Health Policies

Policy description

MaineCare health strategy is a plan that covers health of the entitled families and individuals. People covered by the service are entitled through laws that govern the plan. Medicaid offers health and medical services to the families with little income, help elderly people, children and those who require medical attention. It is financed by the federal government with intention to pillar the disadvantaged citizen to acquire the cost of medical bills. The plan is also entitled to expectant mothers and children who are not citizens of the United States. Persons who are not legal permanent residents can only access the plan cover in cases of emergency.

Medicaid program was established in 1965 by the Social Security Amendments. As in the early 90s, a lot of states in America joined to creation of Medicaid care units by the federal government. The health care units enrolled the eligible recipients who qualify for the policy, the needy individuals, and families (Goldberg, 2007). As by today Medicaid program targets the low income earners. The service recipients have to be accommodated in the policy requirements. These people include children with an age limit, pregnant women and mothers with young children.

Medicaid program is a state funded medical policy, which covers related health services in the United States. It was established by the federal government and several states that also fund the program. The policy is managed and implemented by the respective states. States are not required to participate in the Medicaid program, but in the current time they all are involved. Each state decides who is eligible for the health coverage. This policy issue was developed to help only the United States’ citizen who are poor and cannot afford proper medical and health services.

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Policy environment

Social policy is essential to ensure that the medical scheme benefits and solves the related health needs. The social policies examine or watch how health care issues are handled by medical practitioners. Legal policies act as guidelines on how to implement the Medicaid programs (Janacek, 2010). The statute provides the recipients of the policy benefits and their qualification. The law limits people who are to be included in the policy issue. Ethics refers to the norms, values and practices that govern human right and wrong deeds. Ethical policies ensure that the health care unit chooses right actions in regard to wrong attitudes and perception. It is good for health providers to keep privacy of the patients; thus the medical coverage is not only intended to provide medical help. It is a multi-dimensional policy that is influenced by three environments.

Effectiveness and efficiency

Efficiency refers if something works as good as intended. Effectiveness shows how useful the policy is to the society. Medicaid health care programs were introduced to care for the health of low income earners. As to date, the scheme has functioned to benefit the target population of the respective states. The health issues have been attended, and health care units are helpful to the needy individuals and families who require health services. The resources introduced help to facilitate the policy and put effective use to many states. The federal government together with states has enabled care units to evolve to offer health services.

Possible options/alterations

Medicare and Medicaid policies are two government medical programs established to provide health services and medical coverage to certain groups of people in the United States. The groups are distinguished in a way that each group gets good medical attention and related health services. Both policies are managed by their respective care centers, which are branches of the U.S Department of Health and Human Services. They are social programs that serve to improve health of different groups of people in participating states. Medicaid serves the low income earners. Some benefits that Medicaid provides are the following: x-rays services, family planning, diagnostics, nursing services, physician services and treatment of young people under the age of 21. Children under the age of 18 years and expectant women are not included in copayments or any contributions.

Medicare pays for medical care and health services for some disabled persons and old people. It is a federal social health insurance project that has a target to benefit persons in ways such as durable and expensive health items, vaccinations, chemotherapy, blood transfusion and hormonal treatments (Edward, 2008). Medicare helps people to make a choice of health needs they prefer and through the plans with private insurance they offer medical services. They also provide for special needs and expensive treatments such as diabetes. Most health care providers do not like attending Medicaid patients. This is because they receive low reimbursement compared to Medicare, where reimbursement is high.

Comparison of policy options

Medicare policy covers patients with disabilities that are long-term and old people of 65 years of age and above. The policy pays services of nursing home care and also helps in planned hospital insurance. In this policy patients may either contribute some or all the money to pay for the services. The policy also covers laboratory tests, medical specialists’ services and other related health services (Ludmerer, 2010). Medicaid, on the other hand, takes care of the poor and low income earners who are under the age of 65. It is also the policy that covers the people whose Medicare policy’s benefits have expired. It pays for screening, specialists’ services, home and hospital care services and family planning. The services are offered by the states in conjunction with the federal government. In Medicaid, such patients as expectant/pregnant women and young children access medical services free. The copayments contributed by patients are little, and so is the reimbursements.


Edward, D. (2008). America’s Welfare, Johns Hopkins. University Press.
Goldberg, K. (2007). Mental Health Management, Oxford University Press.
Janacek, L. (2010). Health Insurance, Allworth Press.
Ludmerer, M. (2010). Time to Heal: American Medical Education. New York publishers.
Pilgrim, B., & Rogers, A. (2009). Sociology of Mental Health and Illness. Open University Press.

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