Implementation and Modification, Research Paper Example

President Bush appended his signature on the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 on December 8, 2003. This legislation carried broad changes on the program of Medicare. The programme provided some limited assistance to the beneficiaries of Medicare who paid for prescription drugs (Frederick, 2010). The congress viewed the bill as able to begin some programs, extend others, which would help Medicare beneficiaries.

Part D of the Act, Prescription Drug Benefit, give a new Medicare in which individuals who are eligible for either Part B or A may get qualified prescription coverage of drug through a Medicare Advantage Plan (MA-PD) or a stand-alone prescription drug plan (PDP) (Kaestner & Nasreen, 2012). The program would offer such programs in CMS developed regions, which correspond to regions with managed care plans.

The main provisions of the new policy are prescription drug programs, benefits and structural changes and other changes. Prescription drug programmes deals with prescription drug discount card, prescription drug benefit, controlling the cost of prescription drugs and prescription drug coverage for low-income individuals amongst other items (Richard et al, 2009). Benefit and structural changes deal with extension of QI-I program, restoration of the moratorium on therapy caps, new preventive benefits and services amongst others.

The provisions seem to accomplish crucial goals in the health of the people if only implemented amicably. Implementation is lacking in most cases, and the society continues to suffer. However, it is worth noting that the policy does not favor all people and thus some people go through hard times even at present with the Medicare changes.

The senate committee on aging initiated the need for the Medicare provisions for the elderly, claiming that the elderly underwent many problems including a lack of access to healthcare, lack of recognition of their social standing and needs, workplace discrimination and immense poverty from eroding or inadequate incomes.

The introduction of the bill into the House of Representatives took place on June 25, 2003 sponsored by Speaker Dennis Hastert. Debate on the bill took place, and after an electronic vote on the bill, there were 218 nays and 214 yeas. The bill passed after some republicans changed their votes. For instance, Ernest J. Istook, Jr. ,who changed for an aye when he got that C. W. Young was, absent because of death in their family and that he would have voted “aye”. Other republicans who changed include Jo Ann Emerson and Butch Otter. On November 22, 2003, the bill came to a vote at 3.a.m. and after forty-five minutes, the bill was losing with David Wu not voting. Majority leader, Tom Delay and Speaker Dennis Hastert convinced some republicans to switch their votes. Istook, with unwavering vote consented and the tally became 218-216. The voting continued as they looked, for two more votes, to support the bill, and finally it passed.

Market forces

The legislation was controversial because of the changes to law components and introduction of private competition incentives in a bid to control Medicare system costs. The competition would produce a strong foothold for care managed within the system. This was a move to repeat many problems because of problems in the private sector managed care. This passing of legislation, like that of 1997, Medicare and Choice program subjects Medicare to private market forces.

This new law attempts to bring rehabilitation for the Medicare+ Choice program via improved subsidies and reimbursement beginning in 2006. The Bill’s opponents such as Sen Ted Kennedy had concerns that private competition would undermine the program of Medicare by letting the sickest patients go into traditional plans while healthy, young persons go for private plans, and by this, they increase their Medical premiums.

Psychological interests

The problems with the legislation have affected healthcare consumers as well as providers like psychologists (Cutler, 2010). Despite the appearance of doing good, this legislation has a potential to worsen the problems. It is clear that most of those who benefit from the program are the rich or the young people. This is because they can   work and pay bills easily unlike the elderly who do not have much.

The supporters of the legislation claim that the laws are fair and would ensure quality Medicare for the Americans and that the laws would ensure fair provision for all people alike. Welch one of the opposers of the legislation claims that the law is the most anti-health measure they have ever passed in America.

Newman asserts that, there will be continuing debates on the issue of Medicare legislation and that those who are in the white house will determine how the debate will go on considering the problems so far created. According to Frederick (2010), it is also worth noting that communication with members of congress and grassroots’ actions will also play a role in influencing situations. The outcome of the legislation is changeable according to Welch, but we need to take it the right way.

Decision making process requires crucial data such as access to individual patient files and costs. The legislation should look, therefore, into having provisions to ensure that data is available for easy access to relevant information about Medicare.

References

Cutler, N. E. (2010). The “Other” Health Insurance Reform: Medicare Part D since 2004. Journal Of Financial Service Professionals, 64(6), 22-27.

Frederick P., F. (2010). Health Policy Issues: 2003 legislative and regulatory update. AORN Journal, 78846,848-846,851. doi:10.1016/S0001-2092(06)60646-7

Kaestner, R., & Nasreen, K. (2012). Medicare Part D and Its Effect on the Use of Prescription Drugs and Use of Other Health Care Services of the Elderly. Journal Of Policy Analysis & Management, 31(2), 253-279. doi:10.1002/pam.21625

Richard R., C., Marcia M., W., Stephen W., S., Jon C., S., Tom A., L., Donald L., U., & Ronald S., H. (2009). Original Research: PDP or MA-PD? Medicare part D enrollment decisions in CMS Region 25. Research In Social And Administrative Pharmacy, 6130-142. doi:10.1016/j.sapharm.2010.04.002