February 13, 2014
One of the reasons for forming a national health insurance opportunity was to curb cost while providing needed health care for millions of Americans that did not have insurance regardless to a reason given; i.e., lack of income to purchase and maintain insurance coverage, pre-disposition, adult students on parent (s) insurance.
On October 1, 2013 the initial coverage started. On January 1, 2014, the full implementation of the Affordable Health Care law went into effect. Today, Americans are more and more finding their way to insurance coverage.
What does that mean?
It means we have opened the door to opportunities and more responsibilities to working with the ups and downs that a NEW national insurance brings to the table. It means all/ALL must do their share to help ensure that our country have HEALTHY PEOPLE. It says, some will find fault and challenges while others will be gleeful and willing to take ownership in making their health and health care a reality. If we continue the course of due diligence to correct issues that are target-rich, over time things will increasingly get better. Patience. Use of open-wide communication that is correct and when it is incorrect, correct quickly and move on.
The trend lines will vary depending on age, income, workers (full vs part-time), individual vs family and group policies on the market. The population at-large will go through preparedness. This too will vary depending on access to knowledge, internet access, customer care and assistance availability, communication of paperwork, accuracy of the information and then correction of information, timeframe of flow of information and of course, the Medicare budget and CMS/Centers for Medicare and Medicaid Centers care coordination and management that is theirs alone. This ranges from access to Healthcare.org to once there is access, can the information be found easily and sign-up is as seamless as possible. It means that the federally-assisted networks providing connectivity for states that chose not to provide the umbilical cord for life with Affordable Health Care law benefits and policies.
Beneficiaries
Here are some today thoughts for looking at some considerations for those who receive Medicare.
Income is a determinate and it is factored in health care payments. This is drastically unfair for those who have been discriminated against and denied equal access to the benefits of employment, education attainment and improvements that are received from employment; i.e., benefits taken from wagers and wages while working in the marketplace. Given the history of discrimination and stolen benefits from African American and other People of Color; the asset investment fund is null and void.
Turning a blind eye, engaging in segregation, exploitation and non-reporting is a chicken-coming-home-to-roost. It turns out that millions are left-in-the-cold with very dismal amounts to garner health care – especially when African Americans have a long history in working in America and for long, long hours per day for Caucasians who by design took funds, failed to pay correct wages as they did for their like-kind. Today, for there to be the necessary changes, this knowledge must be exclaimed to highest rooftops and mountains of Congress.
The Code of Conduct that has supported greed and wrongful fact that disallowed education attainment for better/best employment, the funds were stolen from African American and other People of Color wages (low and unequal wage to support family) and the wages that were not placed in the labor bank for Social Security must be vocalized as part of the solutions. Casting blame and demonizing is out-of-order.
Truthful and strategic solution building is the prudent way to go.
This is very critical in the dialogue of today - It cannot be swept under the rug. Lack of INCLUSION and WIDESPREAD “un- and under-employment” in the labor force coupled with low-no wages is still a growing concern to African American and other People of Color. It must also be a solution concern for/of those in governing, budgeting and policy making.
The widespread discrimination is yet a factor for improved employment and introduction to higher paying jobs. Therefore, the coming generations of African American and other People of Color will have similar if not worse seeking to gain the status of Social Security, Medicare and Medicaid. For the coming generations, they will likely continue and the cost will no doubt be higher. Not only must the policies be realistic but it must also seek ongoing opportunities that will curb and delete the disparity gap.
To set-up policies that disown the discriminatory and predatory policies in America that now put drastic and disproportionate rates between what Caucasian have in income (8x that of African American) and asset that include retirement and equity in homes again is night and day difference.
Social Security, home equity, and present income is ludicrous and inappropriate as an asset tool that is used in determining cost sharing and other budgeting issues. Likewise, to try to demonize and penalize folk who have worked in environments of hostility, low wages, exploitation, lack of education attainment and sometimes brutality is insane and should be pointed out as loudly as possible. It is important to note, African American and other People of Color, usually have two or more jobs (one or all part-time; one or more with a temp agency) and still can not make ends meet; and, do not have an increase in their labor bank or asset bank.
Since the formula for cost-sharing going forward looks at income, equity and investment nest eggs (mutual fund benefits, 401k, etc.), federally-assisted exchanges and all exchanges should be out-front with communication, face-to-face dialog, encouragement and incentives to academic health networks, dialog when negotiating with insurers of the marketplace, and re-occurring dialog with the Department of Labor to ensure that the training is across the board for adding geriatrics to hospital and clinical rotations in academic training. A boost in salary for geriatric care should also be one of the incentives for career selections. Given the population care that will be needed now and in the decades to come, aging is one of the top allopathic and osteopathic services.
Budget and financing
• Medicare is 16% of the federal budget and rising as a share of the budget and the economy
• Medicare faces long-term financing challenges, with fewer workers to support retirees, and growing number of Medicare beneficiaries
Beneficiaries
• Beneficiaries incur relatively high out-of-pocket expenses as a share of income and household budgets (no limit on spending, dental, or long-term care)
• Medicare’s benefit structure is complex (traditional Medicare); unclear how well beneficiaries navigate private marketplace, but have many choices
Other challenges
• Improving care management and targeting interventions to beneficiaries with the greatest needs and highest costs
• Setting fair payments to plans and providers (e.g. the SGR/Sustainable Growth Rate)
Most people on Medicare are of modest means, and half lived on less than $23,500 in 2013
– A small share has high incomes
• Most people on Medicare have some savings and home equity, but the range of assets among beneficiaries is wide
– Half of all Medicare beneficiaries have less than $61,400 savings or less than $66,700 in home equity
• Income and assets are projected to be somewhat greater among the next generation
– Much of the growth is projected to be realized among the upper income and asset levels
Budget and financing excerpts:
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Updated: Valentine Day 2014
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