USA Healthcare: Medicare and Medicaid


Healthcare is one of the most important parts of a nation’s Social system. As such, the US government has always taken a keen interest in the healthcare provision of its citizens. Nathanson states that this idea of government involvement in the health concerns of the citizens can trace its existence from as far back as the 17th century (85). It is a known fact that full productivity cannot be achieved without good health. Kovner, Knickman, and Jonas contend that the insurance issue is the most rampant and troubling in healthcare since approximately a 45million Americans (as of 2005) were uninsured hence facing tremendous financial risk if they became ill or injured (112). Most services in hospitals cannot be provided to someone unless they have comprehensive insurance cover owing to the expensive nature of the services or the complexity of the operations.

Medical system analysis

The Institute of Medicine notes that the USA is the only industrialized nation that fails to provide its citizenry with some form of insurance and thereby leading to unnecessary deaths owing to the lack of access to health care facilities. Proponents of the public insurance option argue that should such a scheme be in place, the number of uninsured people will drastically decrease. With a big majority of the uninsured Americans insured, the number of deaths that result from lack of insurance cover will depreciate.

However, Porter and Teisberg state that as the cost of health care continues to escalate, more and more Americans lose access to this important amenity leading to great anxiety and frustration (71). This paper shall therefore explore the Medicaid and Medicare options put forward by the US government to combat this deficiency. The various aspects that have contributed to their success shall be highlighted and those that have hindered their efficiency discussed. The impacts of the health care reforms on Medicare shall also be analyzed.

Over the years, medical experts and policymakers have tried to establish a system that will provide cheaper or free health care to the masses. Many people throughout the world die each day due to a lack of insurance and insufficient medical facilities from which they could have access to proper health care. To prevent these bleak phenomena, the US government has taken the initiative to provide cheap to free medical care for its citizens. According to Harrington (399), these health care plans will improve the quality of life of the citizens while promoting equality during service rendering. With free health care, people can easily adopt preventive measures by having regular checkups and physical examinations. This is very good as opposed to going to the hospital to be treated after the disease has already taken its toll.

The distinction between Medicare and Medicaid

In as much as they are both funded by the US government, there are very distinct differences between Medicare and Medicaid in terms of their intended population and how these health care plans work. Medicare can best be described as a prerogative health care program that is fully funded by the federal government in the US. Established in 1965, the program was designed to cater to the health needs of US citizens above the age of 65 years. However, to be eligible, one must have paid their taxes into the social security fund. The program offers hospital and medical care coverage as well as prescription drugs coverage to ensure that all the health care needs for the members are fully met.

Medicaid on the other hand refers to a health care program designed purely to assist those in poverty get quality health care. Unlike Medicare, one has to apply for this program and prove that they are indeed in dire need of such assistance (medical aid). The kind of services offered under this program differs from state to state as do the standards for coverage.

Societal change and its effects on Medicare

As of today, most of the health care systems are characterized by being curative. Smeltzer asserts that an ideal health care system should focus mainly on prevention, promotion of healthy living, and the management of chronic ailments and disabilities (801). She describes the current population trend as one characterized by a large percentage of people over the age of 45 who are increasingly getting sicker more often than before. Health care programs should focus on cost-effectiveness and resource management to ensure that they meet the medical needs of the whole population. These programs require money for them to be implemented. As a result, consumers are forced to dig back into their pockets and pay for medical insurance covers which are very expensive. On the same note, such programs have increased marginalization and discriminatory tendencies in health care institutions. For example, in America, the quality of healthcare a patient receives in some cases depends highly on the insurance cover that one has or on their ability to pay. These facts show that such a program undermines the main focus of medical care which is the preservation of life and should therefore be amended or abolished completely.

Effects of the health care reforms to the Medicare program

The current health care reforms in the US have affected the Medicare program in different ways. According to Smeltzer, the government has been proposing to adopt a universal health care system in a bid to curb the rising costs of medical amenities in the US (57). The problem, to begin with, has been propagated by the rapid commercialization of the health sector (Boychuk, 94). Due to this fact, there is little accountability by the companies to the public as the chief obligation of the insurance companies is to their shareholders. The implementation of health care reforms would lead to the government being in a position to regulate the price that the consumer pays through the market competitive forces. This would create a scenario similar to the highly effective healthcare plan in Switzerland where the insurance companies and medical providers in Switzerland are obliged to negotiate health care prices each year. Due to this government-enforced price control, the medical costs for the average American citizen can be projected to fall by over a third thus making the system more cost-effective (Boychuk, 79). This would ensure that insurance firms do not exploit the citizens as they would be accountable to the government. The insurance system would therefore be faithful and honor its commitments to the public making such programs as Medicare more effective and affordable to the masses.


The American Health Care System has long been observed to be faulty and from the above discussions, it is clear that the system needs radical changes. This paper set out to show that there is a need to reform the health insurance system in our country to deal with the ethical issues that are posed by the current system. From the arguments presented in this paper, it can irrefutably be stated that better and ethically sound health care in America can only be achieved using reforms. While most of these proposed reforms are radical and would require billions of dollars to implement, they are necessary for our nation’s health care system to become efficient and affordable for the good of the entire American citizenry.

Works Cited

Boychuk, Gerard W. National Health Insurance in The United States and Canada: Race, Territory, and The Roots of Difference. USA: Georgetown University Press, 2008. Print.

Harrington, Charlene, et al. Health policy: crisis and reform in the U.S. health care delivery system. USA: Jones & Bartlett Publishers, 2004. Print.

Kovner, Anthony, et al. Jonas and Kovner’s health care delivery in the United States. USA: Springer Publishing Company, 2008. Print.

Nathanson, Martha D. Health care providers’ government relations handbook: shaping policy to win. USA: Jones & Bartlett Learning, 2005. Print.

Porter, Michael, and Teisberg Elizabeth. Redefining health care: creating value-based competition on results. USA: Harvard Business Press, 2006. Print.

Smeltzer, Suzanne C, et al. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing. USA: Lippincott Williams & Wilkins, 2009. Print.

Find out your order's cost