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Three major components of the Medicare and Medicaid programs are that they cove
Three major components of the Medicare and Medicaid programs are that they cover prescriptions, hospitalizations, and outpatient visits. Based on these three, each have patient coverage gaps. In regards to outpatient visits, gaps include out of pocket costs as well as lack of coverage for certain outpatient visits such as dental and vision coverage. Many offices also do not take Medicare or Medicaid as an insurance option for their patients, which will cause them to have to find an office that accepts their insurance, which limits their options and access to healthcare.
For prescriptions, out of pocket costs are also a gap in coverage as well as not having access to the brand of a medication the doctor may have prescribed, in which case they will often have to call their doctor from the pharmacy to prescribe the generic medication rather than a brand. I have seen this be the case many times for my mom who has rheumatoid arthritis, and she has insurance from her job. She often has issues battling with her insurance company to try to be approved for a medication ordered by her doctor. If it is so difficult to receive care for someone who has insurance, I cannot imagine the battles that people with Medicaid must face if there are less options and availability for medications which they are willing to cover for them.
Lastly, for hospitalizations, the coverage gap may include a shortage of providers, depending on the area in which the patient lives. Another gap may be that providers will be hesitant to order certain tests at the hospital based on the cost if they know they have Medicare/Medicaid. They prefer to only treat emergent issues, which leads to a gap because they are not receiving preventive care. Preventive care may be an even bigger issues for younger patients, as I have heard of people being denied labs and tests due to their young age being indicative of a disease process being less likely, thus not deemed worth of drawing labs and ordering expensive tests for. Medicaid/Medicare may not be willing to cover these costs in younger patients who are considered to be lower risk. My position on the Social Security program for the American public is to modify it to strengthen the program for the benefit of the American public. Modification of the program can yield extensive benefits for those who are disabled or elderly. Many retired and disabled people are unable to afford health insurance, and it is important to aid this population. Changes can be made to strengthen this program to provide adequate care for Americans.
Reference: Dickson, E. L., Mason, D. J., McLemore, M. R., & Perez, G. A. (2021). Policy & Politics in Nursing and Health Care. Elsevier.
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