Act Modernizing and Improving Medicare Prescription Drug

The healthcare industry is large and has a variety of strategies. Healthcare laws and regulations are in place in many nations, including the United States. The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) was implemented in the United States in 2006. (Channick, 2007). Users of the policy must pay monthly premiums as part of the voluntary scheme. Prior to this policy, the nation had the Medicare policy, which dealt with drug-related problems. In order to allow for the prescription of medications within the outpatient department, this policy extended the Medicare policy. The elderly over 65 are one of MMA’s main objectives. The policy also targets individuals below 65 years with disabilities and unable to secure employment (Channick, 2007).

Although the policy aimed at reducing the cost of drugs, the introduction, and implementation processes faced some difficulties. According to Okpala (2013), the approval of the policy became controversial. Initially, various stakeholders doubted the policy. Legislators had negative perceptions towards it because they felt that White House had deceived them. Moreover, it is important to note that before the implementation of the new policy; the stakeholders established a transitory program to ensure that drug discount program meet particular merit.

Research Conducted

Research reveals that a majority of the elderly individuals in the U.S society could hardly afford the cost of healthcare because of unemployment (Okpala, 2013). Stakeholders through different researches established that the initial program for Medicaid lacked the coverage prescription drugs in the outpatient department. This omission resulted in the establishment of other programs such as the Medigap to provide the coverage, which failed to solve the problem. Research further indicated that between the late 1960s and late 1990s, the coverage for prescription drugs depended on the reforms on other healthcare policies (Oliver, Lee, & Lipton, 2004).

A task force established that the cost of prescription drugs had increased significantly between the period 1950 and 1965 (Oliver, Lee, & Lipton, 2004). The task force through their research found that although insurance firms offered prescription drug policies, restrictions limited extensive coverage. These restrictions included coinsurance controls, allocation of maximum amounts, and deductibles of the minimum amounts. Moreover, research established that a majority of the existing policies covered individuals of over 65 years only (Oliver, Lee, & Lipton, 2004).

Promotion of Policy

The failure by Medicare to solve the issue of drugs resulted in discussions and consultations across the country. The number of discussions increased in the 1990s as the baby boomers were approaching retirement (Okpala, 2013). Moreover, different stakeholders became concerned with the rising costs of medication. Various entities came up with different programs to help ease the crisis. These entities such as the American Medical Association took up the initiative of campaigning for the privatization of healthcare. The campaign was successful and resulted in expanding the Medicare policy. Although the opponents of the policy claimed that it was an expensive initiative, they later affirmed that the policy was good.

The Heritage Foundation, a non-governmental entity, promoted the policy by informing the public about the benefits of the MMA policy. The organization focused on explaining the advantages of the healthcare policy to the elderly and the disabled. However, other entities campaigned against the policy. They argued that the policy would fail because it restricts users from getting prescriptions without serving monthly premiums. According to Okpala (2013), these individuals suggested that the elderly have meager stipends and they will be unable to service the premiums restricting them from enjoying the benefits of the plan. Moreover, those against the policy claimed that the policy is discriminatory because it depends on individual incomes.

Impact of Policy

MMA facilitated the prescription of drugs, especially to the outpatient department. Moreover, the policy has great positive effects on the elderly (Channick, 2007). MMA is a social insurance policy that seeks to take care of the demands of the various sectors in the U.S society. According to Okpala (2013), the policy seeks to promote universal healthcare to all. MMA targets the elderly who are too old to work and pay for their health costs. Previously, the elderly had to enroll in different healthcare programs to get significant health care benefits.

The policy benefits all patients because it seeks to offer subsidies. Although Medicare was a good healthcare plan, it failed to solve the issue of costly drugs. As such, MMA provided a solution to this problem by subsidizing drugs to reduce their costs (Okpala, 2013). Moreover, this policy seeks to give individuals with insurance plans better deals for their money. Furthermore, the policy provides broader coverage for patients. MMA also changed the existing cost-sharing plan. This health policy increased the monthly premiums for the high-income earners and couples. Moreover, it increased the deductible value by considering the value of the payable amount to the Federal Supplementary Medical Insurance (O’Sullivan, Chaikind, Tilson, Boulanger, & Morgan, 2004).

Effects of Other Healthcare Policies

MMA affects other healthcare policies. For instance, the policy expands the original Medicare policy forcing it to accommodate other healthcare plans. The policy resulted in calls for coordination between the MMA and the pharmaceutical assistance program (O’Sullivan, Chaikind, Tilson, Boulanger, & Morgan, 2004). This coordination is important to facilitate effective collection of premiums and payment for the drugs. As such, the policy resulted in new procedures that affected the pharmaceutical plan. Moreover, MMA introduced new coordination procedures in other prescription programs such as the Medicaid, group health programs, TRICARE, and the federal employee’s program on health (O’Sullivan, Chaikind, Tilson, Boulanger, & Morgan, 2004).

MMA made few changes to other policies such as the Medicaid. The policy excluded the aspect of age among employees to enable the employee benefits program to provide several benefits to employees eligible to the Medicaid plan. These benefits are different from the ones that non-Medicare employees receive. Moreover, the policy requires other programs such as Medicaid to raise their direct spending. Furthermore, the Act increases disproportionate share hospital allocations for the different states (O’Sullivan, Chaikind, Tilson, Boulanger, & Morgan, 2004).

Moral and Ethical Implications

MMA has moral and ethical implications because it became a political item. Debates about prescription drug plans became prominent in the presidential campaigns of 2000 (Oliver, Lee, & Lipton, 2004). All the major candidates proposed a prescription drug plan for low-income earners and the elderly. Moreover, legislators doubted the plan after it emerged that White House had lied about the exact cost of implementing the policy. Moreover, White House failed to specify the expected savings resulting in ethical concerns.

Other Countries

Other countries also have a similar version of the MMA. However, the cost of coverage of prescription drugs in other countries is lower than in the U.S. These other countries including Denmark, England, Germany, France, and Sweden. These countries have adopted the cost-sharing model to reduce costs.

References

Channick, S. (2007). The medicare prescrption drug, improvement, and modernization act of 2003: will it be good medicine for U.S health policy? The Elder Law Journal, 14, 237-283.

O’Sullivan, J., Chaikind, H., Tilson, S., Boulanger, J., & Morgan, P. (2004). Overview of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. CRS Report for Congress.

Okpala, P. (2013). Medicare Modernization Act (MMA) of 2003. Journal of Applied Medical Sciences, 2(3), 61-66.

Oliver, T., Lee, P., & Lipton, H. (2004). A Political History of Medicare and Prescription Drug Coverage. Journal of Health Policy Law, 82(2), 283–354.