Introduction
There are two primary concerns for an individual once they enter late adulthood: healthcare and economic security. Economic security deals with the financial resources one has once an individual is either too old or too disabled to work. It also involves resources an individual has access to while facing involuntary unemployment. Healthcare concerns, on the other hand, deal with the health issues that present during the aging process and the financial resources need in order to maintain such health issues. Because the number of aging individuals is growing throughout the country, the government has created two different programs in order to assist these individual with their aging needs. This paper discusses the past, current, and future configurations of the Social Security program and Medicare in the United States.
Social Security
History
Social insurance is used as a method for addressing the problems of modern industrial societies when it comes to economic security. “the concept of social insurance is that individuals contribute to a central fund managed by governments, and this fund is then used to provide income to individuals when they become unable to support themselves through their own labors” (DeWitt, 2010, p. 2). In such cases, benefits become weighted based on the individual factors. In the U.S. Social Security system, for example, bases how many benefits one individual receives based on their past earnings. Those individuals with a lower past earnings receive a higher benefit than those individuals who have higher earnings (p. 2).
Social insurance became a societal need through the Industrial Revolution. Economic security was not a concern in preindustrial American because the people had short life expectancy. In 1850, the typical American male had the life expectancy of only 38 years old. However, the growth of the twentieth century created a revolution when it came to health care, public sanitation, and generally living standards. These factors created a population growth when it came to Americans having longer life expectancies. Thus, a need for economic security became a growing concern when it comes to industrialized societies (DeWitt, 2010, p. 3).
The original program was designed to give individuals retirement benefits at the age of 65. Furthermore, the program was only designed to cover the individual who was working, no their families. Social Security benefits were based on the total cumulative wages that the worker had received in covered employment. In other words, the more years that the individual had in covered employment, the more the individual was intended to receive. Social Security also used a benefit formula that was used when it came to social weighting. This formula would allow workers with lower earnings to receive higher benefits than a worker with high wages (DeWitt, 2010, p. 3).
When the Social Security program was first established, coverage was considerably limited. A little more than half of workers throughout the economy participated in the original program. The coverage of the program was categorized occupationally. Most employees throughout the program were considered “commerce and industry” employees. There were also some groups who were excluded from the social security program. These individuals consist of: government employees, individuals who were already 65 prior to the creation of the program, the military, and self-employed individuals (DeWitt, 2010, p. 5).
The program was financed from payroll tax. Payroll taxes began at the beginning of 1937, with the first benefits to be payable by the beginning of 1942. Both employers and employees contributed to the Social Security program. The tax rate was one percent for each party, which increased every three years until three percent. From 1937-1939, more than 440,000 individuals became recipients of Social Security benefits. This number totaled over $25 million in the United States economy at that time (DeWitt, 2010, p. 7).
Current configuration of the program
The Social Security program is currently facing several challenges. “Nearly 80 million baby boomers will file for retirement benefits over the next 20 years, an average of 10,000 per day” (Puckett, 2010, p. 27). The current state of the Social Security program is struggling due to the growing number of individuals who are needing Social Security benefits. In 2009, the Social Security Administration processed over 175,000 claims than anticipated. This is causing several issues for the program; the main being it is not staffed to be able to handle this type of demand. Thus, the program had to employee over 8,000 new workers in 2009 (p. 71).
Projections for the future of the program
The future of the Social Security program is dependent on the benefits that are available. Currently, it is estimated that Social Security benefits will be payable until 2037. At this time, the funds for the Social Security program will become exhausted. When the funds are used up, taxes are expected to continue to pay 76 percent of benefits that are scheduled. This is a pressing problem that Congress needs to address in order to make changes to the scheduled benefits for the future of the program. “The Social Security Board of Trustees project that changes equivalent to an immediate reduction in benefits of about 13 percent, or an immediate increase in the combine payroll tax rate from 12.4 percent to 14.4 percent, or some combination of these changes, would be sufficient to allow full payment of the scheduled benefits for the next 75 years” (Goss, 2010).
Medicare
History
Medicare was created with the idea of improve the health and well-beings of older individuals while also protecting families. “It was established to provide financial protection to individuals from the catastrophic costs of medical care, and to hospitals from losses accrued while caring for uninsured patients- the largest number of whom were older than aged 65” (Fried, 2015, p. 180). Medicare was developed as a family policy. This way the program could protect both older individuals and their children. The idea of Medicare was important when it covered the children of aging parents. This is due to the fact that their standard of living could be altered if the older parent became ill (p. 180).
Current configurations of the program
Medicare has made significant progress within the past fifty years. The progressive expansion of Medicare has been able to better meet the needs of the individuals throughout the country. Medicare currently funds graduate medical education. It also finances the healthcare of several individuals throughout the country. It is estimated that approximately 87 percent of Medicare beneficiaries are currently living with one or more chronic illness. Approximately 65 percent of Medicare beneficiaries have two or more chronic disease, while twenty percent have five or more suffer from chronic diseases. The twenty percent of Medicare beneficiaries that are currently living with five or more chronic illness account for 66 percent of Medicare costs (Fried, 2015, p. 181).
Medicare also covers hospice care and home health services, capitated hospital and outpatient care, prescription medication coverage, and vision and dental care. Medicare is also responsible when it comes to clinical disease prevention and mental illness treatment. Ever since the 1980s, Medicare has contributed to prevention for older adults. Such prevention consists of screening for early detection of a number of chronic disease. Medicare also contributes to the screening of geriatric conditions (Fried, 2015, p. 181).
Projections for the future of the program
Medicare is investing in the future health of their current beneficiaries. Over the past fifty years, Medicare has created chronic disease management and clinical and community services for prevention for the aging community. “This expansion of the principles of how to improve the health and well-being of older adults, which was Medicare’s initial goal, is foundation to what needs to be accomplished in the next fifty years” (Fried, 2015, p. 181). Today, we currently have the knowledge and education to understand that prevention is key when it comes to most disease and conditions. For example, it is estimated that 50 to 70 percent of cancers could have been prevented if proper steps were taken. Prevention is key when it comes to the future for Medicare (p. 181).
“Medicare can and must continue evolving into a system that optimizes health and function in aging, while supporting a coordinated continuum of prevention and care matching the needs of an aging population” (Friend, 2015, p. 183). The Center for Disease Control has stated that the key for living longer is healthy aging. Healthy aging must involve the maintenance of mental, physical, and social well-being in older individuals. The future concerns for Medicare lye in preventing diseases and geriatric conditions amongst the aging community. Medicare has four strategies when it comes to the future and the aging population. These strategies are: 1) extend clinical prevention, 2) creating integrated health systems between Medicaid, Medicare, the Administration on Aging (AOA) and Public Health, 3) expand support of health professional training, and 4) create a shared data collection and referral system (p. 186).
The first strategic is to extend clinical prevention for all adults from the age of fifty and older. These individuals would receive full sets of screenings, vaccinations, and preventive services that are recommended by USPSTF. Doing this would help ensure that people who reach the age of 65 are in good health and that their health can be optimized until they are in their seventies. “There is strong evidence now that those who turn age 70 in good health are positioned for longer and healthier future lives- at no additional cost to Medicare” (Fried, 2015, p. 184).
Creating integrated health systems between Medicaid, Medicare and the Administration on Aging (AOA) would improve the health and well-being of these older individuals. “Medicare should collaborate with the AOA and the public health system to develop transitional and cross-setting programs that can recognize the need for medical care and establish access, the transition individuals effectively back into the community” (Fried, 2015, p. 186). Also, supporting the growth of the health profession and their training in order to better serve the gaining population.
Conclusion
Both Medicare and Social Security were set up intended to give the general public the resources necessary in order to live long, healthy lives. Social Security gives individuals benefits based on how much they have worked and made throughout their lifetime, while Medicare assists the aging community with their health care needs. Both are necessary in order for the aging community to live longer and healthier lives. Once an individual reaches a certain age, they may be physical unable to work and need benefits in order to carry out the remainder of their live. Social Security with the healthcare resources that Medicare offers gives an individual the benefits and resources they need in order to have healthy aging throughout the remained of their lives.
References
Aaron, H. & Reishchauer, R. (2015). The transformation of Medicare, 2015, to 2030. Forum for Health Economics and Policy, 18(2), 119-136.
DeWitt, L (2010). The development of social security in America. Social Security Bulletin, 70(3), 1-27.
Fried, L (2015). A prescription for the next fifty years of Medicare. Journal of the American Society on Aging, 39(2), 180-189.
Goss, S. (2010). The future financial status of the Social Security Program. Social Security Bulletin, 70(3).
Puckett, C. (2010). Administering Social Security: challenges yesterday and today. Social Security Bulletin, 70(3), 27-80.
Smith, D. (2013). Making history. National Nurse, 16-19.
