2003 MEDICARE LEGISLATION
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Executive Summary
The Medicare program is a comprehensive scheme managed by the federal government with the aim of offering quality and affordable healthcare to all American nationals regardless of one’s age, race, income level, or political link. One of the major sub segments in this project is Medicare Part D. This sub section resulted from the endorsement of the Medicare Prescription Drug, Improvement and Modernization Act by Congress in 2003. However, its implementation commenced three years later.
The main program governed by this guiding principle is the Prescription Drug Plan. Based on the main principles of this medical system, the centralized government of the United States works closely with other relevant stakeholders such as pharmaceutical corporations and private insurance companies in order to execute the stipulations of this act. The main benefit of this program is the issuance of flexible prescription drugs coverage to senior citizens above sixty-five years or disabled nationals. Moreover, the aged citizens in the low-income category benefit from subsidies offered by the federal administration.
The execution
of the Prescription Drug Plan concurs with the short-term and long-term goals
indicated in the policy. These objectives include establishment of appropriate
structures as well as identification of skilled human resource as a way of
easing the completion procedure. Moreover, the program has attained success
with reference to the goal of enhancing communication among stakeholders as
well as increasing the number of benefactors. Other objectives, which are yet
to realize full accomplishments, include monitoring of the utilization of
prescription drugs among the beneficiaries and increasing the enrollers through
further reduction of medical charges.
Introduction
There are several policies enacted by the legislative arm of government with the aim of improving the physical condition of the general population. One of these public laws is the Medicare Prescription Drug, Improvement and Modernization Act. Congress endorsed the policy in 2003 as a way of improving the existing legal provisions in the national health sub sector. This occurred because of the several loopholes present in the preceding medical programs with reference to public access to drugs. For this reason, this act has been benefiting a large portion of the general populace. It not only caters fro the medical needs of the elderly nationals but it also considers the plight of the family members taking care of these senior citizens.
The accomplishment of the objectives encompassed in this set of laws relates to tariff reductions on prescription drugs. Most of the beneficiaries of this program are senior citizens of the United States since a large percentage of members in this age bracket suffer from various ailments that are costly to treat. Moreover, their retirement benefit package is not enough to cater for the cost of quality remedies. These subsidies offered by the federal government are available through private health facilities and insurance corporations. The programs controlled by this act aims to accomplish the federal responsibility of facilitating quality healthcare to all citizens regardless of their race, income level, or political affiliation.
Paper Analysis
The Medicare program advanced from the Social Security Act of 1935. The Congress has been endorsing various policies and legal improvements with the intent of assisting the elderly in the American community (United States 2003, 34). The purpose of the constant amendments was to address various social issues affecting the wellbeing of the general populace. The initial legal stipulation of 1935 sought to suppress the impacts of redundancy and poverty. This resulted from the situation experienced by a significant portion of American citizens in the 1930s. This decade comprised of the Great Depression era, prior to the World War II period. There was financial depression in all major economies of the world.
This was the worst fiscal depression in the twentieth century in terms of its impact. One of the most affected countries was the United States with the stock market experiencing a major operational breakdown on the Black Tuesday (29th October 1929) (United States 2003, 41). During this period, personal revenue levels as well as the returns and prices in several sub sectors of the American economy plunged rapidly while the intercontinental operations dropped by more than half. Consequently, a large percentage of the general population lost their jobs in an attempt by business proprietors to evade dissolution of their organizations. These individuals had to rearrange their priorities in order to survive.
In the United States, the unemployment rate increased to twenty-five percent. Such sectors as the agricultural sub division experienced massive losses with crop prices dropping by sixty percent. Agricultural segments such as wheat, cotton, and lumber estates recorded low outputs. Moreover, the value of exports from America declined by $ 3.5 billion (Partridge 2005, 45). Subsequently, there was a severe famine in most regions of the United States. For this reason, the general population had to reduce their daily expenses in order to cope with the harsh economic times. However, the country began the recovery process in 1933. Although the developments were evident, the negative impacts of the economic depression were persistent.
Not only did the high unemployment rate persist but underemployment also increased among members of the American society. Most people could no longer afford basic needs such as quality healthcare, shelter, and nutritious food. As a way of assisting the general population, Congress endorsed several legal guidelines. For instance, the Federal Home Loan Bank Act sought to facilitate the construction of houses for the large percentage of people left homeless by the Great Depression (United States 2008, 74). Other programs were also part of the centralized economic recovery efforts in the country. All the established schemes were in line with the intentions of the federal administration regarding the advancement of the living standards of its citizens.
The Social Security Act was one of these recovery efforts initiated by the American government. During the inception proceedings of the Social Security Fund, most women and other minority groups did not benefit from the stipulations governing the unemployment insurance policies and pensions meant for the senior citizens. This is because the original employment descriptions concurred with specific classifications that only recognized members of the male gender from the white race. However, the numerous campaigns against gender and racial discrimination led to the alteration of the provisions in the program (United States 2004, 53). Consequently, the government introduced various plans to comply with the demands of activists and the public.
These existing social problems resulted in the introduction of several schemes under the Social Security Fund. For instance, the Medicare project seeks to address the needs of the elderly and disabled members of the society. The analysis of all sub segments of this program indicates the purpose of the government to address poverty and inequality in the American community. This is because most of the aged citizens have low revenues. Moreover, they are vulnerable to various ailments and their families have to struggle to meet the treatment costs required to improve the healthiness of their old relatives. The insufficient retirement benefit package also makes it hard for most aged nationals to acquire quality healthcare.
Historical Content
The Medicare Prescription Drug, Improvement, and Improvement Act of 2003 is a major landmark in the Medicare program of the United States. The former legal provisions under this health project are all responsible for attaining the federal objective of offering quality healthcare to all American citizens. It is under the social insurance scheme initiated by the centralized administration in 1966. The original stipulations of this framework catered for disabled people above the age of sixty-five as well as individuals suffering from the developed stages of renal disease or Amyotrophic Lateral Sclerosis (Maryland 2004, 60). This disadvantaged a large portion of the elderly who were not eligible for this program yet could not afford excellent healthcare.
Prior to the introduction of this portion of the Social Security Act, more than fifty percent of the senior citizens did not benefit from health insurance covers because of their low income levels. Over the years, amendments in the Medicare program have benefited a large portion of this group of American inhabitants regardless of one’s medical history or income. For instance, in 1972, an official adjustment to the program enabled aged American citizens to acquire verbal, corporeal, and chiropractic treatments at subsidized charges. Moreover, all patients with permanent incapacitations or the end-stage renal disease were able to acquire Social Security Disability Insurance (SSDI) or make payments to health-promoting institutions (CCH Incorporated, and United States 2004, 81). This development increased the number of beneficiaries.
In 1982, Congress improved this medical scheme by introducing the sanatorium element with the main aim of offering health services to the elderly on a transient basis, a provision later transformed into a permanent medical structure by the legislative branch of the federal government. An analysis of the Medicare system indicates major operational developments since its establishment. For instance, it initially consisted of two sections, part A and B. Part A comprised of inpatient services while part B enclosed outpatient care, visits to general practitioners, and other remedy-related services (Health Policy Alternatives, and Henry J. Kaiser Family Foundation 2004, 101). This element necessitated various improvements in order to accomplish the intention of the centralized administration to offer superior healthcare to the public.
Later, Congress improved the program by introducing part C, which is the Medicare + Choice or the Medicare Advantage section. This sub division offered a system upon which participants could benefit from the centralized medical scheme through a personal health program as stipulated in the Balanced Budget Act of 1997 (Welsh 2007, 72). Part D is the most recent improvement in the Medicare system. The Medicare Prescription Drug, Improvement, and Improvement Act of 2003 is responsible for controlling the proceedings of this sub segment. The provisions in this portion became effective in 2006. Various stipulations of part D of the Medicare scheme have enhanced acquisition of quality healthcare among members of all age groups, income levels, and racial backgrounds (CCH Incorporated 2003, 29). A large portion of senior citizens with low revenues can now enjoy the benefits offered by this federal program.
Objectives
The operations of part D segment of the Medicare program relies on several interim and long-term objectives. Some of the short-term goals governing the implementation procedure of the Medicare Prescription Drug, Improvement, and Improvement Act involve establishing a firm and committed medical team and proper facilities that will enhance a large coverage of superior prescription drug benefits among a large portion of the general population. This includes offering advice to the public regarding the most appropriate medical plan as well as efficient and quick processing of prescription drug claims (New Jersey 2004, 30). This aims at ensuring that all participants of the part D Medicare program acquire the services stipulated in the official document without experiencing delays due to insufficient or inferior medical amenities or incompetent personnel.
Moreover, the aim of the government is to promote proper communication and professional collaborations among all relevant stakeholders in order to transmit the positive impact of their efforts to the enrollers of this Medicare sub segment. This goal concurs with the intention of the centralized administration to involve members of the public and private sectors in the attainment of the mission controlling the Prescription Drugs Plan and the entire Medicare program. For example, well-established insurance companies work closely with private and public sanatoriums in order to achieve this goal. Other stakeholders of this scheme include the federal government and pharmaceutical companies (O’Sullivan 2003, 122).
Another short-term goal in the implementation of the Medicare Prescription Drug, Improvement, and Improvement Act includes the provision of comprehensive, synchronized, and revolutionary medical services to all enrollers of the part D Medicare sub section regardless of one’s ethnic background or income level. This goal is in line with several health initiatives promoted by members of the public and private sectors in various geographical zones of the United States. For instance, the Million Hearts campaign seeks to reduce incidences of heart complications and stroke among the general population (United States 2006, 97). With the elderly being susceptible to such ailments, this goal will benefit a large percentage of American citizens. Moreover, the poverty levels in the country will reduce with health being a major accomplishment of the federal administration.
In terms of long-term objectives, the Prescription Drug Plan seeks to offer quality healthcare to all American inhabitants at negligible charges. According to the current state of affairs, the federal and regional administrations are only able to subsidize the treatment costs for patients above sixty-five years as well as all individuals suffering from end-stage renal disease or Amyotrophic Lateral Sclerosis. However, a large segment of the American community does not benefit from the Prescription Drug Plan because of the eligibility requirements. Moreover, the subsidies are not enough for individuals or family units with low revenues (Massachusetts 2004, 58). Increase in the federal and regional revenue will assist the regime to accomplish this objective. For this reason, the government intends to improve the project in order to offer quality and affordable medical care to all nationals.
Additionally, the objectives of the Prescription Drug Plan involve monitoring the utilization of medicines provided to the beneficiaries of the Medicare program. This is because the main mission of the whole Medicare scheme is to offer quality medical services to the community in order to promote a healthy nation (Dallek 2004, 110). For this reason, the government and other relevant stakeholders realize the need to monitor the utilization of the treatments offered to the beneficiaries of this scheme. This will help in ensuring that the beneficiaries not only gain financial help from the government but also acquire improved healthiness from this federal project. Although this aspect is not a component of the implemented essentials of the current Prescription Drug Plan, it is one of the long-term objectives of the Medicare scheme.
Another long-term objective regarding the Medicare Prescription Drug, Improvement and Modernization Act is increasing the number of sponsors involved in the implementation proceedings of the Prescription Drug Plan. This involves participants in the public and private sectors. The administration recognizes the need to work closely with other participants like private insurance corporations and pharmaceutical organizations. This is because an increase in the facilitators of this health project will help in the provision of treatments at lower costs than the existing tax subsidies (Burger 2005, 47). Consequently, the ultimate mission of the government with reference to offering quality healthcare to all American citizens will be successful.
Tools
There are several mechanisms incorporated in the implementation process of the Medicare Prescription Drug, Improvement and Modernization Act that aims at accomplishing the interim and long-term objectives of the part D sub division of the Medicare project. One of these tools includes advertisement mechanisms meant to enhance proper communication and professional partnerships among stakeholders of this health program. This includes the use of websites, social media, and public forums (Powell, and Darla 2006, 66). Through these advertisement platforms, the general population is able to comprehend the benefits of enrolling in this scheme as well as its operational terms.
Furthermore, there are various skilled human resources in private and public health amenities. These are important facilitators of the Prescription Drug Plan in line with the stipulations of the Medicare Prescription Drug, Improvement and Modernization Act. These professionals are able to offer various medical services to the enrollers of part D in the Medicare scheme. This includes physical, chiropractic, and speech-related remedies (Henry J. Kaiser Family Foundation, and Harvard School of Public Health 2006, 89). In addition, the experts in different fields of the medical sub sector help in accomplishment of the program’s objective regarding monitoring utilization of medicines offered to the beneficiaries of the scheme.
For this reason, the experts in various sanatoriums is a major tool in the implementation process of the Prescription Drug Plan. The national revenue is also a crucial tool that has facilitated the successful execution of the Prescription Drug Plan under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. The main source of income for the operations conducted by the federal and regional administrations is the excise obtained from various business transactions. The achievements of the part D sub sector of the Medicare scheme are primarily because of the government revenue. Based on this argument, the tariffs controlled by the government are a vital instrument in the accomplishment of the objectives governing the actions of this medical project (Fincham 2007, 91).
Apart from these mechanisms, several techniques have facilitated the successful execution of the Prescription Drug Plan as well as other elements of the Medicare Prescription Drug, Improvement and Modernization Act. To start with, there is a late enrollment penalty as one of the terms guiding the proceedings of the Prescription Drug Plan. This fine is the amount included in the premium of an enroller, sixty-three days after the preliminary enrollment period has elapsed (North Dakota 2005, 38). These charges depend on the period an individual disregards the payment terms of the Prescription Drug Plan.
To offer supplementary fiscal assistance to the medical scheme, the government uses the revenue obtained from this penalty program. This has enhanced the implementation process since an increase in financial aid results in provision of quality healthcare to a larger portion of the general population. Moreover, it warns the enrollers against the consequences of disregarding the conditions stipulated in the legal framework of this project (California 2006, 88). This technique has led to the successful execution of this section of the Medicare project. Consequently, the government is in the right direction with reference to attainment of its mission of offering quality healthcare to all American citizens.
Costs and Benefits
Implementation of part D of the Medicare program will benefit various stakeholders at the expense of other individuals and corporations. One of the beneficiaries of this project is the group of the senior citizens in the American community. It is a great relief especially for the aged individuals with low revenue. This is because they are now in a position to benefit from the provisions of the Prescription Drug Plan since they are eligible for treatment subsidies. Its coverage involves a comprehensive benefit package for senior citizens. For example, nationals above sixty-five years can now acquire a discount card for free or at minimal charges depending on one’s income category (Peterson 2004, 40).
This card grants fifteen percent and above of one’s savings as a funding for the charges of outpatient treatments. Although most Medicare beneficiaries are qualified for this dispensation scheme, most recipients have incomes below 135 % of the poverty category for the stated size of their family unit (Jensen 2005, 61). With these old nationals applying for a projected two prescriptions on a monthly basis, these discount cards will smooth the progress of the program by availing fourteen to thirty prescriptions per month to people who may otherwise not afford these high-cost prescription drugs. Not only does this initiative have fiscal benefits but it also promotes the wellbeing of the senior citizens.
Other beneficiaries of the Prescription Drug Plan include pharmacies and the Pharmacy Benefit Management (PBM). These administrators are in charge of dispensation dealings regarding prescription drug claims to the beneficiaries of this medical venture. They also work closely with pharmacies and medicine manufacturers in order to settle the reductions involved in the program. Currently, there are less than a hundred companies involved in these operations. For this reason, they are one of the beneficiaries of Medicare part D specifications. This is because an overwhelming percentage of enrollers will fill prescriptions with the help of Pharmacy Benefit Managers.
Other major receivers of the benefits laid down in the Prescription Drug Plan under the Medicare Prescription Drug, Improvement and Modernization Act are the producers and dispensers of the injectable medications categorized in the top levels in terms of costs and quality (McCormick 2005, 47). This is because most of these biologics have great remedial advantages. Consequently, these qualities will increase the number of patients using these forms of medication, an aspect that enhance the profits of these commercial institutions. Patients using these drugs are also major beneficiaries of the project. This is because of the therapeutic advantages related to these prescription drugs.
Nonetheless, the benefits of the Prescription Drugs Plan are at the expense of various benefactors. An analysis of the entire project illustrates various individuals and corporations who will be disadvantaged by the implementation of this health-related policy. For example, the aged citizens who have loaded retiree remunerations may not benefit from the provisions of this guiding principle in the medical sub sector. This is because the plan, controlled by the centralized government, focuses on offering discounts to senior citizens with low-income levels or no prescription drug coverage. Other losers include affiliates of the Medigap insurance program or the Medicare + Choice scheme.
This is because part D of the Medicare project has the power to liquefy their benefits in order to cater for the health needs of other individuals with minimal or no prescription drug coverage. Subsequently, they will have to endure the high costs of treatment acquisition. Likewise, although most pharmacies are beneficiaries of this medical scheme, some of these organizations may be disadvantaged if the large number of claims presented by the Pharmacy Benefits Management does not make up for reduced charges stipulated in the program. Business enterprises in the health sub sector that do not embrace this transformation in terms of identifying business opportunities will also be indirect benefactors of the project (Frank and Joseph 2007, 109). This entails pharmaceuticals and other institutions offering medical services to the enrollers of the Prescription Drug Plan. This is because the large number of eligible nationals with reference to the Medicare scheme offers a feasible opportunity for these organizations.
Critique of the Policy Response
An analysis of the entire project indicates the successful and effective implementation of part D of the Medicare program. To begin with, there are several organizations and human resources tasked with facilitating various elements of the Prescription Drug Plan. This includes institutions such as the Pharmacy Benefits Management (PBM). This agency has the responsibility of working on prescription drug claims and conducting the reimbursement dealings (Levinson 2009, 61). The operations of this institution concur with the objective of the scheme in terms of establishing numerous agencies, which will aid in the attainment of other interim and long-term objectives regarding the project.
Additionally, the seniors benefiting from the specifications of this program, also indicates the success of the policy. For example, according to several surveys on the effectiveness of the prescription drugs plan, eighty-eight percent of the interviewed senior citizens indicated approval of the coverage terms stipulated in the policy. This number consisted of ninety-three and eighty-nine percent of the elderly interviewees in the states of Florida and New York respectively (Mahan 2006, 39). In addition, eighty percent of the senior citizens in various zones are glad that their payments and co-pays are valuable and within your means. Consequently, it is evident that the costs of this program are lower than the initial projections.
Furthermore, the partnerships involved in the implementation of this project illustrate the success of the formulated legal course of action. The accomplishments in this plan are because of the effective collaborations among the involved stakeholders. The major shareholders in the Prescription Drugs Plan include the centralized administration, private medical-indemnity sources, and pharmaceutical organizations. Their consistency and competence has enabled a large portion of senior citizens in the American community to access receptive medical plans and low-cost quality services for those in low-income categories (Zycher 2006, 77). This is a major accomplishment since it concurs with the objectives governing the project as well as the mission of the federal government regarding provision of quality healthcare to all nationals.
In relation to other federal agendas, Medicare Part D indicates a budgetary accomplishment with reference to the cost of its implementation. For example, on average, the monthly premiums in 2010 were $ 30 (Mahan 2005, 133). Although the amount exceeded the payments of 2009 by $ 2, it was much lower that the original projections. This low-cost strategy has been consistent and effective for more than four years, an indication of the budgetary success of the Prescription Drugs Plan. This achievement is because of the forecasted competition in the medical sub sector. Centers of Medicare and Medicare Services estimated an overwhelming advancement resulting in two-thousand forms of the Prescription Drug Plan in the near future (Partridge 2005, 64).
Moreover, the approval exhibited by most nationals illustrates the success of this federal program. According to several surveys conducted regarding the implementation process of this scheme, eighty percent of the senior citizens of the United States admit that their medical plan covers for all the biologics prescribed by their general practitioner (Henry J. Kaiser Family Foundation 2006, 18). This is because of the numerous categories of the plan, which allows enrollers to select the cover that best suits their medical needs. This vast satisfaction by members of the general populace is an illustration of the accomplishments of the Prescription Drug Plan with reference to the set objectives. It is one of the few federal programs enjoying massive support from the public in a consistent manner.
Conclusion
Based on the discussions addressed in this paper, it is evident that the Medicare Prescription Drug, Improvement and Modernization Act is one of the effective federal programs with respect to improvement of the living standards of the general population. Its success is apparent through recorded approvals exemplified by the senior citizens as well as the budgetary elements of the program. Several surveys indicate that the enrollers of the Prescription Drug Plan adopt medical schemes that suit their needs. Consequently, the federal mission of offering quality and affordable healthcare to all American nationals is achievable if these accomplishments persist in the future.
Various tools have enabled the attainment of the set objectives. These tools include experts in different fields related to the program as well as advertisement platforms that enable the general populace to comprehend the terms and benefits of this scheme as stipulated in the Medicare Prescription Drug, Improvement and Modernization Act. Other mechanisms such as the late enrollment penalty program have enabled the government to implement the policy in an effective manner. This is because the set conditions force the enrollers to follow the payment terms stipulated in the scheme in order to avoid any form of financial strains.
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