Medicaid program

PART ONE

a. Purpose of the program

The US government established the Medicaid healthcare program with intentions of making healthcare accessible and affordable to the citizens. The program was perceived as one of great importance because in the US there are a high number of people who belongs to the low-income class and hence could not afford healthcare services which are relatively high. After the establishment, different US states embraced the program into their respective healthcare industry and the program is normally operated independently in various US states. For example, I come from Illinois, and in this state, the Medicaid program that offers health care assistance has been branded as Illinois Medicaid Program. The program is jointly funded by the US national government and the federal government program. The program's main purpose is to pay for necessary medical individuals who cannot access or afford health care services, and they are citizens or legal aliens of Illinois (Thompson, 2012). The Illinois Medicaid program pays for medical services for children and their caregivers, parents, pregnant women, persons with disability, the blind, and also citizens older than 65 years. The services that are catered for by the Illinois Medicaid program is the physician bill, hospital bill, long-term care, drugs, medical equipment, laboratory tests, family planning, x-rays, and transportation among other health care services.

b. Effectiveness of the program

The Illinois Medicaid program cannot be classified as one that is very efficient. The reason is that, despite the program being targeted to help low-income earners and people in need of medical assistance like the disabled and the old, the program has not been able to prevent people from middle-income class to enjoy free health care services. In Illinois, there are a big number f people from the middle-income class who are not supposed to benefit from the program, but they end up benefiting. The reason is that the program has not set limits on the extent that the program can accept when it comes to the classes of people that should enjoy the services. For example; the program allows pregnant women to enjoy the service. The program does not put into consideration whether the woman is financially capable or not and this paves the way for fraud to take place in the Illinois healthcare service delivery (Rudman, et al., 2009). This is also the same case when it comes to caring givers or parents of a child who has been born disabled. The reason is that despite the child being with a disability, the parents might have ample financial ability to take care of their child's medical bills and the program only left for the low-income earners and those extremely poor individuals.

Luckily, according to Quinn, et al., (2016); the Illinois Medicaid program cannot be said only to have failed. The program has achieved numerous goals especially when it comes to making healthcare affordable not only to the low-income earners but also to the middle and high-income earners (Thompson, 2012). The reason is that the program has also strived to make sure that the government funds has been used to provide quality medical services available at different healthcare facilities. Thus, the funding has made it possible for the industry to lower the cost of healthcare in Illinois. But for the people, who fall under the set required income level, they enjoy free medical services, and this has made over 85% of poor people in Illinois to be beneficiaries of the program.

c. Viewpoints or opposing views to the program

Since the Illinois state government established and implemented the Illinois Medicaid program, different stakeholders have shared different viewpoints and ideas about the program. There are individuals who have been in support of the program while others have emphasized that the program is not good enough and that it should be amended. For example; the people under the poverty level support the idea that the Illinois Medicaid should be for the low-income people who unfortunately happens to occupy a big percentage of the population as compared to middle and high-income earners. The reasons provided for this viewpoint is that the middle and high-income earners can afford the high cost of healthcare and also the amount demanded by the insurance companies (Pressman, 2015). Thus, the program should target only the individuals who cannot afford healthcare and only relies on the government for assistance. The people who are from the low-income class, as well as humanitarian agencies, have been in the front line claiming that the program should work only for the poor individuals as they are the ones in dire need of medical assistance.

Another reason why the Illinois Medicaid program is said to be a good program and that should continue supporting the low-income earners is because the middle and high-income earners heavily rely on low-income earners. The latter is in the sense that the middle and high-income earners search for low-income earners to work for them and hence the health of the low-income earners should be the state's priority. The reason is that when the low-income earners are of bad health, and they cannot afford medical services, the middle and high-income earners would also be affected because they would not have enough people to hire and this economic status will be compromised (Pressman, 2015). This is an opinion that was once shared by the Illinois State governor. By making the program to be only for the low-income, disabled, and the aged was a way that the state and national government was trying to bridge the wide gap that has always existed between the rich and the poor. This is not forgetting the reality that diseases further makes the level of poverty to exceed and hence offering medical services to the poor people is also a way of making sure that the poor are in good state of health so that they can be empowered to improve their livelihood.

Some individuals share a different point of view that Illinois Medicaid program should not only be for the poor and the aged. Some people from the middle and high-income earners claim that the Illinois state government has the ability and resources that can enable them to establish a program that can cover even the individuals from the middle and upper-income earners (Pressman, 2015). These people claim that the fact that they have worked hard to improve their economic status is not a good enough reason to lock them out of the program. They share the feeling that they are also a part of the Illinois community and establishing a program that offers services to a particular group of people is a form of segregation.

PART TWO

From: The Managing Director

Cc: Head of the department

To: All the staffs

Date: April 19, 2017

Subject: Healthcare programs

Since the healthcare programs were established and implemented into the system, we as health care professionals can do little to avoid the programs and hence it is our duty to make sure that the programs work efficiently. The reason is that effective working of the programs would help us to perform even better and have medical bills that have affected the industry and as paid through the programs. I am on the realization that it is tough for healthcare professionals to keep up with all the programs offered through the government. But, in every challenge, there is always a solution, and this is the reason why I am providing you with important tips that will help you deal with healthcare programs challenge.

As you all know, there are different programs, but the difference is that they do not work the same. Some are easier to operate as compared to others. This is information that even the patients are not aware of, and hence it is our duty to inform the patients. Comparing the many health programs that there is in the industry today, Medicaid is one of the most effective and easy to use programs. Also, it is a program that has many benefits that the customers can benefit from regardless of the social and economic backgrounds. The reason is that the program has diverse options and this means that it is for every member of the society. With a Medicaid program, patients can enjoy low cost services, and the program is available in almost all the medical facilities including our facilities. Thus, when offering services to clients, it is important that you offer them advice so that they can choose the Medicaid program as their selected health care program. This way, the patients will be able to enjoy the benefits that come along with the program, and we as healthcare providers will be able to experience the convenience of the program.

Thank you

References

Lee, N. R., & Oral, O. P. (2014). The Changing Face of Healthcare Fraud and Abuse in America

Myth of lobbyists

Part 1

In general definition, a lobbyist is an individual who takes part in an organized strategy attempts to influence the legislators. In the US government system, lobbyists have been present and have since the 1800s sought to influence lawmakers especially over healthcare projects. Lobbyists in the US healthcare system have played a major role as they strive to protect and advocate the interests of the people that they represent. In 2009, the then US president Barrack Obama introduced the Patient Protection and Affordable Care Act that was intended to provide affordable medical services to the people of US. The PPACA was a complete care act was also designed to reduce the cost of healthcare which was escalating hence locking out a high number of people who belonged to the middle and low-income economic classes from accessing healthcare (Rosenbaum, 2011). However, after the bill was proposed and information about the bill was made public through the legislature, lobbyists started to raise different issues with intentions of influencing legislature so as to advocate particular interests.

For example, in the PPACA bill was to use approximately $130 billion of taxes to endorse the bill. The US health insurers, retailers, and medical device makers selected individuals to act as lobbyists and influence the Senate Democratic members to overturn or vote against the use of $130 billion meant for endorsement of the PPACA. The lobbyists claimed that that was a relatively high amount while as there were significant issues that could be sufficiently addressed using public taxes. In this case, the lobbyists were advocating for general public stating that it is illegal and unprofessional to use such a hefty amount of taxes to endorse a bill (Rosenbaum, 2011). Also, the PPACA bill required employers to provide an insurance cover for all full-time workers something that the lobbyists were against claiming that the demand was exaggerated. In this case, the lobbyists were advocating for employers arguing that providing insurance for full-time workers was extremely expensive and unaffordable to many employers considering the high cost of healthcare.

According to Cannan, (2013); in the PPACA bill, there were some ethical issues and moral disputes that were realized. First, with the issue of PPACA bill using a relatively high amount for endorsement purposes; it is evident that there was a moral dispute. The reason is that the bill was supposed to improve healthcare in the US by making healthcare accessible and affordable to many. Hence, using such a hefty amount of $130 million for endorsement shows like the bill has hitches and requires an enormous amount of finances to influence the legislature to pass the bill.

On the other issue of the employers having to pay for medical insurance for full-time workers, the ethical challenge was that this requirement could not have applied to all employers. The reason is that employers are operating big, medium, and others small businesses. The requirement going with the cost of healthcare in the US as well as the amount paid for insurance covers could only be affordable for employers running large businesses. Thus, making such a demand would adversely affect employment. The latter is in the sense that with employers being required to provide medical insurance to full-time employers mandatorily would make employers who cannot afford to reduce the number of full-time employers and hire employees on a contract basis or temporary. Notably, temporary employment can lead to reduced salaries and benefits hence adversely affecting a big number of Americans.

The actions that the lobbyists took concerning different issues raised by the PPACA bill can be said to have both negative and positive effect on healthcare legislation in the US. First, the lobbyists’ action had a positive impact because it made the legislatures who were supporting the bill to have a rethink and review the bill (Hill, et al., 2013). The reason is that some of the issues raised were critical and sensitive and it is only a review of the bill that could have made the passing of the bill possible. The review of the bill hence led to making the bill comprehensive and considerate of all stakeholders' interest.

Secondly, the lobbying action made it possible for the people of American people to air their ideas and suggestions about the healthcare program. This was a positive thing because the government was able to have diverse ideas and this helped in developing a higher quality and an involving program that the people felt that it was meant to help them (Sade, 2012). This is an important action because a health program should involve the people so as to obtain information about their feelings and opinions about the proposed bill. This way, it becomes possible to make the law, people's bill hence making it have adequate support. The third positive effect was that the tax amount that was supposed to be used for endorsement was significantly reduced hence saving public finances for other purposeful activities.

The action caused an adverse impact on the healthcare reform bill because it prolonged the time that the law took before it could be passed. Thus, the benefits that people were supposed to enjoy after the passing and signing of the bill were delayed hence the pains of unaffordable healthcare continuing to adversely the people. Secondly, lobbyists’ action opened a way for a well-intended project to be mixed up with politics hence causing confusion among members of the public (Hill, et al., 2013). This is the reason why as more time was being used, more and more lobbyists to start influencing the legislature in different ways. More so, the action made it hard for the legislature to make a conclusive and well thought out decision because of the constant influence as well as perceiving the issue from different point of view.

Even with the passing of the bill and being signed by the president into law, the action of lobbyists continued to affect the bill negatively. The reason is that even the implementation process was compromised as different lobbyists continued to raise different ideas and opinions. This is an action that causes a mixed reaction among members of the public especially when some lobbyists shared views of what could have been done before the bill was passed to make effective and impactful to all American citizens (Hill, et al., 2013). Thus, the bill failed to receive ample support and as a matter of reality started to realize objection from different interest groups hence significantly reducing its importance and intended effectiveness. The reason is that some stakeholders in the healthcare industry who felt that their interests were not considered failed to play their roles effectively so as to make the program efficient since collaboration of all stakeholders was important to make the bill successful.

Part II

Memorandum

TO: The Supervisor

CC: Head of Department

From: Human Resource Manager

Date: 12/4/2017

SUBJECT: Lobbyists actions and Impacts on the Patient Protection and Affordable Act

This memo is in regards to two main lobbyists' actions and their impact on the PPACA. As you all know, the PPACA was established in 2009, and since then, different issues has been raised by lobbyists representing different stakeholder's interest. Importantly, the lobbyists' actions have in a great way influenced the legislature regarding their support or opposition to the bill. To start with, the lobbyists raised the idea that the PPACA healthcare program was using a relatively high amount of public taxes ($130 million) an amount that could have been used for other programs. Secondly, the lobbyists raised the idea the requirement set by the PPACA program that employers have to provide a medical insurance cover to all full-time employees was inapplicable especially to employers running small businesses.

From the lobbyists' actions, both good and bad effects have been realized that have in different ways affected healthcare legislation in the United States. First, the lobbyists' action has made the legislature to have a review and rethink about the issue and hence making necessary amendments. Also, the lobbyists' action has opened up the public eye and attention on the issue hence making the public to raise ideas. However, the lobbyists’ action has also caused massive delay to the implementation of the program hence making the program more costly. Again, the lobbyist's action triggered confusion over the issues and more so attracting political interests on the issue hence overshadowing the initial intention of the of the plan. Lastly, the lobbyist's action which led to the arouse of many stakeholder's interests being preserved and protected led to resistance from the stakeholders who felt that their interests were never observed hence causing conflict and lack of moral observation in the US healthcare industry.

References

Cannan, J. (2013). A Legislative History of the Affordable Care Act: How Legislative Procedure Shapes Legislative History. Law Libr. J., 105, 131

Hill, M. D., Kelly, G. W., Lockhart, G. B., & Ness, R. A. (2013). Determinants and effects of corporate lobbying. Financial Management, 42(4), 931-957

Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: implications for public health policy and practice. Public health reports, 126(1), 130-135

Sade, R. M. (2012). The Health Care Reform Law (PPACA): Controversies in Ethics and Policy, 523-525