Financial Health and Future Sustainability of Medicare

Medicare is a national insurance program which provides access to healthcare for Americans who are over the age of 65, disabled, or have conditions like end stage renal failure or Lou Gehrig’s disease; it currently has approximately 48 millions enrollees and this number is expected to increase to approximately 80 million by the year 2030 (Wikipedia, 2013, p. 1). These numbers alone make Medicare an important issue, not only to the Medicare beneficiaries but to Americans as a whole. This paper deals with the current financial health of the Medicare Program as well as what is projected for Medicare sustainability in the future.




Medicare, a government-sponsored health insurance benefit for older persons in the United States, provides a number of opportunities for seniors to obtain preventative and specialized health services as required. Over 50 million Americans are supported by Medicare either as a primary or supplementary insurance benefit, which includes the provision of prescription drugs, surgical interventions, and physician-related services for these patients (The Henry J. Kaiser Family Foundation, 2012). Medicare is one of the key providers of health insurance in the United States and included approximately 21 percent of all expenditures for healthcare in 2012 (The Henry J. Kaiser Family Foundation, 2012). Also in 2012, expenditures for Medicare were approximately $536 billion (The Henry J. Kaiser Family Foundation, 2012). However, the manner in which Medicare is financed is complex; therefore, funding will be addressed in greater detail in the following paragraphs.

Criminal Justice

The Efficacy of Critical Incident Debriefing

Critical Incident Debriefing (CISD), according to Rabstejnek (N.D) is an intuitively appealing and popular means of debriefing and informing military personnel, police officers, firemen, and rescue personnel, after they have been exposed to or involved in what can be classified as traumatic events.

In order to effectively prescribe remedial treatment for individuals that might be potentially affected by mental distress, two medical principles must be adhered to according to Rabstejnek (N.D), by organizational management and human relations specialists. These are (a) adherence to the medical model of assessment, diagnosis, and treatment, and (b) conformance to the dictum that all helpers should do no harm or primcum non nocere.

According to Mitchell (1983), Critical Incident Stress Management (CISM), which is a multiple component of CISD, is a package of crisis intervention tactics that is strategically woven together to, mitigate or reduce the impact of traumatic events, facilitate the normal recovery process in normal people reacting normally to traumatic events, restoring individuals, groups and institutions to their adaptive functions, and to identify beneficiary to these processes or serve as referrals for their evaluations and psychological treatment.


Crime Theories


Crime has the implication of any behaviour, act, or idea that is perceived to be wrong in a given society. It is important to include the element of society because, what can be termed as crime in one area may not be termed as such in another area (APA 2004). Different authors, academicians and law enforcers have since time immemorial tried hard to research on the causes of crime in order to help deter, treat or even punish offenders. According to Allport (2007), several theories have been advanced to explain why individuals commit crime. They include the following:

  1. Deterrence along with Rationale Choice Theories
  2. Biological Theories
  • Psychological Theories
  1. Social Learning Theory
  2. Social Bonding & Control Theories
  3. Social Disorganization, Anomie, plus Strain Theories
  • Conflict Theory
  • Marxist and Critical Theories
  1. Feminist Theories.

Patient-Centered Medical Homes

The current trend of Patient-Centered Medical Homes (PCMH’s) seeks not only to lower the costs of healthcare but to improve patient outcomes; it is an important concept to understand in regards to the state of healthcare in America, and as of 2011, 41 out of the 50 states have made some progress towards the formation of PCMH’s (Kaye, N., Bauxbaum, J., & Takach, M., 2011, p. 12).  Despite their name, PCMH’s are not a place but a concept, a  method of healthcare delivery that “provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes” (Wikipedia, 2013, p. 1).  The PCMH has seven defined components: the personal physician to provide continuity of care, a physician-led team, whole person orientation, coordinated care, quality and safety, alternative scheduling arrangements, and payment reform (Goldberg & Kuzel,  p. 303).   This paper seeks to explore the development of PCMH’s in Virginia, focusing  on methods of healthcare delivery, targeted populations and conditions, participating payers and reimbursement, and the effects of the development of the PCMH on healthcare in the state.


Health Maintenance Organizations and Patient-Centered Medical Homes

Health Maintenance Organizations (HMO’s) and Patient-Centered Medical Homes (PCMH’s) are both important part of healthcare delivery in the United States, and while there are some similarities between the two healthcare delivery methods, there are some important differences as well. This paper seeks to examine the similarities and differences between HMO’s and PCMH’s and to discuss why things like healthcare information technology, workforce development, and payment reform are integral parts of the PCMH.

Public Relations

The Multi-Layered Issue of Gun Control

Gun control in America is an issue frequently spoken about, but rarely actually acted upon. No matter the reason America has lax gun control laws, there is one thing that is certain: people that should not be allowed to own guns do. The result is Columbine, Newtown, gang violence, as well as guns ending up in the hands of children. The problem lies in the conflicting views, very often emotionally charged, on both sides of the issue–naturally leading to a definitive lack of any kind of concessions for a compromise on either side.


Health Insurance Coverage

With the Affordable Healthcare Act prominent in each individuals mind, it is important to understand health insurance coverage. Health insurance options vary on an individual basis. Each person qualifies for a different type of coverage based on age and employment status. The Commonwealth of Virginia has specific guidelines regarding health insurance coverage.


Health Care Finance in the U.S.

Today’s healthcare costs are rising at a significantly higher rate than that of the average national income. The National Health Expenditure Accounts are responsible for estimating and calculating the total health care spending in the United States. This organization has been measuring the annual expenditures for the United States dating back to the early 60’s. They calculate health care products and services, public health activities, government administration, the net cost of health insurance, and investments related to health care. In 2011, healthcare costs reached 2.7 trillion dollars or 8,680 dollars per person in the United States. This equates to a 3.9 percent increase from the previous fiscal year. Healthcare spending accounted for 17.9 percent of the total spending in the United States. Data suggests that the increase in consumers’ use of health spiked in 2011 and has been on a constant increase since then. If this prediction is accurate, healthcare spending is expected to spike even more by 2014. According to NHEA, between 2011 and 2014 the national health spending is expected to grow at an annual rate of 5.7 percent. The United States healthcare expenditures can be divided into several sub-groups- individual out-of –pocket costs, private health insurances, Medicare, Medicaid, Veterans, third party programs, public health programs, and investments.  Medicare and Medicaid costs have increased 35 percent collectively since 1976. Private insurance has increased 33 percent in that time; as a result, out-of-pockets costs have decreased over 15 percent since 1976. Today, 52 percent of the healthcare expenditures in the United States are publicly funded by tax payers. The remaining cost is paid by the government.

IT Management

Children and Technology


The use of technology by children and adolescents spans many different activities, at school and in the home environment. This technology is available in many forms, including computers, smartphones, video gaming systems, and other devices. In many cases, these technologies offer significant benefits in the form of expanded learning and cognitive development. However, in other cases, these technologies are limiting and are often addictive, thereby impacting their lives in a negative manner. Therefore, a balance must be drawn that will encourage children and adolescents to use technologies wisely and in moderation in order to improve outcomes.


How is this ACO organized

                Accountable Care Organization is a network of health care providers, with a common goal/agreement of transparency in practice and payment procedures ensuring responsible quality care is offered to their patients/clients. As such, the organization has three models through which they function. First it is headed by providers who must have a solid primary care base through which interventions are executed. Together they are to ensure that quality care per total capita costs is provided according to health care protocol (McClellan, 2010).

East European Studies

Slave Revolution in The Carribean

What exactly, is David Bell’s definition of “Total War”? How did “total war” result from the French Revolution, and influence its course?  Would you argue that “total war” expanded the slave rebellion in Saint-Domingue?  Or do you think that what happened in the Caribbean was independent of Bell’s thesis about the revolutionary wars?  In addition to Bell, use at least two primary sources from Slave Revolution in the Caribbean in your answer.


What Feature(s) Enable ACOs (Accountable Care Organizations) to Control Cost and Improve Quality of Care

Accountable care organizations (ACOs) contain features that enable them to control costs by designing a distinct payment model which correlates care delivery with provider reimbursements through an electronic coding system. Importantly, a group of health care providers form the Accountable Care Organization (ACO). This is mandatory if they are to qualify for state benefits from Medicare/ Medicaid clients and federal tax exemptions. Typical payment models used to gather funds in lieu of services rendered to patients include capitation and fee for service. In adapting these approaches they become accountable to both patients and third parties and quality of services are improved while cost is controlled (McClellan, 2010).


Nursing: Health assessment on a newborn infant.

Article summary

This article evaluated the positive impacts of breast-feeding as being associated with reduction in perceived stress and negative mood in mothers. Two researchers Mezzacappa, Elizabeth Sibolboro (2002) and Katkin, Edward (2002) used an experiment to compare 28 breast feeding mothers with 27 bottle feeding ones during the post-natal period. They analyzed perceived stress and mood within the past month of utilizing the feeding intervention. The experiment revealed that mother who breast fed reported far less perceived stress and mood variations. Researchers concluded based on this small study that breast feeding buffers negative moods (Mezzacappa & Katkin, 2002).

Information sharing

Contemporary health promotion strategies enable the nurse to demonstrate relevant skills as an information disseminator (Jarvis, 2012). As such, my approach in sharing this study would entail a diagramtic representation of two sets of women feeding. This could be best communicated utilizing a power point presentation. One group would appear agitated by furious babies with mothers trying the force bottle feeding and the other group would have well composed happy women gently embracing their infants during breast feeding.

One picture says a thousand words. Therefore, with this pictorial image introduction, I would ask them to interpret the power point and how they feel about the two groups of women captioned in the scenes. At this point concerns raised will be given attention and clarifications offered while discussing the other long term benefits of breast feeding (Oddy, 2010)


Community resources available for breast feeding

A valuable community resource accessible at no cost to mothers is the women infant and children (WIC) nutrition services. Others are located at community health centers across the nation and non-profit organizations inclusive of Planned Parenthood. Generally, community breast feeding resources are limited



Mezzacappa, E., & Katkin, E. (2002) Breast-feeding is associated with reduced perceived stress

and negative mood in mothers. Health Psychology, 21(2), 187-193.Retreived on April, 28th,

2002 from



Jarvis, C. (2012). Physical Examination & Health Assessment (6th ed.). St. Louis, MO: Saunders

Oddy, W. Kendall, G. Li J, P. Robinson, M. de Klerk, N. Silburn, S. Zubrick, S. Landau, L., &

Stanley, F.( 2010). The long-term effects of breastfeeding on child and adolescent mental

health: a pregnancy cohort study followed for 14 years. The Journal of Pediatrics 156 (4),