were eligible for dual enrollment calling for the spending of approximately $319.5 billion. Duals comprise of 14% of the Medicaid enrollment but spend around 36% of Medicaid expenditures. Likewise, duals make up 20% of Medicare enrollment, yet they spend 36% of the Medicare finances. They are often in poorer health conditions and need more care as opposed to other Medicare and Medicaid beneficiaries. Additionally, the cost for long-term care for duals is high because they are a complex group with complicated sets of needs (Austin&Wetle, 2016).
Impact of government sponsored insurance on my current practice
Medicare, Medicaid and other government-supported insurance have a positive impact on my current practice. First, they enable me to provide healthcare services to a wide base of health consumers who cannot afford to access healthcare due to socioeconomic constraints. Also, it enables me to focus on delivering safe and quality care to beneficiaries instead of prioritizing payment methods since the government makes assured payments on their behalf.
References:
Austin, A., &Wetle, V. (2016). The United States Health Care System. Pearson.
Barr, D. A. (2016). Introduction to US Health Policy: the organization, financing and delivery of health care in America. JHU Press.
Shi, L., Singh, D. A. (2014). Delivering health care in America. Jones &Barlett Learning.
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