Regulatory_and_Legislative_Issues

* Running Head: REGULATORY AND LEGISLATIVE ISSUES * * * * * * * * * The Medicare Prescription Drug Improvement and Modernization Act (MMA) of 2003 Ethical, Legal and Regulatory Issues in Health Care University of Phoenix Online April 5, 2010 * * * * * * * * * * The Medicare Prescription Drug Improvement and Modernization Act (MMA) of 2003 * Society is governed by laws, which are established by the representative’s of its habitants; laws are there to pursue social justice in the areas individual’s existence. A law is the body of rules and regulations that govern people’s behavior and their relationship with others in society and with the state (Aiken, 2004, p. 57); laws are susceptible of modification, and adaptable to society concerns. Aiken (2004) states that laws promote order by resolving conflicts and disputes nonviolently, by defining responsibilities, and by protecting the health, safety, and welfare of the citizens (p. 57). * The Medicare Prescription Drug and Modernization Act (MMA) 2003, sets a precedent of social justice especially for the senior citizen of the US. “This bill presents us with an historic opportunity of providing 40 million Medicare beneficiaries with relief in the face of rising prescription drug costs (Castle, 2004 p.58). * Evaluate the Impact of This Law on Health Care * The MMA is statutory law, Aiken (2004) this law is based on statues, formal written laws enacted by federal, state, and local legislative authorities or bodies (p.59). Implementing new procedures in providing a health services initially will impact the economy, industries, and organizations. Changes require investment and there is always a risk in making projects, plans, and reforms to work. Jarrett (2006) affirms that “MMA has adversely affected the financial bottom line in health system” and “by 2006 financial resources had become scare and the price of many pharmaceuticals had increased” (pp.S1-S3). * The Impact Health Care in Terms of Cost * Castle (2004) stated “this bill aims to make prescription drugs more affordable and more accessible by creating a voluntary prescription drug benefit” and with “the creation of the Medicare program, seniors, no matter where they live, will be able to receive financial assistance to help pay for these drugs, which are becoming increasingly integral to disease prevention, management, and treatment” (p. 58). * According to Jarrett (2006) the Medicare Prescription Drug Improvement and Modernization Act (MMA) of 2003 has had a large impact on the financial bottom line health system by reducing reimbursement rates for pharmaceutical products at the time when the purchase prices of many pharmaceutical products increased (p. S10). By controlling the price of the prescriptions it will benefit the seniors, but it will also have a negative impact in the cost of production of drugs, revenue for the pharmaceutical companies, and reduction of job opportunities. * The changes in Medicare Reimbursement rate in money from 2004 to 2006 has decreased, Jarrett (2206) in hospital outpatient departments the brand name product reimbursement in 2004 was $112.14, in 2005 the price was $ 93.50, and by 2006 it decrease to $ 15.58. For the generic products in hospital outpatient departments prices between 2004 and 2005 remain the same $ 79.40 and by 2006 the price dropped considerably to $ 15.58. Now the tow pharmaceutical industries are marketing the drugs at the same price in 2006 (p. S12) with the difference that brand products require more investment in research, testing and to be approved by the Food and Drug Administration FDA. * The Impact of MMA in Quality Care * Provision of medical services and drugs for the senior’s throughout Medicare has being done over the years some with positive and negative outcomes. The positive of this law is that now seniors can select different health plans private and public, but some elderly participants do not how this works, and do not take advantage of all the services they offer. * The failure of private health care to provide quality care at a cost savings to Medicare, research has constantly demonstrates that the provision contained in the MMA established capitation method provides an excessive and profitable payment structure for private health care plans (Bakk, 2008, p. 2). Data presented by Bakk (2008) states “that Medicare and choice enrollees in good health spent an average of $ 1,564 out-of-the pocket on health care compared with $ 5,305 by enrollees in poor health (p.2). * Introducing a health care reform requires time and education; customers need to become familiar and comfortable with a plan, case management and education is the key to make this law work. * * The Groups that Favors the Medicare Prescription Drug Improvement * and Modernization Act (MMA) of 2003 * In 2003 was proposed by the republicans in the senate, they voted for the Medicare prescription-drug benefit, out of 122 still remaining in the House, 108 voted in favor for it (Weisberg, 2009, p.1). During the Bush administration health care reform was looking forward to benefit the seniors, Weisberg (2009) states that “the republicans bill stands as the biggest expansion of government’s role in health care since the passage of Medicare and Medicaid in 1965, created an entailment for seniors to purchase low-cost drug coverage” (p. 1) * The implications of passing a bill is not only a matter of political debate, the health care system is aiming to make accessible the health care services and drugs for its seniors * * The Group Against to the Medicare Prescription Drug Improvement * and Modernization Act (MMA) of 2003 * The democrats by the other hand are not in favor of this law, Weisberg (2009) according to “the 2009 report to Congress, the Medicare trustees’ estimates that the 10-year cost of Medicare Part D is as high as $1.2 trillion. That figure-just for prescription-drug coverage that people over 65 still have to pay a lot of money for-dwarfs” and “ George W, Bush signed was financed entirely trough deficit spending” (p. 1) * Conclusion * Establishing a law is not only a matter of a political debate or to favor political parties, other factors as if financial, and socio-economic background of the beneficiaries requires more research to be done before implementing a reform. The health care system is aiming to make accessible the health care services for the seniors, and at the same time is struggling to survive with a low profit. The financial impact is evident; the investment is high, the cost in delivering a service is perform with a deficit. * The willingness to establish regulations that favor the vulnerable citizens is a good intention, but it requires more research and responsibly in the long term. This law has affected the pharmaceutical, the health care industry with the reduction of reimbursement for drugs and services. * References: Aiken, T. D (2004). Legal, ethical, and political issues in nursing (2nd ed.). New York, NY: McGraw-Hill. Bakk, L (2009). Medicare Prescription Drug, Improvement, and Modernization Act of 2003: Implications for the Future of Health Care. Health & Social Work, 34(1), 59-63.  Retrieved April 5, 2010, from ProQuest Health, and Medical Complete (Document ID: 1660502061). Castle, M (2004). Should the House Approve H.R. 1, the Medicare Prescription Drug, Improvement, and Modernization Act' Pro. Congressional Digest, 83(2), 58-62. Retrieved from Academic Search Complete database. Jacob Weisberg (2009, December). Do As We Say, Not As We Do :The Republican Party's health-care hypocrisy.. Newsweek, 154 (25), 5.  Retrieved April 5, 2010, from ProQuest Nursing & Allied Health Source (Document ID: 1922350511). Jarrett, A. (2006). Effect of the Medicare Prescription Drug Improvement and Modernization Act on the bottom line. American Journal of Health-System Pharmacy, 63S10-S13. doi:10.2146/ajhp060462. .