Southern New Hampshire University Benefits and Challenges Discussion


Respond to two of your classmates, contrasting and comparing the benefits and challenges.Reply to Adrian
Medicare: If you are approaching the age of 65 then you are eligible to receive Medicare.
• The Pros: It covers millions, costs very little each month, offers additional coverage, leads
to prescription innovations, and increased medical standards.
• The Cons: Costs a he amount to administrate, hospital stays are expensive, costs
taxpayers for medicare.
Medicaid: Is a program for social welfare, provides access to affordable health insurance to
those who meet select criteria.
• The Pros: Affordable healthcare for individuals on the lower end of the income spectrum
and cannot afford insurance premiums for basic and specialized healthcare. Mandatory
benefit have states that offer certain benefits to all medicaid recipients.
• The Cons: There are limitations for coverage, limited health care provider options, and
an unfair treatment of the elderly.
HIPAA: Congress approved the Health Insurance Portability and Accountability Act (HIPAA) to
guard the privacy of personal medical information, and to give individuals the right to keep their
health insurance coverage for pre-existing conditions in place even if they change jobs.
• The Pros: It allows the legal right to see, copy and correct their personal medical
information. Prevents employers from accessing and using personal health information
to make employment decisions.
• The Cons: The effects have not been positive, it increased the regulation paperwork
burden for doctors. Some professionals who deal with medical paperwork have become
over cautious about releasing protected information.
Reply to Mariem
Medicare, Medicaid, and the Health Insurance Portability and Accountability Act (HIPPA) have
had impacted the healthcare system ever since they were introduced. There have been some
significant positive impact and challenges such benefits, cost, affordability, and privacy. As I keep
researching, I will identify two benefits as well as two challenges. When we think about HIPPA
automatically we think privacy. According to Edemekong et al. (2022), HIPPA main goal is to
protect and limit the use of health information, penalized those who do not comply with
regulations, but mostly is to keep health information of individual private (Edemekong et al.,
2022). The benefit of HIPPA is that it protects personal information from being disclosed to
other individuals, it also helps individual have control over their information. Also, based on
Nowicki (2022) research, HIPPA was design to help improve the availability of health insurance
to working families (Nowicki, 2022). Furthermore, Medicare is beneficial for elderly, this
insurance federally funded to American at the age of 65 or older. According to Nowicki (2022),
in 1972 Medicare expanded their coverage to people younger than 65 that were diagnose with
a disability and qualified for social security (Nowicki, 2022). This information gives us the benefit
of Medicare in its own. One thing that we should also know is that medication is divided into
four parts. Medicare Part A which covers inpatient services, Part B- outpatient service
(preventive service), Part C- which is consider a medication advantage that helps expand
services and lastly, Part D which helps with prescriptions (Nowicki, 2022). Lastly, we have
Medicaid which is an insurance that help provide care at a low-cost and for people with lowincome. Medicaid is an insurance that helps patient that are financially struggling- this is a way
for them to receive the care that they need without paying too much for health insurance.
Although Medicare, Medicaid and HIPPA can be beneficial for patient, they also have their
challenges. One of the challenges is the reimbursement to providers. Medicare and Medicaid
can decline payments to the hospital is the cost is too high or if patient has a adverse event such
hospital acquire-injury. According to the centers for Medicare and Medicaid services, the
hospital will be responsible for the cost of any hospital acquire injury (Centers for Medicare &
Medicaid Services, 2017). Sometimes, patient do no received Part D coverage due to limited
budget which can be very challenging especially when there are medications needed to treat
any chronic or acute disease. Medicare and Medicaid challenge is fraud and abuse as both
received federal aid. This could lead to fraudulent claims. Identifying challenges when it come to
HIPPA can be somewhat difficult. HIPPA very beneficial in all contents but one challenging
situation could be obtaining information. Obtaining information could challenging especially
when the patient must sign the consent in the patient is unconscious, elderly with cognitive
behaviors, or a minor. People could be fined for different offense such knowingly or
unknowingly release of information without proper guideline or consent. According to Cornell
Law School penalties could be monetary or imprisonment or both. Money and years of
imprisonment depend on how bad or intention of the offense (42 U.S. Code § 1320d–6 Wrongful Disclosure of Individually Identifiable Health Information, 2009). I know people might
think that the benefit outweighs the challenges but are you willing to risk your life and go to jail
for no following the guidelines and procedure for HIPPA.

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