Medicare and Medicaid

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Differences between Medicare and Medicaid

Medicaid and Medicare are both government-supported initiatives designed to assist in covering healthcare costs. Similar names of the programs, usually make people confused and mislead about how the programs function and what they cover. Although both programs were set up by the United States government in 1996 and are funded by taxpayer money, they are, in fact, very dissimilar initiatives with differing eligibility prerequisites and coverage (Ng & Kitchener, 2010). In simple terms, Medicare is framed to assist with long-term care for elderly people, while Medicaid covers health costs for poor people. However, there is much more that distinguishes these programs.

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Initiated by the federal government, Medicare is the program that is seen as a close one to Social Security. This program is available to every Unites States citizen aged 65 years and above and covers individuals with particular disabilities (Hanoch et al., 2009). Medicare is available irrespective of the beneficiary’s income. Medicare consists of four parts which include hospitalization coverage (Part A), medical insurance (Part B), privately bought supplemental insurance that offers added services, and through which every Medicare service provided by hospitalization coverage and medical insurance can be accessed (Part C), and prescription drug coverage (Part D) (Hanoch et al., 2009). Parts A and B are funded through subtractions from Social Security income and taxes from the payroll. On the other hand, parts C and D are funded by individuals who participate in the programs. Part D was added to Medicare in 2006 to solve the problem of medication price hikes.

Medicaid on the other hand is a joint federal and state initiative that allows low-income people and families to cover the expenses for medical and long-term non-medical care (Sommers & Rosenbaum, 2011). The federal government pays up half of the expense of every state’s Medicaid initiative, with one amendment that rich states receive fewer funds than poor. Due to this state and federal cooperation, there are in fact fifty diverse Medicaid initiatives, one for every state. As opposed to Medicare, which anyone can access, Medicaid has stringent eligibility preconditions. The requirements vary from state to state (beyond the fundamentals outlined in the federal guidelines), but the initiative is built to assist poor people in the first place. As such, several states require individuals who receive Medicaid to possess no more than a few thousand dollars in liquid assets to take part in the initiative.

Even though Medicaid is aimed at providing help to those below the poverty line, low income may not be the only justification that grants the right to use its privileges. Additional qualification requirements are imposed to make sure that the initiative caters to specific categories of people, such as children, the elderly, families, the disabled, pregnant women, and caretakers of children (Sommers & Rosenbaum, 2011). In addition, services vary through the country, but the federal government requires states to cover the following services when they are judged to be urgent: hospitalization, nursing services, laboratory services, medical and surgical dental services, doctor services, x-rays, family planning, clinic treatment, and midwife services (Costigan, 2013). Added coverage services mandated by the federal government include pediatric and family nurse practitioner services, home healthcare for individuals qualified for nursing facility services, screening, diagnosis, and treatment services for individuals aged below 21 years, and nursing facility services for persons who are 21 years and above.

Additionally, every state has the alternative of including added benefits, such as physical therapy, prescription drug coverage, dental services, medical transportation, eyeglasses, prosthetic devices, and optometrist services (Sommers & Rosenbaum, 2011). Individuals covered by Medicaid use these services free of charge and are totally covered by the medical services.

What is more, Medicaid is usually applied to fund long-term care that Medicare does not cover. For example, when private insurance companies cannot support clients with insurance policies that will cover them fully, Medicaid is here to help. Actually, Medicaid is the country’s largest lone source of long-term care financial support. The expenses are the precondition that the program’s recipients are in majority without any real estate property and it was decided to boost the cottage industry, which is on the rise now, and encourage the lawyers to help people to become eligible for Medicaid. In essence, Medicaid covers a vast array of healthcare needs.

Qualitative Research Study: Positive Nurse-Resident Relationships

Rationale

As of 2011, there were more than 1.4 million individuals living in nursing homes in the U.S., with the figure expected to rise as the baby boomer population attains retirement age and beyond (Costigan, 2013). Nursing homes are often called places of last resort. Many analogies have been developed to compare them to different establishments with strict order such as poor houses, and prisons and these places were said to have no tolerance and fundamental human respect. However, despite such negative undertones, they have continued to be an important and highly exploited segment of society. This qualitative ethnographic study aimed to ascertain the relationship between nurses and residents of nursing homes. Typically, a cordial relationship between nurses and residents is imperative for the successful rehabilitation of residents of nursing homes. Thus, it is vital to understand the kind of relationships that exist among nurses and residents of nursing homes to improve on areas found to be deficient.

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Purpose of the Study

This study was focused on ethnography, observation, and interviewing 10 nursing home workers. The study was employed to give insight into the nature of productive cooperation between nursing home residents and nursing assistants in a premise with an established reputation for the quality of life of the residents (Costigan, 2013). This study was conducted to answer the questions about the types of interactions and relationships are found in the facility, the nature of the relationships that the setting’s residents perceive to be positive, the development of relationships, and how were they sustained over time. Another question was about environmental aspects which supported these relationships. The study aimed to give a full answer to these vital questions and establish the forms of relationships found in nursing homes.

Methodology Design

A qualitative inductive method that uses focused ethnography was chosen to investigate and illustrate positive relationships between nursing assistants and individuals residing in a specific nursing home. Focused ethnography was chosen because it focuses on comprehending a particular facet of the culture and nursing home (Costigan, 2013). In this study, focused ethnography was crucial for acquiring implicit information about positive relationships between nursing home residents and nursing assistants. In addition, the study used research questions to understand the nature of relationships in nursing homes.

Conclusion

The main result of the study was that residents and nursing assistants proved to have positive relationships but they vary and heavily depend on the level of involvement (Costigan, 2013). Every participant regarded themselves as having a positive relationship with the nursing assistants. The study identified the following three types of positive relationships: positive relationships with specificity, positive non-specific relationships, and positive-distant relationships. Regarding the third and fourth research questions, the study concluded that residents found it difficult to remember their first days and weeks in the setting. Consequently, the residents were not able to tell how the relationships developed. Concisely, the study established that nursing attendants played an important role in ensuring the overall well-being of the facility.

References

Costigan, R. A. (2013). Positive Nurse-Resident Relationships a Focused Ethnography in a Nursing Home. Open Access Dissertations. Paper 40. Web.

Hanoch, Y., Rice, T., Cummings, J., & Wood, S. (2009). How much choice is too much? The case of the Medicare prescription drug benefit. Health services research, 44(4), 1157-1168.

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Ng, T., Harrington, C., & Kitchener, M. (2010). Medicare and Medicaid in long-term care. Health Affairs, 29(1), 22-28.

Sommers, B. D., & Rosenbaum, S. (2011). Issues in health reform: how changes in eligibility may move millions back and forth between Medicaid and insurance exchanges. Health Affairs, 30(2), 228-236.

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NursingBird. (2022, July 22). Medicare and Medicaid. Retrieved from https://nursingbird.com/medicare-and-medicaid/

Reference

NursingBird. (2022, July 22). Medicare and Medicaid. https://nursingbird.com/medicare-and-medicaid/

Work Cited

"Medicare and Medicaid." NursingBird, 22 July 2022, nursingbird.com/medicare-and-medicaid/.

References

NursingBird. (2022) 'Medicare and Medicaid'. 22 July.

References

NursingBird. 2022. "Medicare and Medicaid." July 22, 2022. https://nursingbird.com/medicare-and-medicaid/.

1. NursingBird. "Medicare and Medicaid." July 22, 2022. https://nursingbird.com/medicare-and-medicaid/.


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NursingBird. "Medicare and Medicaid." July 22, 2022. https://nursingbird.com/medicare-and-medicaid/.