Evolution of Healthcare: Medicare

Evolution of Healthcare: Medicare

Serious diseases were of primary interest to early humans, although they were not able to treat them effectively. Many diseases were attributed to the influence of malevolent demons, alien spirit, a stone, or a worm into the body of the unsuspecting patient. These diseases were warded off by incantations, dancing, magic charms and talismans, and various other measures. If the demon managed to enter the body of its victim, either in the absence of such precautions or despite them, efforts were made to make the body uninhabitable to the demon by beating, torturing, and starving the patient. As time progressed and man got smart so did Healthcare. With the advancement in healthcare the way the services where paid for need to be changed also. Many programs like private insurance, Medicaid, and Medicare were born.

The Medicare program was first established in 1965 as Title XVIII of the Social Security Act. In passing this legislation, Congress separated Medicare into one common definitional part, Part C, and two substantive parts, Part A and Part B. The purpose of Medicare was to provide the same type of health care as could be provided by a comprehensive insurance plan by a private entity. Specifically, Medicare was to provide a coordinated and comprehensive approach to federal health insurance and medical care for the aged and disabled (www.cms.hhs.gov).

The Medicare program went into effect July 1, 1966. It entitles persons age 65 and over (and their spouses who are at least age 65) who have paid into the Social Security system or Railroad Retirement benefits to federal health insurance coverage. In addition to those over the age of 65, the program also covers two categories of person under age 65: those with end-stage renal (kidney) disease and disabled persons who have been receiving Social Security disability benefits for 24 months. Medicare is an entitlement program and is not a needs-based program like Medicaid, a federal-state program of medical assistance. Medicare is funded from payroll taxes, general taxes, interest accumulated from the Health Insurance Trust Funds, and monthly premiums paid by Medicare beneficiaries. Furthermore, beneficiaries are responsible for paying deductibles and coinsurance amounts.

Medicare is divided into two parts: Part A, hospital insurance (HI); and Part B, medical insurance (also called supplemental medical insurance or SMI). Medicare does not pay for all of a beneficiary's health care costs; it only pays a portion of it. Because of this, many Medicare beneficiaries supplement their coverage with private health insurance. Medicare Part A covers areas such as inpatient hospital stays, skilled nursing facility stays, home health care, and hospice care. While Medicare Part B covers the services provided by physicians, medical supplies, second opinions regarding surgery; clinical laboratory diagnostic services; limited mental illness services; limited chiropractic services; limited podiatrist services; limited optometrist services; and limited dental surgeon's services. There is no monthly premium to pay for Part A because coverage has been earned through a person's payroll taxes deducted during his or her working years. Part B, on the other hand, is voluntary and requires a monthly premium, most often deducted from a person's Social Security check each month.

Today, Medicare provides health care coverage for more than 40 million Americans. Enrollment into