Assessing the scope and equity of Medicare to determine policy improvements

Abstract Purpose: The purpose of this study was to determine the effectiveness of Medicare in providing universal access to equitable healthcare for those 65 and older. Medicare went through iterations to adapt to changes in medical practice, and today is organized into parts that cover hospital insurance, health insurance, and prescription drug coverage. It is funded by a combination of payroll taxes, premiums that beneficiaries pay, and general revenues. Methods: Through a literary analysis, we compiled data to illustrate a statistical presentation of Medicare’s current population and the disparities present within it. Results: 46% of Medicare recipients are age 65-74. 16% of recipients are under age 65 and qualify for Medicare for other reasons. Roughly 80% of recipients live in urban settings, in line with population demographics. Roughly half of recipients live with a spouse, almost 30% of beneficiaries live alone. 15% of recipients are under the poverty line, slightly higher than the United States census poverty rate of 12.7%. Despite widespread effectiveness, disparities are still present. There is a sizable difference in the coverage of white beneficiaries against their minority counterparts. Female beneficiaries outnumber male beneficiaries by a significant amount, despite a near equal gender ratio at the population level. Furthermore, while Medicare was designed for the aging, 65+ population, theexpenditure, due to the impact of end stage renal disease patients. Costs also rise as recipients’ ages increase, though the number of recipients in the upper echelons of age decrease. Medicare recipient numbers are expected to increase rapidly in the next decade, until 2030. At the same time, the number of recipients enrolled in Medicare Advantage continues to rise as well, in both absolute and relative terms, easing some of the government’s burden onto private contractors’ shoulders. Conclusion: An important question to answer is how much to spend on Medicare, and how effective an increase in funding would be. For many, Medicare does not fully cover their health-related costs, and this is expected to worsen in the coming years. Since poverty is correlated with increased liability, targeting that group may present opportunities for improvement. Though outside the scope of Medicare, it is crucial to consider other programs that may work in tandem to achieve its goal of providing universal, equitable health care.