Medicare Health Program
- National Healthcare Expenditure (NHE) grew 4.6% to $3.6trillion in 2018 accounting for 17.7% of the Gross Domestic Product and is projected to grow at an average rate of 5.5% per year for 2018-27 to reach nearly $6 trillion as reported by the CMS. 21 percent of the total NHE budget was channeled to Medicare program. This money was used to finance Medicare advantage plans (like HMOs and PPOs), Medicare prescription drug coverage as well as hospital and medical insurance.
- According to a 2017 study in the Journal of the American Medical Association (JAMA), the general factors that drive healthcare spending included population growth, aging population, disease prevalence, service utilization, and service price and intensity. Most of U.S. healthcare spending is influenced by population growth, aging population, and price and intensity; however, the underlying components of price are the key drivers of rising healthcare costs. The study further revealed that in recent years, U.S. spends more on financing Medicare as more people are qualifying for the program due to positive population growth and increase in lifespan thus a high aging population.
- The methods of financing healthcare insurance include out-of-pocket, voluntary private insurance, statutory private insurance, community pooling, social insurance, and tax-supported financing (C. Paton, 2008, as cited in Tulchinsky, 2014). These methods of finance have led to ease of access to quality healthcare services for the elderly as well as proper allocation and utilization of healthcare resources for Medicare clients.
- The healthcare sector just like any other market is affected by market forces of demand and supply such that higher-quality hospitals attract higher market share. Chandra et al (2016) suggest that the relationship between performance and allocation is stronger among patients with a greater scope for hospital choice. Currently, enrolment in the Medicare advantage program has doubled over the past decade and the premiums paid by these enrollees have slowly declined since 2015.
Chandra, A., Finkelstein, A. & Syverson C. (2016). Health Care Exceptionalism? Performance and Allocation in the US Health Care Sector. American Economic Review, 106(8): 2110-14 DOI: 10.1257/aer.20151080
Centers for Medicare and Medicaid Services. National Health Care Expenditures 2018 Highlights. Retrieved from https://www.cms.gov/Research-Statistics-Data-and Systems/Statistics-Trends-andReports/NationalHealthExpenddata/Downloads/highlights.pdf
Dieleman, J. L., Squires, E, & Bui, A.L. (2017). Factors Associated With Increase in U.S. Health Care Spending, 1996-2013. Journal of American Medical Association: 213(17). Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2661579
Tulchinsky, T.H. & Varavikova, E.A. (2014). The New Public Health (Third Edition) Health Care Financing: Measuring Costs. Retrieved from https://www.sciencedirect.com/topics/medicine-and-dentistry/health-care-financing&hl=en-KE