This month we will acknowledge and celebrate Medicare, a landmark social health program currently covering 49.4 million Americans. Of great relevance, particularly as it relates to Medicare, is the development of agencies such as Community Home Health Care, and the important roles they play in the direct provision of healthcare services as a result of this very significant legislation and the amendments that followed. But first a little basic information.
What is Medicare? Explained as simply as possible, it is our federal system of health insurance for people over 65 years of age and for certain younger people with disabilities. The different parts of Medicare cover different services, for example: Part A (Hospital insurance), Part B (Medical insurance), Part C (offered thru private companies and combines both A&B) and Part D (Prescription drug coverage).
This history of Medicare can be said to have begun when Teddy Roosevelt chose healthcare as part of his platform when he ran for president back in 1921. The idea for a national plan unfortunately, did not gain momentum until President Truman’s presidency some 24 years later when Truman in 1945, pushed Congress to adopt a national health insurance fund which he envisioned to be open to all Americans. Truman was unsuccessful as well as President John F. Kennedy 19 years later in 1964, but their efforts laid the groundwork for legislation signed by Lyndon B. Johnson in 1965, finally providing Medicare health coverage for Americans.
Following are just some of the primary milestones and advancements in Medicare over the years.
· Of significance as it relates to home health care is the Omnibus Reconciliation Act passed by Congress in 1980. This Act expanded home health services by eliminating the limit on the number of home health visits, the prior hospitalization requirements and the deductible for any Part B requirements. This Act allowed for the growth an expansion of home health care agencies.
· President Nixon signed the first major change in 1972 expanding healthcare to individuals under 65 with long-term disabilities and end stage renal disease (ESRD), which is permanent kidney failure requiring a transplant or dialysis.
· In 1980 Congress passed the Omnibus Reconciliation Act, expanding home health services.
· Legislation in the 90’s required State Medicaid programs to cover premiums for the new specified low-income eligibility group (SLMB) which included individuals eligible for Medicare whose incomes fell within 100 to 120 percent of the federal poverty level. As well as options in the private market through Medicare + Choice later known as Medicare part C.
· In 2003 President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act, which allowed a
greater number of individuals to have a prescription drug plan.
· And most recently in 2010 the Patient Protection and Affordable Care Act (a federal statute), known colloquially as Obama Care, which along with the Health Care Education and Reconciliation Act amendment, represents the most significant overhaul of the U.S healthcare system since the creation of Medicare and Medicaid in 1965. This Act put in place comprehensive insurance reforms that improves access, affordability and quality in healthcare for all Americans.
Medicare has allowed for the development and success of Community Home Health Care (CHHC) and other agencies like it around the United States. The role that CHHC plays and its importance to the health system and immediate community is of great value considering shifts and trends in the provision of medical services. CHHC currently provides quality health care services in the home, hospital or extended care facility and provides specialized services for a variety of medical and personal needs. We should never forget the significance of this landmark legislation and the manner in which it has helped shape the healthcare landscape. And even more importantly, how it is helping to improve the quality of lives.