I would like to continue about Health care.
2. What does it do to Medicare.
Medicare,introduced into law in 1965 and now covering 38 million,is one of the most popular social programs in U.S. history, which is why the health reform legislation, in its early stages, will not fundamentally change the way the program operates. Americans 65 and older will continue to receive comprehensive health insurance;doctors and hospitals will continue to be paid per procedure. But if there are to be far-reaching changes in the way medicare is practiced in this country, Medicare will have to purchasing health care services, Medicare has the buying power that Texas does in the textbook market. “Medicare has to go first” says Len Nichols, director of the Center for Health Policy Research and Ethnics at George Mason University. It’s the only buyer with enough to make the hospital pay attention.
Medicare is in a position to be a platform for the developing and implementing new approaches. It’s perhaps the thing in the health care legislation that holds the most hope for the future. It begins by phasing out the wasteful subsides that go to private insurers that contract with the federal government to provide Medicare type benefits to seniors. Some 10 million elderly Americans get coverage from these Medicare Advantage plans, which often require lower co-payments than tranditional Medicare and provide extra benefit like eye care, hearing aids and even gym memberships. However, come at an extra cost, and experts say the government pays about 14% more for each Medicare Advantage beneficiary than for a traditional Medicare patient. These overpayments will be gradually ended beginning in 2011, and seniors enrolled in Medicare Advantage will feel the pinch as insurers try to find a way to continue.
As the same time, the government will start spending more money, which provides prescription-drug coverage. The law will begin closing this gap immediately. Seniors on Medicare will also get free preventive services under the reform. The new law will set up an independent board to study clinical oytcomes and evidence and come up with ways Medicare can reduce spending without sacrificing quality or access. The reason that Congress didn’t nor do more is that right now we don’t have all the answers for what we need and what will work and how it will work.
3. Who treats 32 million Patients?
with 32 million Americans gaining health care coverage in the coming years and demanding services as a consequence the next challenge is addressing the supply side of the equation. Once these folks start putting their freshly minted insurance cards to use, who will actually perform the blood-pressure checks treat the cancers and monitor the diabetes? Family physicians, who are on the front lines of this surge in demand, are already in short supply. Bu 2020, when most of the currently uninsured will have been fully brought into the health care system, the American Academy of Family Physicians predicts a shortfall of 40,000 in the ranks of primary care providers to treat them.
One way to address that gap would be to make primary care medicine a more attractive field not just for physicians but also for nurse practitioners. The new law calls for appropriations over five years to fund further training programs, scholarships and loan repayments for those entering primary care. But even if new students take up those offers this year, they won’t be ready to treat patients for three to seven years. The law would also temporarily boost what primary care providers receive for treating patients insured by Medicaid, the plan that will pick up nearly half of the newly covered. In the long run, addressing the short-age of primary-care providers will take much more than money. The law is expected to ultimately spend $11 billion to create more health centers based in communities and schools as well as nurse managed clinics.
The funding will also support programs like the “Medicare home” a team based approach to delivering health care that breaks down the traditional hierarchy in which all health decisions are made by the physician. The medical home concept is already being tested in many markets for just this reason. But Making this shift on a national level, however, won’t be easy. As long as patients still view health care as an only when sick!! The key to achieving real reform within the constraints of that reality will rest on persuading new and existing patients to seek care to maintain their health rather than treat a disease after it has taken hold. If all goes accrding to plan, the bill’s greatest achievement may be to make it possible for more people to access the health system in many different ways. Health care will increasingly take the form of preventive services such as regular diabetes check ups and weight liss origrams instead of patients waiting tosee their doctors untill they nedd coronary bypass operations or kidney dialysis.
4. State by state
After 2014, the health care system will look far more uniform across the nation than it does now. But the new law leaves a lot of room for variation and experimentation by individual states. Goverment have been lukewarm to the Obama health care bill, in large part be cause it calls for adding 16 million people to the Medicaid rolls, which ar jointly administered by the states and the feds. The most important challenge for the states will be setting up health insurance exchanges marketplaces where small business and individuals will be able to shop around, choosing from a selection of insurance policies, much as federal government employees do now. “Right now there are a lot of people out there own or small businesses buying health insurance on their own. Their don’t work for a big company. They’re not part of a big pool. So they have no leverage. They’ve got no bargaining power with insurance companies,” Obama said in a speech shortly after he signed the bill. But to work right, each exchange will need to have enough enrollees and enough insurance-plan offerings to assure vigorous competition. That’s no small challenge, given the near monopoly power insurers have in many states.
Indeed, many of the battles that took place in Washington during the 14 months of debate on the legislation are likely to be reprised in state capiols across the country over the next few years. At latest count, conservative legislators in 39 states have introduced bill- or plan to- that would exempt their citizens from the new law’s requirement, effective in 2014, to have health insurance or else face a fine.
5. What come next
Administration officials say their most immediate concern will ve implementing the “early deliverables” the parts of the new law that go into effect almost right away. Among them are tax credits to help an wstimated 4 million small businesses provide coverage for their workers, assistance for people who have pre-existing conditions, a provision allowing young adults up to age 26 to stay on their parents’ policies and a $250 rebate for seniors whose initial Medicare drug benefits have run out.
There’s a lot of money that’s going to be spent in accomplishing these goals then they will be watching closely to see whether it is working as intended. As the forces of reform take hold, there is also the possibility that Congress will be tempted to meddle too much-interventing, for instance, to take care of hospitals in members’home districts or to insulate powerful and moneyed special interest groups like drugmakers. As Stern puts it,” The question is whether Congress can rstrain itself and let the market work,or whether they are going to be distorting the system day by day.”
So if there is a victory lap to be taken now, it had better be a short one. As Obama said shortly after sighing the bill, “For those of us who fought so hard for these reforms and believe in them so deeply, I have to remind you our job is not finished.” Indeed, it has only just begun.
In my opinion, I agree with Medical home because nowadays when people are sick, they wait for doctors and don’t treat yourself. I think Medical home is very great idea to treat people to take care yourself first before going to the hospital.