Dental and Medical Insurance problems faced by geriatrics
Institution: Pima medical Institute
Instructor: Priyanka Handa
With the advancement in medicine and medical technology, there has been a steady increase in the life expectancy of the population of the elderly. This segment of the population is much more vulnerable to chronic illnesses, physical disabilities, dental problems, and mental problems compared to younger people. Such demanding healthcare needs discourage private health insurers because of many compensation claims and footing high hospital bills. This paper examines both dental and medical insurance challenges that people above the age of 65 faced not only in the United States but also across the world. The paper ends with the implications for the future.
Dental and Medical Insurance problems faced by geriatricsIntroduction
Aging is a natural and inevitable process that all living human beings must undergo until death. Coping up with aging presents many challenges to all section of the society as the elderly require medical attention. Based on the definition of the World Health Organization (WHO), an elderly person is one whose chronological age is 65 years and above. However, the physical and mental changes vary depending on one’s social environment and mental health. With the advancement in medicine and medical technology, there has been a steady increase in the life expectancy increases the population of the elderly. These demographic trends show the need for shifting the healthcare focus to cater to the dental and medical needs of this deserving population. The elderly population is disproportionately facing dental and medical insurance problems compared to younger cohorts mainly because of the increased vulnerability to illnesses.
Unlike other age groups, an aging population is more vulnerable to chronic illnesses, physical disabilities, dental problems, and mental state issues. Such demanding health needs discourage private health insurers because of many compensation claims and footing high hospital bills. It is for the same reasons that Medicare was enacted in 1965 with a view of helping the elderly people without health insurance. Medicare is a public health insurance program that covers all uninsured elderly Americans. It guarantees physician services and access to inpatient services when needed. For decades, Medicare has assisted the poor, elderly persons in the United States to enjoy the improvement in health care (Cohen ; Martinez, 2015). They have been forced to only rely on Medicare. Although the coverage is only limited to the basic health insurance. Medicare does not cater for all medical problems and conditions. Hence, it turns out to be disadvantageous to the beneficiaries with poorer health than those with better health.
The design and scope of Medicare pile the financial burden the elderly beneficiaries. The financial obligations for the elderly recipients disfavor them compared to the non-elderly beneficiaries. Although it is essential, the Medicare coverage is incomplete, and one cannot rely on it for all medical expenses. Many healthcare needs required by the senior persons such as dental services and vision care are conspicuously absent from the Medicare coverage. Even the disabled elderly in the under-nursing home care is not covered by the Medicare (Wall, Vujicic, ; Nasseh, 2012). Helping the old people to curb their health problems requires a multifaceted approach where health care programs and social welfare initiatives are synchronized through the creation of a comprehensive policy. Implementing such policies is imperative for the effective management of health risks facing the elderly population.
Private medical insurance is available to complement the areas left out by Medicare. However, the low-income elderly population cannot afford to the finance the premiums charged. The affordability of the private insurance is the most significant barrier to access to health care services by the senior persons. Only the high-income elderly persons can enjoy private insurance for their medical needs left out in the Medicare program. Out-of-pocket spending on insurance premiums significantly increases the expenses for an average elderly individual. With the limited ability to pay the exorbitant premiums, most aged persons are having unending health problems that eventually cause untimely death.
Over the years, having dental insurance has proved to be an area of great concern for those who regularly seek dental care. Dental care is costly for anyone to depend on out-of-pocket payment. Although the occurrence of dental problems does not depend on the age of an individual, elderly people are more susceptible to periodontal diseases and root caries. Thus, it is essential for people to undertake preventive needs so they can keep their teeth even in old age. Unfortunately, most public health insurance coverage does not provide for dental insurance. The implication here is that most elderly people, especially in the United States, do not have dental insurance. Only a handful of them that can comfortably afford the private dental insurance is assured of dental care. Medicare excludes dental care from the plan complicating the situation of the low-income elderly Americans in need of dental care.
Despite the pressure for the interested groups, the federal government is overly reluctant to include dental care in Medicare because of the macroeconomic impact the move will have. According to the latest data from the National Center for Health Statistics, only 24 percent of the elderly population in the United States has access to private dental insurance. It implies that over 70 percent of elderly Americans do not have dental coverage altogether (Wall, Vujicic, ; Nasseh, 2012). Although Medicare is partly to blame for the low rates of dental insurance coverage, the retired people also lose their employer-based coverage upon retirement. With many employers shying away from the post-retirement health benefits, high rates of dental insurance among the elderly become inevitable. The retired population has limited financial resources. Compelling them to self-insure through out-of-pocket payment is potentially unwise and may cause other problems like lacking basic needs. The only group assured of the continued access to dental care is the high-income elderly. The disabled and institutionalized elderly persons are equally affected by lack of coverage for dental care. This category of people spends a considerable percentage of their disposable income on their medical conditions paying little attention to the dental health care needs.
Even younger cohorts need to pay attention to the dental insurance because they are likely to have tooth-specific diseases in the future. Studies have shown that more people are living longer without losing their teeth prematurely because of the improved medical technology and relatively healthy lifestyles (Wall, Vujicic, ; Nasseh, 2012). There is a problem in the dental health care delivery system. It is upon the policymakers to consider incorporating dental care in the public health insurance programs such as Medicare and Medicaid. Even though many people have access to dental preventive and treatment options, a lot still needs to be done to ensure oral health is a priority. The burgeoning elderly population has legitimate needs as far as their dental health is concerned. By increasing the channels where one can get the financing for dental health care, the government would work towards the development of a healthy society.
Implications for the Future
Equally accessibility to health insurance is one way of reducing the inequality in healthcare that has faced the society for many years. Although public health insurance plans like Medicare have played a significant role, the cost-sharing requirements have negatively affected the elderly persons especially those in low-income cadre. Programs like Medicare also do not cover specific services like dental care, vision care, and outpatient prescription drugs common to people with ages above 65. Private insurance supplements the gaps left in the Medicare coverage. Sadly, only upper-income old persons can afford to pay the set premiums. A significant percentage of the elderly population has dwindling financial resources, which cannot be subjected to monthly deductions and annual payments. Going forward, it is critical that elderly people are provided direct help by either the state or federal governments so that their access to dental and medical care is uncompromised.
Understanding the dynamic of dental and medical insurance and the associated effect on the elderly population is vital to creating a healthy society. Public health insurance programs are essential but inadequate. With the ever-increasing elderly population, failure to create a health system that would guarantee dental and medical insurance to the senior citizens would be detrimental to the society at large. It is imperative that the government, employers, and insurance providers understand the significance of dental and medical coverage of the senior population. They will go a long way towards enhancing good healthcare. The changing health services needs and demands of the elderly segment of the population should be factored in the development of healthcare policies for posterity.
Cohen, R. A., ; Martinez, M. E. (2015). Health insurance coverage: Early release of estimates from the National Health Interview Survey, 2014. National Center for Health Statistics.
National Center for Health Statistics (US). (2002). Chartbook on Trends in the Health of Americans. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
Wall, T. P., Vujicic, M., ; Nasseh, K. (2012). Recent trends in the utilization of dental care in the United States. Journal of dental education, 76(8), 1020-1027.
World Health Organization, ; World Health Organization. (2010). Definition of an older or elderly person. 2013. Geneva, Switzerland. Available at: http://www.who.int/healthinfo/survey/ageingdefnolder/en/World Health Organization. (2015). World report on aging and health. World Health Organization.