Medicare Program: Benefits, Limitations, and Healthcare Strategies

This report analyzes the Medicare program, a federal initiative in the United States, focusing on its benefits and limitations. The program provides healthcare coverage for individuals over 65 and those under 65 with specific conditions like Social Security Disability Insurance (SSDI) recipients and those with End-Stage Renal Disease (ESRD). The report highlights that the program makes healthcare affordable for American citizens. However, the report also acknowledges the limitations of the program, such as the requirement for beneficiaries to pay coinsurance and copays. The report suggests the role of nurses in educating people about the Medicare program to help them access quality healthcare. References include studies on pharmaceutical influence and national trends in hospital admissions for hyperglycemia and hypoglycemia among Medicare beneficiaries.

Medicare is a special program by the federal government of the United States that
provides coverage for health care of people above and below 65 years old. However, for those
under 65 years old, they must be either receiving Social Security Disability Insurance (SSDI) or
have been diagnosed with End-Stage Renal Disease (ESRD). This program.
One of the main benefits of this program is that it makes quality healthcare affordable for
American citizens. Health care in the United States is very expensive when compared to other
developed countries (DeJong et al., 2016). As a result of this, most people especially old people
are not able to cater for their healthcare bills out of pocket. However, with Medicare program,
these people are able to access quality care since most of Medicare program plans cost $0 a
month. Also, the Medicare program covers both healthcare needs of the patients. For example,
the program covers the cost of gym and that of drugs. This makes health even cheap for the
American citizen. However, despite those benefits, the program has some limitations. For
example, the program still requires people to pay coinsurance and copays fees. This is a
limitation because this program was to make healthcare affordable especially for the old people.
Therefore, by asking people to pay for coinsurance and copays fees out of the pocket, the
program is still making healthcare expensive for American citizens.
Most people who cannot access quality care in the U.S are found at the local community
level (Lipska et al., 2016). Therefore, nurses can organize for outreach programs to teach these
people the essence of enrolling in Medicare program and why it’s important for their health.
Also, nurses can talk to patients about the importance of enrolling in this program at hospital
when they are offering treatment to this patients.

Reference
DeJong, C., Aguilar, T., Tseng, C. W., Lin, G. A., Boscardin, W. J., & Dudley, R. A. (2016).
Pharmaceutical industry–sponsored meals and physician prescribing patterns for
Medicare beneficiaries. JAMA internal medicine, 176(8), 1114-1122.
Lipska, K. J., Ross, J. S., Wang, Y., Inzucchi, S. E., Minges, K., Karter, A. J., ... & Krumholz, H.
M. (2014). National trends in US hospital admissions for hyperglycemia and
hypoglycemia among Medicare beneficiaries, 1999 to 2011. JAMA internal
medicine, 174(7), 1116-1124.