Persuasive Essay On Medicare Advantages And Disadvantages

Medicaid is defined according to our textbook on page 233 as a “federal and state entitlement program that pays for medical assistance for certain individuals and families with low incomes and resources”. Physicians who accept Medicaid have both advantages and disadvantages to do so. Some of the advantages are that they will have a steady flow of patients to see, Advertising that they accept Medicaid usually will not even cost them anything as the state government has a list of physicians on their website that accepts Medicaid, and you are guaranteed to get paid. The disadvantages would be that the state and federal government sets the rate you will be paid based on what the visit is for and it is going to be way below what a patient with either no insurance or private insurance is most likely going to pay for the same service. So if a physician would have
to see twice as many Medicaid patients as he/she would have to see if they were private pay or had private insurance. Another big disadvantage for the physician and in turn even the patient is that the government determines the treatment the patient can and cannot receive. This puts limits on the physician in a lot of instances to provide the best care possible for their patients.
Medicare is according to the textbook on page 217, designated “health insurance for the aged and disabled”.
It was established in 1965 as a health insurance program to complement retirement and/or their survivors and those that are disabled. Medicare consists of Parts A, B, C, and D. Part A is hospital insurance, Part B is medical insurance, and Part D is prescription drug coverage and Part C is actually is where private medical insurance companies can offer Medicare. As with Medicaid if a physician’s accepts Medicare they will have a steady flow of patients especially since the elderly population is growing and expected to continue to grow and they are guaranteed to be paid. But a big disadvantage with Medicare is the physician is limited as to the scope of treatment they can give to their patients. Medicare has a “chart” that determines what can and cannot be prescribed for any given illness the patient may have. They also have a set number of days for hospital stays for each illness, disease process or surgery. So this can limit the physician in providing the best possible care to their
patients.
The only experience I have with Medicaid is from my time of working in the hospitals. When I worked at Arkansas Children’s Hospital a huge number of our patients were Medicaid. I can remember in my early years of nursing it was not uncommon at all to see a parent bring their child into the ER for very minor things such as a running nose. Medicaid would pay the high hospital with no questions asked. Over time and as things inevitably change, Medicaid would no longer allow physicians to treat children in the ER for such minor illnesses. As far as Medicare goes my experience has been with my aging parents. Overtime my parents premiums have gone up and the amount and quality of care they are able to get has gone down. For example my dad was able to get an EGD done yearly when he was first on Medicare to monitor health concerns his doctor has but now Medicare has limited it to every 3 years. So this hinders not only my dad but his physician from giving him good quality care for this condition. I also know that I have heard more and more physicians complain about how with the Affordable Health Care Act and the subsequent changes in Medicare and Medicaid as a result has them very frustrated.
Longest, B. (2010). Health and Health Policy. In Health policymaking in the United States (5th ed.). Chicago: Health Administration Press.