Question

What are two differences between Medicare and Medicaid. What are two similarities between the programs? Some people are eligible for both Medicare and Medicaid. Who are they? Describe an example of an alternative policy approach that might improve the care provided to this group of people and do so at a lower cost.

Answer 1

Under the Medicare, the health insurance is being provided to the senior citizens or people 65 years or older whereas the Medicaid provides the health insurance to those who cannot afford it or those with little or no income.

The Medicare pays for the treatment in the nursing home for a short period of time given those eligible for it have paid into the system. On the other hand, the health insurance under Medicaid covers the long-term care.

Both Medicare and Medicaid are the government-run social health insurance programs which were created in 1965. Both allow the financial medical burden to share the same between rich and low-income families plus the healthy and the sick persons.

One can be eligible for both Medicare and Medicaid, given that the individual is older or disabled (eligible for Medicare) and is also eligible for Medicaid which means that he/she has very low income. In this situation, one is also eligible for out of the pocket expenses and is known as dual eligible.

An alternative policy approach to this is to use the market approach. A market approach should be used wherein the eligibles would contribute to the program to purchase the insurance plan based on the income group they fall in plus the respective health problems they have. This would help decide the cost of the medical care efficiently plus progressive in nature where the higher income group people would pay more than their low-income counterparts. Another part of the problem is from the payment side wherein the payment structures or the procedures could be modified to avoid wastage and manage the complex and chronic diseases efficiently.

The market for insurance and payment modes would ensure that the cost to the government is minimum and those who needed it would get the best treatment timely.