Introduction
In the US, Medicare is a single player, national social health insurance program which is was setup by the US federal government in 1966. It is presently utilizing almost 30-50 insurance companies, majorly private, in the US under administration contract. The aim of establishing Medicare was to offer health insurance for American citizens aged 65 years and above who have been employed and made contributions towards the system via the payroll tax. Additionally, it offers health insurance for young people with disabilities and those with “end-stage renal disease and amyotrophic lateral sclerosis” (AIDS.gov, 2016). This program was set up in two parts, A and B. Part A caters for skilled nursing care in addition to hospitalization which are obligatory and is funded by 2.9% of the payroll. Other than outpatient care, part B caters physician service care which are optional and funded by general proceeds and premiums paid monthly by the beneficiary.
Medicare has been one of the biggest health insurance programs in the world, its impact on health care, economy and American life has been significant. For example, the program has created a financial benefit to the elderly; has successfully brought about the initiation of prospective payment systems; that is the development of diagnosis-related group (DRG) and creating of several services necessary to treat a common diagnosis into a lone pre-negotiated fee. Medicare has also caused transformation of the American hospital system by offsetting the declining hospital revenues (Rosenbaum, Skivington, & Praeger, 2002).
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This health program accounts for one-quarter of state expenditure on HIV-AIDS care in the United States of America and it is also an essential form of support for individuals living with HIV-AIDS. This disease remains to be a persistence problem for the United States and countries around the world (Kaiser Family Foundation, 2004). The disease prevalence, incidence and mortality rates due to this illness varies according to the following data:
Through the current analysis of prevalence, incidence and mortality of HIV data scenarios indicate that the prevalence increases by 24-38% in a decade. If the transmission is cut by 50% within ten years the incidence reduces by 40%; prevalence escalates by 20% to about 1.3 million persons with HIV (AIDS.gov, 2016). If the transmission is halved in 5 years incidence decreases by 46%, prevalence increases by 13% to 1.2 million people living with HIV. Interventions to change this trend can only be halving the transmission rates within five years which reduces the number of new cases. Studies show that racial and ethnic minorities have been excessively infected and affected by HIV-AIDS from when it was discovered and they signify the bulk of new HIV diagnoses, people living with HIV disease, and deaths among the individuals with this disease ( Rosenbaum, Skivington, & Praeger, 2002 ).
Blacks and Latinos represent the biggest percentage of new HIV diagnoses and about their size, the Blacks have the highest number of people with HIV than any other racial group. They also record the highest degree of new HIV diagnoses as per the 2014 statistics with Latinos coming in second. After HIV diagnoses survival for blacks is lower “than for most other ethnic groups and the age-adjusted death rate due to HIV/AIDS” was high among the blacks (AIDS.gov, 2016). HIV positions higher as a death cause for Blacks and Latinos in comparison to Whites. It should be noted that HIV has adverse effects in the country which include economic crises where around 170 million dollars is channelled towards HIV prevention. Secondly, due to the life-prolonging treatments benefits more people live with HIV creating more opportunities for transmission. The third major effect is complacency whereby most people have become complacent with HIV thus creating a lack of awareness even though they may be at a high risk of contracting the disease. However, despite the racial and ethnic groups, HIV causes poor health, economic constraints and the shortage of labor in the country. Since the risk of HIV is affected by social, economic and demographic factors such as stigma, discrimination, education and geographic region, these factors should be addressed appropriately and equally among all the racial groups to minimize the spread of disease among some races.
Estimated New HIV Diagnoses in the United States for the Most-Affected Subpopulations, 2014
Under the Affordable Care Act and HIV, various resources need to be put in place to combat this disease. Some of these resources include: improving access to coverage by avoiding discrimination of those with pre-existing health conditions like asthma and making the coverage more affordable to those with low and middle incomes in the form of tax credits and low cost of their monthly premiums. Also lowering the prescription drug costs for the Medicare recipients can help to make them more affordable to the medication they need. Enhancing the capability of the healthcare delivery system by increasing community health centres, providing customarily competent care and amplifying the healthcare staff for underserved racial groups can be a the main recommendations for the national HIV-AIDS approach. This will help in increasing the quantity and variety of existing providers of clinical care and associated services for those with HIV/AIDS, many of whom live in underserved areas (Finkelstein, 2004).
Following the bio cases from research the resources needed in 5 years are a “total of 30.4 billion dollars for domestic HIV and AIDS” (AIDS.gov, 2016). Out of this 57% is required for care and treatment, 9% research, 10% housing aid and cash and 3% for prevention. This is the constrained sum, but there has been no commitment to surge financing. As a result of the increase in new infections among the citizens, we should have a combined mitigation approach which includes HIV prevention education other than only the historical abstinence approach used.
References
Kaiser Family Foundation (2004). Medicare and HIV/AIDS. Retrieved from https://law.duke.edu/healthjustice/400_01/Fact-Sheet-Medicare-and-HIV-AIDS.pdf
Finkelstein, A. (January 01, 2004). The interaction of partial public insurance programs and residual private insurance markets: Evidence from the US Medicare program. Journal of Health Economics (amsterdan), 23, 1, 1-24.
Rosenbaum, S., Skivington, S., & Praeger, S. (January 01, 2002). Public health emergencies and the public health/managed care challenge. The Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics, 30, 3, 63-9.
AIDS.gov. (2016). The Affordable Care Act and HIV/AIDS. Retrieved from https://www.aids.gov/federal-resources/policies/health-care-reform/
