In the United States, Medicare is a type of socialized health insurance coverage that is extended to all citizens over the age of 65 and others that meet specific criteria. Revenue to cover elderly citizens (regardless of their income or their work history) is provided by two separate trust funds held by the US Treasury. These funds can only be used to fund Medicare-related expenses. In recent years, there has been frequent debate in healthcare reform regarding whether Medicare could be expanded to cover all United States citizens, as well as what that infrastructure change would look like, how long it would take, and how much it would cost.
These talks have come about primarily because the United States has an unusually high number of citizens without health insurance (over 50 million as of 2012) when compared to the rest of the developed world. When people cannot access healthcare services, life expectancy and quality of life decrease, while additional strain is placed on a healthcare delivery system that attempts to absorb the costs of providing emergency healthcare services to uninsured citizens. The Affordable Care Act of 2010 (also known as Obamacare or the ACA) was designed in part to address some of these concerns by mandating that all small business owners with 50 or more full-time employees must provide health insurance coverage for their employees. That mandate has been activated (as of 2013), but its long-term effects remain unknown. Although the Affordable Care Act has extended coverage to tens of millions of American citizens who did not previously have access to healthcare, it still does not give coverage to all citizens. The ACA also ties coverage to employment, similar to the private health insurance companies’ policies already in place. The options for unemployed citizens may cost less, but they also have extremely high deductibles and cover fewer healthcare services.
In order to extend affordable, effective health insurance coverage to all US citizens, some of the policies within Medicare need to be expanded. The policy change goals must be centered on constructing a universal coverage system in the United States funded (as is the case in almost every other developed nation) by taxpayer revenue. Under universal coverage, the government controls the distribution of healthcare funds via national health contracts, which they award to healthcare providers and product manufacturers for their services. This gives tremendous incentive to product manufacturers to keep products safe, effective, and affordable. The leverage provided by national health contracts also greatly reduces the price creep for services and premiums typically practiced by private health insurance companies.
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