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Changes to Medicare

In 1965, the U.S. created Medicare for the sake of the senior citizens and also patients. It was meant to make the access to prescription drugs easy and to lower their costs. However, over the time, new and expensive drugs have been introduced in the industry. This has perpetually led to the deviation from the initial purpose for which Medicare was created. As a result, it was necessary for the legislators to entrench some of the initial aspirations of Medicare. This was done through the Medicare Modernization Act (MMA) which was signed by President Bush on December 8, 2003.


Main Provisions and whether they accomplish the Desired Goals

The provisions of the MMA are myriad. The first one was to entrench the issue of entitlement to Medicare for the senior citizens. It considers every citizen as having the right to healthcare. Secondly, it encourages large employers to partner with private health insurance companies. It does so by providing subsidies to such organizations. The other provision seeks to allow patients choose their insurers without the coercion of the federal government. In other words, it allows them to choose private insurers as opposed to the traditional Medicare. The MMA also deals with issues of financing of the drug benefit. It provides that the Federal government should not negotiate discounts with pharmaceutical companies. By closely scrutinizing the goals of Medicare, it could be said that it seeks to achieve holistic health benefits for retired workers and ordinary patients. However, the 1965 version adopted different approaches to pursue these goals. The aim of the 2003 MMA was to bring some changes in the way Medicare was to be delivered. Therefore, the desired goals are accomplished.

Those Involved and their Interests

Although the 1965 Medicare policy had been in existence for 38 years, there had not been explicit efforts to change it. If such moves were there, it appears they were not very revolutionary like the 2003 changes. Regarding the latter, several players were involved. To begin with, the legislators took a leading role in initiating, lobbying and voting for the policy change. However, the margin was very minimal. According to Morone, Litman and Robins (2008), the Bush administration, during the campaigns, had promised to change the Medicare system. Therefore, the Republicans were very involved in the passage of the Act. However, since the Republicans were not the majority in the Congress, there was a need to get other parties involved in the lobbying process. Specifically, Senator Ted Kennedy was predominantly influential in lobbying for the Republicans.

Although the policy ramifications were geared towards helping the Americans, there were vested interests in its initiation. There is no doubt that the private sector played a role in pushing for this policy change. According to Barr, the policy change would see the private insurers and health businesses benefit a lot. This is because under tier 2, Medicare was to pay 75% of the patient’s expenses between $250 and $ 2,250. This means that if the private insurers managed to get many Americans subscribe to their policies, they would benefit a great deal. Morone, Litman and Robins observe that in the history of Medicare, private plan enrollment hit 8.3 million in 2007.

Why it was Controversial: Supporters and Detractors

The proposed policy changes initiated immense controversy especially along party lines. However, a small number of Republicans did not endorse the idea. They cited that the plan would be too expensive for the Medicare to fund. This controversy appears to have been genuine for the detractors. According to Moon under the new law, federal spending would increase to $395 through 2013. The drug benefit was to increase to $410 in ten years but later projections revealed that the total spending would hit $534 billion. The second controversy was that the traditional beneficiaries of Medicare would be put at a disadvantage. This was chiefly because the traditional Medicare would not provide adequate drugs for the expanding needs as contained in the new policy. As a result, it was controversial for federal-affiliated health institutions to let go financial gains previously in their domain. The other controversy was whether it was justified to shift the risks on health matters from the government to the citizen. Once again, this was based on the private plans to offer better packages in health insurance than the traditional Medicare. In other words, the supporters of the new plan were aligned to the traditional care will the detractors were aligned to the private plan. Most supporters were Republicans while most detractors were the Democrats.

Who will benefit?

The policy changes were to benefit all the citizens of America. Moreover, there was an emphasis on the need to make healthcare affordable and more accessible to the retired and senior citizens. To achieve affordability, Medicare was to fund 75% of health expenses above $250 per year. To achieve more accessibility, the private organizations of healthcare were to be involved.

Electronic Storage and the Decision

Some of the provisions of the new law would see an adoption of electronic storage of patients’ information. This may have led to the adoption of the new policy. According to Campbell and Morgan (2005), with the increased use of internet and electronic data, healthcare practitioners will be able to make decisions faster than it would have been prior to the adoption of the new.

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