Medicare and Medicaid: A Reference Handbook

by Greg M. Shaw

Overview

Medicare and Medicaid: A Reference Handbook provides an in-depth discussion of these two large government health insurance programs. It additionally addresses such related issues as health care, government spending, and socialized medicine.

Many Americans hold conflicting views on how to pay for health care. They fear that government involvement will either undermine the quality of care or cost taxpayers too much. However, over the past half-century, hundreds of millions of Americans have come to rely on government health insurance because they are elderly, low-income, or both.

Medicare and Medicaid: A Reference Handbook provides high school and college readers with a one-stop resource on these two government insurance programs. A background and history of the topic are followed by a chapter on problems, controversies, and solutions. Perspectives and profiles speak to current program strengths, political concerns, and problems. There is a strong focus on current program challenges and opportunities.

Moreover, most of the government documents referenced in a dedicated resources chapter are produced periodically, with updates accessible online, so the book should enjoy an enduring shelf-life. The volume closes with a glossary and bibliography.

Product Details

ISBN-13:	9781440873348
Publisher:	Bloomsbury Academic
Publication date:	01/26/2021
Series:	Contemporary World Issues
Pages:	328
Product dimensions:	6.35(w) x 9.25(h) x 1.10(d)

About the Author

Greg M. Shaw, PhD, is professor of political science at Illinois Wesleyan University.

Table of Contents

Preface,
Acknowledgments,
1 Background and History,
The Historical Roots of Medicare and Medicaid,
The 1965 Enactment of Medicare and Medicaid,
Challenges for Implementation,
State Medicaid Experimentation: A Departure from Freedom of Choice,
Confronting Medicare Expenditures: The Prospective Payment System,
Medicaid Reforms and Efforts to Control Costs,
The Children's Health Insurance Program,
Medicare's Prescription Drug Benefit: Part D,
Medicare and Managed Care: Part C,
Medicaid Expansion under the Affordable Care Act,
Looking Back, Looking Forward,
Sources,
2 Problems, Controversies, and Solutions,
Problem #1: Medicare's Spending Is High and Not Well Controlled,
Addressing Medicare's Budget, Option 1: Protect the Status Quo,
Addressing Medicare's Budget, Option 2: Adopt a Public Insurance Option,
Addressing Medicare's Budget, Option 3: Adopt a Premium-Support Model,
Problem #2: Building Medicare for All Would Pose Multiple Challenges,
Problem #3: Medicare Advantage Is Not Generating the Expected Savings,
Problem #4: Medicare Part D Is Not Getting Taxpayers the Best Value for Their Money,
Problem #5: Low Medicaid Reimbursement Levels Limit Patient Choice and Medical Provider Participation,
Problem #6: Medicaid Is Not a Sustainable Way to Cover Long-Term Nursing Home Care,
Problem #7: The Medicaid Expansion under the ACA Has Been Uneven,
Problem #8: Medicare Experiences a High Level of Improper Payments,
Conclusion,
Sources,
3 Perspectives,
My Jourbaney on Medicaid,
Aianna Zachary
Medicaid and the Family Medicine Practice,
Adam Houghton, MD
A Nonprofit Clinic's Perspective on Medicare and Medicaid,
Tory Lynch-Dahmm
Closing the Gap in Health Care Access,
Amanda F. Hopkins, PhD, RN
Medicaid and Emergency Department Use,
Mollie Ward, MDiv
Medicaid Expansion: Nationalized Politics Meets Intergovernmental Reform,
Philip Rocco, PhD
Medicare from an Enrollee's Perspective,
Ann C.
The Growing Privatization of Medicare,
Andrew Scholnick
The American Health Care State,
Robert Y. Shapiro, PhD
4 Profiles of People and Organizations,
Introduction,
The American Hospital Association,
American Medical Association,
Americans for Prosperity,
America's Health Insurance Plans,
Centers for Medicare and Medicaid Services,
Healthcare-Now!,
Kaiser Family Foundation,
National Nurses United,
Partnership for America's Health Care Future,
Pharmaceutical Research and Manufacturers of America,
Physicians for a National Health Program,
Senator Bernie Sanders (b. September 8, 1941),
UnitedHealth Group, Inc.,
U.S. Chamber of Commerce,
Sources,
5 Data and Documents,
Data,
Figure 5.1. Medicaid Enrollment by Year (1968–2018),
Figure 5.2. Medicaid Spending by Year (1968–2018),
Figure 5.3. Medicaid Enrollment by Age Group as a Percentage of Total (2017),
Figure 5.4. Medicare Enrollment by Year (1968–2018),
Figure 5.5. Medicare Spending by Year (1968–2018),
Figure 5.6. Medicare Advantage Enrollment (1999–2019),
Figure 5.7. The Uninsured Rate (1997–2018),
Figure 5.8. Enrollment in the Children's Health Insurance Program (1998–2018),
Documents,
President Lyndon Johnson's Remarks upon Signing Medicare and Medicaid into Law (1965),
President Barack Obama's Remarks upon Signing the Patient Protection and Affordable Care Act into Law (2010),
U.S. Senator Lamar Alexander on the Proposed Expansion of Medicaid (2009),
U.S. Supreme Court Ruling in National Federation of Independent Businesses, et al. v. Kathleen Sebelius, Secretary of Health and Human Services,et al. (2012),
Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (2019),
National Health Expenditure Fact Sheet (2019),
GAO Report on the Medicare Advantage Plan Finder (2019),
6 Resources,
Broad Overviews of the Medicare and Medicaid Programs,
History,
Policy Reform Failures,
Changes under the Affordable Care Act,
Prescription Drug Coverage,
Consumer-Driven Health Care,
Financing and Coverage Challenges,
Recent Politics and Policy,
Commentary on Proposals for a Public Option Government Insurance Program and Analyses of Medicare for All Proposals,
7 Chronology,
Glossary,
Index,

Editorial Reviews

★ 08/01/2021

Shaw (political science, Illinois Wesleyan Univ., Bloomington; The Dysfunctional Politics of the Affordable Care Act) offers an in-depth political perspective of Medicare and Medicaid, government programs that provide health care coverage to Americans who are over 65 or disabled and low-income Americans, respectively. He reviews the history of the programs, beginning with 1930s discussions about public health care. Chapters Five ("Documents and Data"), Six ("Resources"), and Seven (chronology, glossary) are the most reference-friendly, while Chapters One through Four delve into political arguments for and against Medicare and Medicaid. Chapter Two identifies problems in both programs, including high, poorly controlled spending; low provider reimbursements; and high drug costs. Chapter Three presents a wide range of public health care opinions, from patients, providers, insurance executives, and politicians; some see Medicare and Medicaid as lifesavers, while others think they're expensive, ineffective, and rife with fraud. Chapter Four identifies many organizations involved in the health care debate, but only one individual (Vermont senator Bernie Sanders). VERDICT Most reference works about Medicare and Medicaid focus on benefits, provider requirements, Medicaid planning and application, health care fraud, or the single-payer concept; this volume sets itself apart, offering a detailed, nuanced look at the debate around public health care. A fascinating, useful book.—Laurie Selwyn, formerly at Grayson Cty. Law Lib., Sherman, TX

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