final health care policy analysis paper

1 Policy Analysis Paper

Aging and Health Care, Obama Care

Denisa Llangos 10/27/14 SW4710 E!"14


#$here is no illness that is not e%a&erbated b stress'()Allen Lo*os Health is the state o+ being +ree +rom illness or in-r' .t is the the most +ear+-l and så iss-e among all h-mans' e&entl, to reent all these health &are di++i&-lties s-&h as mone, no re&o-rses, and e%enses, the high rise o+ the oor and ill o-lation, resident Obama signed into la $he A++ordable A++ordable A&t' A&t' 3Whiteho-se n'd $here hae been man 5-estions and do-bts abo-t the ne a&t, there+ore it de&ided to e%and the *noledge on this ne iss-e' A&&ording to 6oa* 3201 $he A++ordable A++ordable Care A&t 3ACA is intended to e%and Ameri&ans8 a&&ess to health &are' 9illions o+ Ameri&ans ill be&ome nel ins-red, and millions o+ others ill &hange the so-r&e o+ their health ins-ran&e' Changes introd-&ed b the la in&l-de ne re5-irements +or emloers to o++er &oerage, ta% &redits and s-bsidies +or indiid-als ho la&* a++ordable &oerage, and a 9edi&aid e%ansion in arti&iating states' 36oa*, 201 .t also made it mandator +or anone ho doesn8t hae health ins-ran&e to get it' $hese &hanges &o-ld hae a signi+i&ant ima&t on &ons-mers8 health &are sending' $he la idel red-&es o-t)o+)o&*et sending, as ell as the ris* o+ e%erien&ing &atastrohi& health e%endit-re' 3:erenson, 2010 E++e&ts on total health sending are aried, ith some indiid-als e%erien&ing a de&rease and others e%erien&ing an in&rease' 3:artelestone, 201 ACA ill hae aried ima&ts on &ons-mers8 health &are sending, deending on their in&ome leel and their ins-ran&e stat-s &omared ith hat it o-ld otherise be in 201; in the absen&e o+ the ACA' 36oa* 201 O-t o+ o&*et health he alth &are sending ill de&rease +or the nel ins-red, as ell as those &hanging their so-r&e o+ ins-ran&e' De&reases in o-t)o+ o&*et sending ill be largest +or those ho o-ld otherise be -nins-red' - nins-red' 3:arlestone, 201


.n some &ases these red-&tions ill be dramati&'
&ons-mers, s-&h as the 11'" million ho be&ome nel ins-red b  9edi&aid and the '> million ith in&omes belo 400 er&ent o+ the +ederal oert leel 3 Others, s-&h as the 1;'" million &ons-mers ho are -nins-red itho-t the ACA and ho be&ome nel ins-red on the indiid-al mar*et, ill see their total sending rise -nder the ACA' O+ these 1;'" million &ons-mers, the ' million ith in&omes oer 400 er&ent o+ the

b 9edi&aid ill see their ris* o+ sending at least 10 er&ent o+ in&ome on medi&al &osts de&rease +rom 4" er&ent to " er&ent' 39ano+o, 2011)12 $hat as e read the in+ormation gien to -s it is &lear that mone has to be sent b-t the er&entage o+ eole sending more on ins-ran&es ers-s be+ore itho-t this a++ordable a&t as is less' .t is not mandator and o- do not hae to &hange anthing i+ o- &hoose not to' $he also hae to hae in &onsideration the o-lation that is -nins-red, here do the go in this dire&tion' $he estimate that in 201;, aro%imatel 11'" million reio-sl -nins-red eole ill obtain ne &oerage -nder 9edi&aid' Abo-t 10'; million o+ these indiid-als ill hae in&omes belo 1! er&ent o+ the  .ndiid-als ith in&omes aboe 1! er&ent o+ the  $he &hanging &omosition o+ the o-lation is -tting in&reasing ress-re on the health &are sstem' s stem' .n 2011, 77 million bab boomers ill begin to t-rn ;", and b 202", the n-mber o+ 9edi&are bene+i&iaries is e%e&ted to rea&h ;>' million, reresenting 20'; er&ent o+ the 'S' o-lation, ith the Bold oldBthose oer age !0 &omrising the +astest groing segment o+ the o-lation' With the in&reased n-mber o+ older


Ameri&ans, the elder o-lation is be&oming in&reasingl dierse it is e%e &ted that b the ear 200, one in +o-r eole e ole oer the age o+ ;" ill be +rom a ra&ial or ethni& minorit' A&&ording to the Health Litera& rogram +or older ad-lts there is &on&ern that &hanges in +ertilit, omens labor +or&e arti&iation, and in&reases in the dior&e d ior&e rate ma red-&e the abilit o+ +amilies to ta*e &are o+ older +amil members ho hae disabilities, la&ing een greater demands on -bli& and so&ial rograms' 3Whiteho-se n'd' <-rthermore, be&a-se o+ these demograhi& trends,31 there is &on&ern that health &are &osts +or the elderl o-lation ill &ontin-e to gro dramati&all' ?er &aita e%endit-res +or elderl liing in the &omm-nit ere more than three times those o+ the nonelderl in 1>>;=",;44 s' =1, !;"1and are roe&ted to in&rease to =7,;74 3in 1>>; dollars b 200"' 32 9edi&are and 9edi&aid long)term &are e%endit-res are also roe&ted to do-ble b 200"'3 $hese roe&ted in&reases in ta%aer)+-nded &osts ill la&e great ress-re on the health litera& rograms +or older ad-lts to red-&e &osts' Conse5-entl, there is arehension that &ontin-ing and rising ress-res to &ontain &osts ill adersel a++e&t health &are 5-alit and a&&ess' (9ano+o, 2012 <-rthermore, the raid &hanges in the health &are sstem hae had signi+i&ant e++e&ts on the &are roided to elderl eole'  eole'

these &hanges on 5-alit and &ost' Can the S meet its aging o-lation8s o -lation8s health &are needsF Desite all o+ the adan&es o+ modern medi&ine, old age &ontin-es to bring ith it &hroni& disease  and so ith the roe&ted in&rease in elderl Ameri&ans ill hae a roe&ted groth in the ortion o+ the 'S' o-lation that ill s-++er +rom &hroni& diseases' 3:erenson, 2010 Some estimates sa that b 200, more than th an 170 million Ameri&ans ill be a++li&ted b s-&h &onditions  and most o+ them, it &an be res-med, ill be demanding treatment' Leading to the &on&ern o+ ho &an e a a  +or all o+ this' Hoeer, a&&ording to the White Ho-se in+ormation on A++ordable Care A&t) strengthens 9edi&are meaning &heaer res&rition dr-gs, end to limit on &are, and also +ree reentie seri&es' As reio-sl des&ribed aboe, the hite ho-se shoing that e do not hae to orr abo-t ho to a +or all this as the ears ass and o-r bab bab  boomers are rea&hing an older age there+ore in in&rease health &are' Also, as the most or all Ameri&ans Ameri&ans get health &are the health h ealth &are ro+ession ill bloom, another ositie o-t&ome that ?resident Obama to-&hes on' 3Whiteho-se n'd' When it &omes to geriatri& and mental disabilities Obama8s A++ordable Health&are A&t A&t is the ideal health &are sstem' $he &oordination o+ &are & are beteen do&tors and the oerall 5-alit o+ &are ill imroe so that o- ill be less li*el to e%erien&e reentable and harm+-l re) admissions to the hosital +or the same &ondition' 36oa*, 201 Hositals ill hae ne, strong in&enties to imroe o-r 5-alit o+ &are' As shon on the i&t-re ab oe the A++ordable A++ordable Care A&t is &losing the the ga in dr-g &oerage *non as the #don-t hole'( .n 2014, eole ith 9edi&are in the #don-t hole( re&eied a " er&ent dis&o-nt on &oered brand name dr-gs and a 2! er&ent dis&o-nt on generi& gene ri& dr-gs' And than*s to the health &are la, &oerage +or both brand name and generi& dr-gs ill &ontin-e to in&rease oer time -ntil the &oerage ga is &losed' 6ationall, oer !'2 million eole ith 9edi&are hae saed oer =11'" billion on res&rition res&rition


dr-gs sin&e the la8s ena&tment, +or an aerage saings o+ =1,407 er bene+i&iar' : haing these saings e &an a++ord to hae eerone e erone in a health &are lan that bene+its them b-t also a++ordable +or -s as a nation and reenting an in+lation' 3Sorell, 200> <-rthermore, stoing medi&al +ra-d, the +ederal goernment is ta*ing strong a&tion to red-&e ament errors, aste, +ra-d, and ab-se in 9edi&are' $he health &are la hels sto +ra-d ith to-gher s&reening ro&ed-res, stronger enalties and ne te&hnolog' Oer the last +ie ears, the administration8s +ra-d en+or&ement e++orts hae re&oered =1>' 2 billion +rom +ra-dsters' 3Whiteho-se n'd'  As S toda rites abo-t here this ne health &are sstem ill lead -s, 1 in ! Ameri&ans 31G or 40' million are ;" or older, o lder, and that is roe&ted to gro to 1 in " 31>'G, or 72'1 in 200, the ear all members o+ the :ab :oomer generation ill hae t-rned ;", a&&ording to Cens-s data' : 20"0, seniors ill ma*e - 2"G o+ the o-lation' 3arger, 2014 $hose !" and older are roe&ted to in&rease +rom "'! million in 2010 to !'7 million in 200' 6earl ! in 10 seniors are liing ith at least one &hroni& health &ondition "0G hae to or more, the Centers +or Disease Control and ?reention estimates' Abo-t 2"G o+ older Ameri&ans are obese 20G hae been diagnosed ith diabetes more than 70G hae heart disease nearl ;0G hae arthritis, a leading &a-se o+ o + disabilit' Ad-lts ;" and older send nearl ti&e as m-&h as those 4" to ;4 on o n health &are ea&h ear the send three to +ie times more than all ad-lts o-nger than ;", a&&ording to CDC' .+ not addressed, the in&reased b-rden o+ &hroni& disease


ill not onl hae seere e&onomi& e&on omi& &onse5-en&es b-t a++e&t older ad-lts oerall ell)being' $his is a reall imortant time in the nations histor +or -s to ta*e a loo* at this demograhi& &hange and the health and behaior o-t&omes +or this o-lation' 36a&he elderl &are n'd' 9an ins-ran&e &omanies hae droed long)term &are lans, or o++er lans that are not m-&h more attra&tie to indiid-als than 9edi&aid'

bab)boom generation, hile 9edi&aid ill see higher -se o+ seri&es b elderl and disabled bene+i&iaries' <-rthermore, the +ederal, state and lo&al goernment share o+ health &are sending ill *ee steadil rising, +rom 44 er&ent in 2012 201 2 to 4> er&ent in 202' 202 ' $he share o+ &osts &oered b b-sinesses ill de&line +rom 21 er&ent er&en t to 1> er&ent a&&ording to 6ACHC' When e eigh the ros and &ons to this iss-e there are more ositie elements that the A++ordable A++ordable A&t &oers' 9 main +o&-s on this aer as the aging o-lation and the a++ordable A&t, A&t, as mentioned aboe as o-r bab boomers ro&eed to retirement ma*ing o-r nation8s biggest gro- and all those hom don8t hae ins-ran&e be &oered b this A&t &an lead to liing longer and hae roer &are' .n&l-ded in this aer are also &redible resear&h and arti&les that e%lain statisti&s o+ A++ordable A++ordable Health Care A&t thro-gh o-r goernment, go ernment, CDC ebsite, 6ACH, een nesaers s-&h as the 6e Kor* Kor* $imes' $imes' .t &oers the bene+its that the aging o-lation ill re&eie -nder this A&t, b-t also the mone that ill be saed eliminating +ra-d, and also the ob in&rease on health &are' Also, as mentioned aboe the #don-t hole(, saing mone thro-gh o-r res&ritions' On the other hand it also e%lains the reasons and &on&erns that eole hae toards this a&t, as mentioned aboe the *e 5-estions still remains on ho is going to a +or all o+ thisF As m-&h data the hae roided the are still not able to redi&t the +-t-re b-t as the ros o-teigh the &ons . thin* e are stirring in the right dire&tion' dire&tion' As o- &an see there are man &ontroersial hen it &omes to the &-rrent health &are stat-s o+ this &o-ntr' Some li*e the idea and see hat the +-t-re holds h ere others +ind &on&erns and don8t seem that this sstem is or*ing and eent-all ill +ail in the +-t-re' On their de+ense altho-gh 9edi&are and 9edi&aid +-nd &are at leels that +ederal and state goernments &annot a++ord, the 5-alit o+ &are and 5-alit o+ li+e roided b these rograms are not - to the leel that :ab :oomers ill most &ertainl demandor the rograms &o-ld


roide i+ the ere +-nded aroriatel' .ndiid-al long)term &are ins-ran&e &o-ld be -sed to ens-re a leel o+ &are higher h igher than that e%e&ted +rom -bli& rograms, b-t b -t these oli&ies hae not been o-lar'


e+eren&es :artelestone, ona' 3201 Jo-rnal o+ eriatri& Care 9anagementM Care Management and the Affordable Affordable Care Care Act (ACA) The Possibilities, The Realities, Realities, and The Concerns. Ari@ona' 6ational Asso&iation o+ ?ro+essional eriatri& Care 9anagers :erenson, obert N Holahan, John' 3J-l 3J-l 2010 Ho Will Will the ?atient ?rote&tion and A++ordable Care A&t A++e&t SeniorsF Timely Timely Analysis of Immediate Health Policy Issues rban .nstit-te, obert Wood Johnson
9ano+o, Eli@abeth N Wong, Sharon 32011)2012' Health litera& rograms +or o lder ad-ltsM a "ystematic literature reie&. S&hool o+ 6-trition, erson niersit, "0 Ii&toria Street, $oronto, $oronto, O6, Canada 9": 2 Iol'27 Iol'27 no'; 2012 ?ages >47>;0 Adan&e A&&ess -blished 2> J-ne 2012

Sarah A' 6oa*, Christine Eibner, Daid 9' Adamson, Ean Salt@man' 3201' # 'ffects 'ffects of the Affordable Care Care Act on Consumer Health Care Care "#ending and Ris of Catastro#hic Health Costs Sonsored b Commonealth <-nd and rod-&ed ithin and Health M CA, DC, ?A, LA, 9S et&' Sorrell, J' 9' 3200>' $he Obama health &are lanM What it means +or mental health &are o+ older ad-lts' *ournal +f Psychosocial ursing And Mental Health "erices, - 31, 31, 21)2' doiM10'>2!/027>;>")200>0101)12

$heodore 9armor, ?hD Jonathan Oberlander, ?hD and Joseh White, ?hD' 3 9ar&h 200> $he Obama Administration8s Otions +or Health Care Cost ControlM Ho#e /ersus /ersus Reality. 'annals'org Ann Intern Med. 200>1"0M4!")4!> 'annals'org httM//'na&h&'&om/elderl)health&are'&+m 'hiteho-se'go


httM//'&d&'go/aging/

final health care policy analysis paper

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