ver, not all the states participated. Arizona did not adopt the program until 1982.
The main components of the U.S. health care program are Medicaid and Medicare. Medicaid provides health care for specific poor people and is a public assistance program. Federal and state governments share responsibility for the Medicaid program. At the state level, Medicaid claims can be processed by either the states or intermediaries. States use their general tax revenues to pay for their Medicaid share. State reimbursements are calculated annually based on the state's population and tax base. All states are reimbursed at least 50 percent for services with poorer states receiving up to a 83 percent maximum. The states have broad authority over implementation of Medicaid policy. They determine the reimbursement for services health care providers will receive. However, the states are under constant pressure to increase revenues to decrease their reimbursement share, and to limit the amount of federal matching funds they receive to the 50 percent maximum.
Medicare provides health care for Americans over 65 and younger people with long-term disabilities. At the Federal level, Medicare is administered by the Health Care Financing Administration (HCFA) which uses numerous intermediaries and carriers to review claims and make payments. As a result of the size and amount of money involved in Medicare and Medicaid, both programs have attracted a number of special interest groups.
Other components in the health care system include: long-term care which is provided for people who cannot perform their personal day-to-day living activities, and may be provided either in nursing home facilities or as home health care; and private health care programs which include health maintenance organizations (HMOs), preferred provider organizations (PPOs), and managed care programs.
A number of unintended consequences resulted from the health ...