Implementation & Modification

Why was it deemed necessary for changes to be made to Medicare?

President Bush in 2003 signed into law what was called the Medicare Prescription Drug Improvement and Modernization act, which means wide ranging changes to this program. It will give people who get Medicare some restricted help paying for their medications. This legislation also expands some services, and starts others, which will be beneficial to those enrolled in Medicare. Nevertheless, this reform to Medicare in 2003 also contains bigger reorganization of the usual Medicare, depending profoundly on personal insurance for the deliverance of money and insurance (benefits). As well as, it enlarges the assignees expense used in common with other accountabilities. The changes to Medicare were considered essential because many of the elder population started to find out that their medications they needed for good health was out of their scope because of the expense. A reconditioning of Medicare would alter this; develop medications that are affordable, improved and within financial means plans for healthcare. Something else, the Medicare reform was to lower the complete costs of Medicare, because at the pace it was going, it was determined that the program would run out of money around 2026. The changes would not only guarantee that prescriptions would be more affordable for the elder population, but it would develop rivalry, develop selections for the elderly population, and would make more efficient.

This policy proposed at giving four hundred billion dollars that would aid over forty million geriatrics get prescriptions at a price that was within their means. The part about prescriptions in the bill, Medicare part D, started in 2006, and people who have this part of Medicare pay the lowest amount of thirty-five dollars a month, with a deductible of about two-hundred and fifty dollars. This part of the plan will pay seventy-five percent of expenses up to two thousand two hundred fifty dollars. Its goal is to bring Medicare up to date and gives twenty-first century care for our elderly population (National Institute of Health Policy, 2003).

For this new legislation what are the main provisions? Were the desired goals achieved?

To make the healthcare system is within ones means and obtainable. An up to date Medicare programs must give more selections and better programs to the whole elderly population. As whole, the elderly population should have extra help in getting their medications; especially the people who can least afford them. All elder citizens should be guarded against out-of-hand increases of insurance premiums and should be able to pick a medical plan of care while not being pushed into an HMO. Here are some of the critical contingencies; Prescription coverage that lets elder citizens get the meds that they require, without government interference telling them what meds they can have or not have; Selections of singular plans of healthcare that greatly fits their demands, just like Congress has;

Selection of physician, hospital, or the place they want to get medical care they want or require; disease prevention coverage (full) for screenings of cancer, diabetes, heart disease and osteoporosis; and guardianship against high personal expense that will take all of the elder citizen's savings. When the Medicare part D was contemplated people were told that they were going to get a program that was similar to the one Congress gets but this part does not meet this standard. Unlike this new Medicare program for prescriptions, Congress and other federal employees does not have a deductible for their prescriptions added to the one in their plan of health. Again, different from the Medicare reform, their coverage does not involve the huge gap (doughnut-hole) in the part of their prescriptions, neither do Congress pay an added sum they pay for their insurance contract as people who receive Medicare. So, I would say they failed in my own opinion.

Who were the agenda setters for these changes in Medicare?

The agenda setters were Labor Negotiators, President Bush and his staff (Tom Thompson, Secretary), AARP President, Jim Parkel, Surgeon General, Rich Carmona, head of the CDC, Julie Gerberding, Director of The National Institutes of Health, Elias Zerhouni, Administrator of The Centers for Medicare and Medicaid Services, Tom Scully, Drew Altman president of the Kaiser Family Foundation and Republicans and Democrats, just to mention a few.

The fact that healthcare costs so much and is still on the rise is a concern in the labor negotiations in 2003; it has put stress on the government to pass a bill on the prescription part of the Medicare program. The backers of the analysis found out that the expense of medical care was also economically very bad. Employees pay considerably more; businesses in turn hike their prices, while they hire fewer employees. Insurance premium payouts for out of money beneficiaries, med co-pays and deductibles went even higher to two thousand, seven hundred ninety dollars in 2003 for a normal employee with coverage for dependents, from one thousand, eight hundred and ninety dollars in 2000.

Why was this legislation so controversial and who gets the advantages from the changes?

The first thing is that you could say the GOP controlled house stacked the deck to get this bill passed (220-215). This was supposed to be a bipartisan vote, the sum was on the side of the republicans because there were 42 republicans, 11 democrats, 01 independent, and these were the supporters. The opposed were 9 conservative republicans who joined 35 democrats. These are all controversial facts; the condition that rich elders pay out more for Part B of the Medicare program and billions to stop companies from getting rid of the current programs they had put in place for the people who were going to retire or retired before the new reform started.

Letting personal insurance businesses a huge new part in medical care for Medicare recipients: At the pulse, of Medicare's law was developed as a great deal, with the new coverage on medications for the whole Medicare population long essence by the democrats mixed with a republic sponsored plan to provide personal insurance businesses a ongoing new part in medical care for the Medicare recipients.

The vote in Congress: Even though First and other colleagues called it a bipartisan vote, the count fell greatly with party lines. There were over forty republicans, forty-two to be exact, 11 democrats, and one independent sponsored the laws made by the legislative body. There were in all forty-four,

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