HEALTHCARE UTILIZATION AND FINANCE

Healthcare Utilization and Finance



Healthcare Utilization and Finance

Introduction

Conclusion

HEALTHCARE FINANCING IN UNITED STATES

[Name of the Institute]

Healthcare Financing

Scenario 1 (A)

It is important for the society to understand the need of providing better healthcare services to its people devote resources and funds for the health benefits of society. Mostly, finance provided for healthcare in developed countries is funded through the taxes collected by the government. Today, Medicare is considered to be the only program that has been assigned with the responsibility to provide insurance for healthcare purpose. People who are above the age of 65 five years are entitled to receive health benefits and financing from the program, and are suitable to participate in the program (Seshamani, Lambrew & Antos, 2008). Medicare can be further categorized into four divisions those are A, B, C and D based on the criteria if financing and the benefits they provide to individuals. Since Mrs. Zwick has crossed the age of 65 years and is now 77 years old therefore she is entitled to receive benefits from Medicare (Docteur, 2009).

Medicare Part A

The financing of Medicare part A is done through the funds and resources from the social security taxes, and allows for paying for the inpatient hospital care, hospice care, skilled nursing care and also other services. This will be free for an individual who has paid social security taxes for at least a period of 10 years, however if not then premium has to be paid monthly (Stein & Chiplin, 2006) (Docteur, 2009).

Medicare Part B

Source use to finance the payment for Medicare Part B is through US treasury. Individuals who have been enrolled for the program can also contribute towards making the payments for part B along with the revenues generated from the government. It is accountable for making payments for outpatient hospital visits, fees of the doctor and other services that are not covered by Part A (Stein & Chiplin, 2006). It also accounts for making payments of drugs, and as Mrs. Zwick has been prescribed with different medicines financing will be done by Medicare (Fox, 2010).

Medicare Part D

According to Medicare Part B, individuals willing to get the services have to get enrolled unlike Part B, in which enrollment is done automatically. A form has to be filled for enrolling oneself for receiving an approved plan. It is mainly responsible for providing drug coverage of outpatient. The provision is done by some of the private insurance companies that have contracts with the government, and no direct provision of funds is received from the government (Stein & Chiplin, 2006) (Fox, 2010).

Scenario 1 (B)

Medicare that is a United States health insurance program was begun in the year 2009 for the people who are elderly and disabled. According to the rules and principles of the program it is not the responsibility of Medicare to make payments for the infections that have resulted from staying in the hospital, therefore if an individual is hospitalized and is being treated for an illness of which the ...