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Abstract
As it happens in all types of services and professions, there is always a change that takes place due to the changes in development of technology and human relationships over time. Many such changes have also taken place in nursing, and that is what is going to be discussed here.
As in the case of many other expenses in life, costs have increased also for nursing. This has also been studied in detail at Medicare and other institutions. All this increase will have an impact on the average United States citizen.
How healthcare economics and affect nursing practice
Healthcare economies are important to nurses as they affect professional nursing practices directly; in deed nursing practices are influenced by either economics or politics. Moreover, healthcare economies have impact on salaries of healthcare practitioners. Similarly, payment mode employed may make some nursing roles redundant. Besides, nurses have the potential to affect the cost and quality of care (Cherry & Jacob, 2011, p.136). Due to limited healthcare resources, nurses are compelled to manage clinical resources efficiently and device care delivery which is reduces total cost of service. In addition, nurses need to understand that when there are limited resources their decisions have to be based on service cost. Therefore, nurses have to learn how to combine non-nursing resources and limited resources to accomplish desired results effectively.
Short-term and long-term implications of adding co-payment for the healthcare system
Generally, co-payment will affect utilization of healthcare and create equity problems. Essentially, majority of the population are uninsured and lower socioeconomic status, thus imposing co-payments will dissuade the population from seeking healthcare (Chawla, 2007, p.43). In the long term the population and the hospital will incur high costs of treating conditions which could have been detected at an early stage.
Description of Medicare
Medicare is a single-payer health program entitlement enacted by the federal government that covers citizens aged 65 years and over or citizen with disability. Primarily, the government funds Medicare with its revenue. This program provides various benefits namely hospital and physician services, nursing facilities, durable medical supplies prescription drug services and Medicare Advantage.
Costs covered under Medicare Part A
Medicare Part A will carter for costs for the five days (inpatient) hospital stay (Mathews & Berman, p.380). Similarly, the cover will meet partial cost incurred in the nursing facility. In addition, Medicare Part A has introduced partial cover for prescribed medication partially (Department of Health & Human Services, 2011, p.2).
Costs covered under Medicare Part B
Basically, Medicare Part B covers doctors services and durable medical supplies required by patients, thus Mrs. Zwick cost of medication and walker are met by the insurance in full. Furthermore, Medicare part B also covers for preventive services that helps patients to maintain their health (Department of Health & Human Services, 2011, p.14).
Costs covered under Medicare Part D
Medicare Part D is designed for covering the cost of prescription drugs which are not covered in other Medicare plans (Department of Health & Human Services, 2011, p.14)
Describe the national insurance regulation that will allow Mr. Davis to continue his insurance coverage while he is out of work
Mr. Davis can benefit from extended healthcare coverage from his former employer by electing COBRA. The Consolidated Omnibus Budget Reconciliation Act (COBRA) permits people to extend healthcare insurance provided by employers even after dismissal or divorce. Essentially, Mr. Davis can benefit from COBRA for a period of 18 months. However, the duration in which one can retain COBRA is determined by qualifying events. COBRA participants pay the entire insurance premium, however this is cheaper than individual insurance cover. All employers will 20 and over employees are required by law to provide COBRA coverage.
Hindrance that COBRA participant face in getting immediate insurance coverage in Texas
The state of Texas permits insurance providers to examine medical history of insurance applicants. Therefore, Mr. Davis might face difficulty in finding an insurance carrier in view of his medical history. Alternatively, the insurance carriers are likely to offer a personalized cover which is more expensive.
Options open to Mr. Davis have if he cannot obtain reasonable insurance coverage
In the event that Mr. Davis does not obtain reasonable insurance coverage he can turn to Texas Health Insurance Risk Pool (THIRP). THIRP assist high risk individuals to access cost effective healthcare coverage. This option also helps persons who have exhausted their COBRA duration but have not qualified for individual healthcare insurance cover.
References
Chawla, M., (2007). Healthcare Spending in the New EU Member States: Controlling Costs and improving Quality. Washington: World Bank Publications
Department of Health & Human Services, (2011). Centers for Medicare & Medicaid Services. Medicare & You. Retrieved on 18 May 2011 from
Mathews, J., & Berman, D., (2011). Social Security, Medicare & Government Pensions: Get the Most Out of Your Retirement & Medical Benefits. California: Nolo. Retrieved on 18 May 2011 from
Cherry, B. & Jacob, S. (2011). Contemporary Nursing: Issues, Trends and Management. Missouri: Elsevier Mosby.
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