The US Government and Medicaid/ Medicare Programs

The US government oversees both the Medicaid and Medicare programs. On July 30, 1965, President Lyndon Johnson signed them into law with the intention of assisting the elderly and low-income Americans in purchasing personal health insurance. The president hoped that by doing this, the financial burden would be shared among the rich, the poor, the sick, and the healthy, enabling everyone to satisfy their health care demands.

Differences Between Medicaid and Medicare

Medicaid and Medicare are different in that Medicare intends to cover all financial costs for persons over the age of 65 and for those with disabilities, regardless of their income. Medicaid, on the other hand, aims at covering health expenses for America individuals who have a meager income. However, someone can have both Medicaid and Medicare if you are eligible for both.

Impact of Medicaid and Medicare Programs

Since the two were enacted into law, the government has discharged a lot of money to the healthcare sector which has led to an improvement in the healthcare sector. Also, there has been a tremendous increase in the number of citizens who are covered by these programs. For instance, when Medicare was passed into law, 19 million citizens were enrolled, but the number is currently at almost 56 million Americans, Medicaid on the other hand, is now able to cater for the medical needs of more than 17 million citizens who are low-income earners.

Medicaid and Medicare Enrollment and Spending

In a recent study it was found that in every four Americans, one is either covered by Medicare or Medicaid. It accounted that Medicare alone uses up about one dollar in five of the national health dollars. Medicaid, however, is more significant than Medicare regarding money spent and the people it has been able to enroll over the years. In 2003 for example, Medicaid had enrolled 41.4 million citizens while Medicare had enrolled 41.3 million people while the amount spent on Medicaid was $259 billion as compared to the $254 billion spent on the Medicare program.

Reducing Racial Segregation in Healthcare

In my opinion, these programs have helped in reducing racial segregation in the healthcare sector. Before the law was passed, hospitals that were set apart for the whites could not serve the blacks, and if they did, they were provided with basement accommodation. The blacks could not access medical care, and most children were born at home which resulted in high infant and maternal mortality rates of the blacks as compared to the whites. With the advent of Medicare and Medicaid, however, medical services became accessible to all hence increasing the life expectancy of children as they can now grow into healthy teenagers (Alisa Chester, 2015).

Prescription Drug Benefit and Medical Innovations

There has also been an addition of the prescription drug benefit to the outpatient under the Medicare. This advantage, though it has been added many years after President Johnson suggested for it to be added (Craig, 2003), has faced many challenges. Today, approximately seven out of ten Americans take prescription drugs.

There has been a lot of innovation in the healthcare sector, and I think that these two programs have contributed significantly to progress. By the government covering a lot of people's medical costs, drugs and also medical equipment, many industries have been able to venture into medical research because they can recover the cost by selling the new products. However, some of the drugs and devices take a long time to reach the market because their use has to be permitted by the Food and Drug Administration.

Improving the Quality of Services

While Medicaid and Medicare have dramatically improved the healthcare system in the United States and also lead to better healthcare spending, the policymakers have continuously tried to devise ways in which the quality of services provided under these programs is improved, and this is achieved at a lesser cost.

Obama Care and Reforms

I think that one of the policies that has improved these programs is the Obama care. This law brought amendments to the programs which sought to increase the number of people who were covered by both Medicare and Medicaid. Those who were eligible for these programs would now be able to access more health services at a lower cost and could also get a wellness visit every year without being charged a single cent. Those who were not subscribed to these programs would even not have to go through a lot of trouble to access services from these programs under Obama care.

Proposed Budget Cuts

Recently, the United States of America president, Mr. Donald Trump, released his budget which aimed at cutting up to $1.4 trillion which is usually directed to the Medicaid. The budget contradicts one of the promises he made while aspiring for the presidential seat where he promised that he would not cut the Medicaid and the Medicare (Caldwell, 2017). In my opinion, these cuts will significantly affect the medical expansion that had been put in place by the Obama care and also will reduce the amount which the national government sends to the state governments. This budget also calls for a $610 billion cut in the Medicaid financing for the next decade.

Drawbacks of Medicaid and Medicare Programs

Though these programs are beneficial to the American citizens, I think that they also have some drawbacks in that; the types of treatment covered by these programs are limited. If a particular medical procedure is believed to be unnecessary or can affect the health of the sick individual, the programs may fail to cover it. The failure of the programmer to include such procedures leaves no choice for the doctor and the patient.

The government ensures that the cost of these programs remains as low as possible. It does this through; the Medicaid compensations are usually lesser than what is charged by the doctors which makes it hard for some doctors to accept Medicaid patients. The reimbursements also take long before they are settled which makes it hard for the patients who require cash for smaller medical practices.

I also think that some of the patients who benefit from these programs face discrimination. Many elderly persons are shifted from one nursing home to another if they shift their payment from private to Medicaid. Some even fail to be admitted to the homes because the nursing homes notify them that their Medicaid allocation has been met.

Reforming Medicaid and Medicare

In my view, the reforms on the Medicaid and Medicare need to be established. The improvements should be made because; the expenses keep on increasing which poses a threat to the national government budget. The amount spent on health per person in the United States of America is double that spent on other developed countries. The healthcare uses up to 17.8% of the gross domestic product of the nation, this makes it the highest in all developed countries. The high cost of healthcare is due to the expensive innovations that are being made in this field, and these changes are mostly used on the children and the elderly with the aim of increasing their life expectancy. Another reason for the rise in the cost is due to the negligence of the doctors and lastly the lack of competition in the healthcare sector as compared to other industries (Amadeo, 2017).


In a nutshell, the Medicaid and Medicare programs have been so helpful to most of the Americans by making health services available to everyone regardless of their age or social status even though maintaining these programs is expensive. By cutting the funds that are usually used in these programs means that many people who cannot afford the health services due to various reasons will have to suffer much.

However, reforms need to be made in the health sector to deal with the challenges that are currently facing healthcare. By reforming healthcare, the medical costs that have been skyrocketing in recent years will be controlled. Secondly, the quality of services that are provided will improve, and lastly, the fraud in the health cost will be able to be dealt with, and this will save the national government billions of money.

If the reforms are not made, the financial sustainability of the country in matters of health will be significantly affected by the cost of healthcare growing faster than that of the rest of the economy.


Alisa Chester, J. A. (2015). Medicaid at 50: A Look at the Long-Term Benefits of Childhood Medicaid.

Amadeo, K. (2017, November 27). Why Reform Health Care. The balance.

Caldwell, P. (2017, May 23). Donald Trump Just Released a Plan to Destroy Medicaid. Mother Jones.

Craig, B. M. (2003). Out of pocket price, prescription medication, and seniors.

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