After reading the scenario for this discussion, it made me think about my mother’s struggle with Medicare and Medicaid during her over twenty year battle with kidney disease. Medicare is meant to cover acute care and provides only limited coverage for long term care (De Nardi, French, Jones & Gooptu, 2012). In order to qualify for Medicaid, you cannot have any assets and your income must be very low. My mother’s social security income did not cover living expenses, so she had to live with me.
We would receive her medical bills which were thousands of dollars for dialysis, hospital stays and doctor appointments. Then we would forward them to her social worker who would process them under the Medicaid “spend down” program. It was not very efficient and periodically she would be kicked off the program for not having enough medical expenses and have to reapply. Whenever she needed physical therapy or home health assistance, it was covered like Mary’s in the scenario for a specific time period and set amount of days per week. However, it was expected that I would fill in the gaps and help her with anything else she needed. Her social worker would give me phone numbers to several organizations that provided home services and a lot of the time they were out of business, no longer receiving funding from the government or my mother did not meet the qualifications for the service.
In looking into other resources on Medicare’s website (medicare.gov) for this discussion, I found the PACE program. I was never advised of this when my mother was alive, but it is a service that works with the patient and family members to coordinate care. They cover authorized expenses that Medicare and Medicaid will not cover.
It scares me to think of other elderly people who do not have children or family members to take care of them and live alone like Mary. Our system does not provide total and complete quality of care to its citizens. It is appalling to witness a country with such wealth, not investing in the health of its people. When you look at France and how they have managed to combine universal coverage with a public-private mix of care, they seem to get it (Rodwin, 2003). The French also have a larger older population than the United States, yet they spent 9.5% of its gross domestic product (GDP) in 2000 on health care compared to the 13% GDP spent in the United States (Rodwin, 2003).
Read the post above and respond the response in detail. This response should entail critical thinking and a real life scenario. Consider the leaner’s evaluation and describe the extent to which you agree. Provide any additional insights that you think might be helpful. This is an assignment discussion and the answer has to have a minimum of 150 words, two critical thinking questions, and also one peer-reviewed reference and citation. The answer should go by the scoring guide listed below.
- Analyzes course concepts, theories, or materials correctly, using examples or supporting evidence.
- Collaborates with fellow learners, relating the discussion to relevant course concepts and extending the dialogue.
- Applies relevant professional, personal, or other real-world experiences to extend the dialogue.
- Validates position with applicable knowledge.