Medical Assistance Programs and Areas of Improvement

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Table of Contents

Discussion
Spending
Possible Solutions
Conclusion
Works Cited

Discussion

It is imperative to note that medical assistance programs are actively discussed by many scholars, and they have recognized that the current approach has several weaknesses. Moreover, some of the policies were frequently criticized, and most think that they should be altered. It is hard to argue with the fact that the initiative was incredibly helpful for many individuals, and many lives were saved as a result.

However, the argument is that changes are required in this case because the government is not in control of the situation. It would be reasonable to examine peer-reviewed articles and the literature on this subject matter. It is necessary to identify primary areas of spending and get a better understanding of the reasons it increases at rapid rates. Some of the solutions will also be reviewed and discussed.

Spending

Eligibility has been expanded on numerous occasions to cover various groups of people. The situation was quite similar in China, and the government understood that many individuals do not have access to healthcare because of their financial status. However, it was recognized that several limitations are required to ensure that the program stays sustainable in the long-term. The focus on efficiency was vital.

The number of eligible individuals has increased dramatically, but an increase in spending did not damage the economy as much (Wagstaff et al. 38). Changes to income requirements could be viewed as especially interesting because such factors as marital status and earning capabilities of the family are not taken into account. The population of the country has aged, and expenses have skyrocketed in the last few years. The same trend can be identified in all the sectors, and the cost of Medicaid is going to increase rapidly from 2010 forward (see fig. 1)

Fig 1. Elderly Population Growth.

Such services as home care are incredibly costly, and they are mostly covered by Medicaid. It is necessary to understand that it was hard to predict that the cost of care would increase at such rates. Available data suggests that most resources were spent in California, and the figures seem disproportional when compared to the situation in Wyoming (Kaiser Family Foundation par. 1). A significant percentage of enrollees are children, and the Medicaid spending they require is relatively small.

The amounts of money used to support impoverished and blind individuals are justified but must be monitored to ensure that funds are used efficiently (Policy Basics: Introduction to Medicaid par. 3). The data should be examined to identify particular trends or areas where unnecessary spending may be minimized. Alterations to the policies have an enormous impact on this case and have led to many complications.

Many suggest that the Affordable Care Act is especially problematic, and several aspects were overlooked by the administration. The biggest problems of the approach were not addressed, and the number of enrollees was increased without the consideration of possible consequences. Some of the projections that are being made are quite shocking, and should not be disregarded. The number of enrollees has increased significantly. One of the aspects that should be considered is that it is believed that they are healthier than the individuals that were previously enrolled, and expenses of care would be lower, but it is hard to make such predictions in the long-term.

Growth rates are quite worrying, and it is not expected that the situation is going to change anytime soon if necessary measures are not taken. A fourteen percent increase in 2014 should be highlighted because it is the highest number in twenty years (Galewitz par. 1). The states that accepted the expansion were affected the most. On the other hand, one of the studies suggests that federal payments could be bigger if all the governors decided to expand because the number of uninsured individuals is statistically significant, and alternative options do not help to mitigate the losses (Price and Eibner 1030). It is quite evident that the difference in philosophies is quite significant, and Republicans think that such support should not be provided to individuals that are healthy and are capable of work.

Another aspect that should not be overlooked is that there used to be numerous instances when the system was abused in the past. Improper payments are quite problematic because they are hard to track and affect the quality of care. Therefore, it leads to worse outcomes. One of the studies suggests that mortality rates were much higher. Understandably, access to professionals should be limited because the governments are trying to minimize the expenses, but the quality still needs to be improved.

Any changes to the policies would be quite slow because negotiations with numerous organizations are required. It is not surprising that it leads to enormous tension. The role of modern technologies also should not be overlooked. The process of enrollment became much easier, and individuals that were previously incapable of dealing with numerous barriers can now apply safely. Understandably, this was the primary goal of the initiative, but damage to the economy was overlooked.

States have to spend such enormous funds to support Medicaid that it is nearly impossible to focus on infrastructure and other vital areas. The states that did not support the expansion can prioritize schools, police, and they believe that such functions are much more beneficial. It is necessary to understand that taxpayers have to pay for the expansion of the program, and it makes an enormous percentage of the population unsatisfied. Moreover, it is nearly impossible to maintain a particular level of spending because the costs of healthcare are always increasing, and it does not seem to be sustainable. Davis suggests that it will cost close to 4,2$ trillion in the next ten years (par. 9). Such numbers are shocking, and the fact that federal taxpayers would help to pay them is an enormous issue.

Possible Solutions

One of the approaches that should be considered is the modernization of the pharmacy. Networks should be improved to avoid unnecessary fees, and the need to minimize waste also should not be overlooked. Some of the items that are purchased by Medicaid have no market value and could be used more efficiently (Pratt 15). Such approaches have proven to be useful but are still not utilized by most states.

One of the most significant benefits of this method is that no changes to access are expected, but the government will save up funds that could be used efficiently in other areas. The most focus should be devoted to evidence-based practice because some of the approaches are quite outdated, and they must be replaced with more useful ones. The idea that it would be reasonable to eliminate the current system, and establish a new one is intriguing and some of the points that are made are quite comprehensive (Pratt 12). The problem is that many view free healthcare facilities as outdated, but this perspective is not based on evidence.

The problem is that Medicaid has established over many years, and most policymakers would be reluctant to accept such dramatic changes. Moreover, enormous resources would be devoted to the development of new guidelines, and it is entirely possible that unexpected complications could occur. Many individuals think that it is not the responsibility of the government to provide free healthcare, and it is only a burden on the economy.

They are not satisfied with the way policymakers handle this situation, and it leads to tension. The lawsuits are also quite problematic because the funds are used on attorneys, and such expenses are hard to handle for most states. The introduction of additional taxation is another solution that should be considered. However, most believe that this approach is not reasonable, and does not address the cause of the problem. Moreover, taxes will have to increase continuously, and Medicaid spending is going to require an enormous percentage of tax revenue according to the alternative fiscal scenario (see fig 2).

Fig 2. Entitlement Spending Projections.

It can be seen that Medicaid is not the only problematic area that the government has to address, but it would be reasonable to focus on this program because growth rates are enormous. One of the primary issues is that healthcare professionals are paid less if they must take care of Medicaid patients, and it reduces their satisfaction levels. One of the studies has found out that such individuals will be forced to wait much more time even when children are involved (Grady par. 1).

Such results are not surprising, and the government should not expect doctors to do what is morally right if their pay is affected. The expenses could be reduced if the quality of services has improved because it would lead to positive outcomes. However, policymakers are reluctant to make such changes because the situation is already problematic and budgets cannot handle additional expenses.

The range of benefits associated with the initiative has also expanded, but its efficiency was not increased. Some of the services that the program covers are viewed as the most expensive, and it makes the situation much harder to resolve. Long-term care accounts for close to forty percent of the spending and only fifteen percents of individuals need it (Klein par 6). Therefore, it would be reasonable to focus on this area because expenses are disproportional, and the problem can be resolved with better management. The lack of coordination between the facilities is also a critical issue because they do not share vital information that could help to reduce the length of stay (Klein par. 7).

The utilization of community-based service initiatives should be considered, and it is expected that it would help to reduce the expenses by nearly 70 percent (Xerox 4). The experience of other countries also should be analyzed, and some of the strategies may be utilized. Current methods should be simplified, and the need to cooperate with organizations specialized in this area should not be disregarded. It is necessary to examine the factors that lead to readmissions and take appropriate measures to ensure that some risks are eliminated. Such aspects as financial stress, housing instability, and others are quite problematic, and most attention should be devoted to guidelines that would help to increase adherence levels.

Conclusion

In summary, it is possible to state that medical assistance programs have an enormous impact on the economy of the country. Understandably, they make the population much more satisfied. However, it would be reasonable to consider the introduction of several limitations because states have to deal with resource shortages. It is quite evident that care should be much more efficient. Understandably, the program has achieved its primary task, but the complications that were introduced are not acceptable, and the harm that has been caused by several policies is enormous. It is expected that presidential elections would also have an impact on Medicaid, and changes to the policies are also likely.

The population will not be satisfied with an increase in taxation, and other solutions should be examined. Therefore, it is paramount to focus on this problem and review all possible options because the economy of the country is at risk, and it is evident that the current approach is not sufficient. The fact that some of the ideas suggested by scholars are overlooked is worrying. However, the system may become sustainable if some of the most significant issues are addressed, and complications are prevented. An enormous effort is required in this case. The government and healthcare organizations should cooperate to develop strategies that would eliminate the problem.

Works Cited

Davis, Sean. 12 Reasons Why Medicaid Expansion is a Terrible Idea. The Federalist. Web.

Elderly Population Growth n.d. Web.

Entitlement Spending Projections n.d. Web.

Galewitz, Phil. Medicaid Spending Soars Mostly In Expansion States. Kaiser Health News. 2015. Web.

Grady, Denise. Children on Medicaid Shown to Wait Longer for Care. The New York Times. 2011. Web.

Kaiser Family Foundation. n.d. Total Medicaid Spending. Web.

Policy Basics: Introduction to Medicaid 2015. Web.

Pratt, Lindsay L. Lets Fix Medicare, Replace Medicaid, and Repeal the Affordable Care Act: Here is Why and How. Sun City Center, FL: Author House, 2012. Print.

Price, Carter C. and Christine Eibner. For States That Opt Out Of Medicaid Expansion: 3.6 Million Fewer Insured and $8.4 Billion Less In Federal Payments. Health Affairs 32.6 (2013): 1030-1036. Print.

Wagstaff, Adam, Magnus Lindelow, Shiyong Wang, and Shuo Zhang. Reforming Chinas Rural Health System. Washington, DC: World Bank Publications, 2009. Print.

Xerox n.d., Eight Ways to Reduce State Healthcare Costs. Web.

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