Public Health Trivia - Ep 1

Learning about public health, one trivia question at a time until you become an MPH. 

Topic: Medicare 

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Transcript

SPEAKER_00 0:02

Welcome to the pilot episode of Public Health Trivia, a series where we learn about public health one trivia question at a time until you have an MPH. 12 questions. There will be a pause after each question before the answer. Today's category, Medicare. Here we go. Question 1. While the US does not have universal health care, the federal government does provide some form of health care for select groups of people. One such federal health insurance program is Medicare. There are many ways to qualify for Medicare, the most common of which is this. The answer is if you are 65 or older, you can qualify for Medicare. Now, if you had a more strict professor, you may only receive half credit because there is an additional qualification that you need to meet. Leads me to question number two. In addition to being 65 and older, the individual must also be this. The correct answer is the individual must also be eligible for monthly social security or railroad retirement board cash benefits. Typically, people qualify for Social Security, that's their main way of qualifying for Medicare. This leads me to the next question. Question number three. In order to qualify for Social Security cash benefits, an individual must accumulate 40 Social Security credits by doing this. The only way to earn these credits. You can earn up to four credits a year, so on average, 10 years you'll earn 40 credits to qualify for Social Security and therefore Medicare once you are age 65 or older. Paying these taxes is the only way to earn these credits because, say with me, this is an earned benefit. Social Security is not an entitlement program, as some conservatives would like you to believe, because you can only get it for free after you have paid into it for a certain amount of time, which is a fixed percentage of your income. So it is not an entitlement program. Question number four. There are three other ways to qualify for Medicare if you are under the age of 65. The first of which is being qualified for this. Social Security Disability Payments has a different set of eligibility criteria that is mainly revolved around your inability to work, so long-term disabilities. We will come back to the other two ways to qualify for Medicare, but first let's go to questions about the history of Medicare. Question number five. Medicare was created not as a standalone piece of legislation, but rather signed into law as an amendment to the Social Security Act by this president. Correct answer: Medicare was signed into law in 1965 by Lyndon B. Johnson with the Social Security Amendment. Specifically, it's Title 18 of the Social Securities Act. Question number six. At this point in time, 1965, Medicare did not cover people with disabilities under 65. That would not come until this year, when Congress passed and Nixon signed another Social Security Act amendment. The answer is 1972. That was when the amendment was passed that Medicare eligibility extended to people with long-term disabilities regardless of their age. Question number seven: The other two ways to immediately qualify for Medicare under the age of 65 is having either one of these two conditions. One of these conditions is this, which was specifically mentioned in the 1972 amendment as a condition that can qualify for Medicare regardless of the person's Social Security disability qualifications. The answer is end-stage renal disease, colloquially known as kidney failure. If you have end-stage renal disease, you qualify for Medicare regardless of whether you qualify for Social Security disabilities. This amendment is funny to me because the reason why they added kidney failure as a standalone qualification condition is they realized that kidney failure is a life-threatening disease, but dialysis, the only thing keeping these patients alive, is very expensive, meaning a lot of people were suffering and dying simply because they couldn't afford dialysis. So they added this particular condition to cover these people. Perhaps it was Nixon's attempt to get good PR, who knows? But my thought about this was always: if you can recognize that people who can't afford life-saving health care is a tragedy, why not extend that to everyone in every condition? Why not just have universal health care instead of saying no, only this condition qualifies for federal health insurance? Too radical, I guess. Question number eight: another way to immediately qualify for Medicare is having this condition. The correct answer is amyotrophic lateral sclerosis, also known as ALS or Lou Gehrick disease. Question number nine, the 1972 Social Security Amendment extend Medicare coverage to people who qualify for Social Security disability payments, which if you have ALS, you most certainly would qualify for. However, ALS is mentioned as a special qualifying condition for Medicare because of the Consolidated Appropriations Act of 2001 that amended the Social Security Act again. This amendment in 2001 exempted ALS from this Medicare qualification requirements for people with long-term disabilities. Typically, just because you qualify for Medicare under the disability categories, they make you wait two whole years before you can actually get Medicare for the most part. End stage renal disease and ALS are the two conditions that do not have to wait, hence why they are a special mention when discussing Medicare eligibility. Question number 10. There are four parts to Medicare, A, B, C, and D. Not all four parts were created at the same time. For example, parts A and B were created at the inception of Medicare and is commonly referred to as traditional Medicare and covers these two things respectively. Correct answer, part A provides coverage for inpatient, hospital, or hospitalization related services, and part B covers medical services like doctors' visits, outpatient services, etc. Question number 11. Medicare Part D was created under the Medicare Modernization Act. We utilizes private insurers to cover prescription drugs for Medicare enrollees. It was passed this year. Part D was created in 2003, though it didn't start until 2006. It was created under the Bush administration. Question number 12. Medicare Part C was created under the same Medicare Modernization Act, though it had a predecessor called Medicare Plus Choice, created under the Balanced Budget Act of 1997. Medicare Part C was also called Medicare Advantage and provides an alternative to traditional Medicare. Besides the fact that Medicare Advantage is operated by private insurance companies, the main difference between Medicare Advantage and Medicare is this. Medicare Advantage is a fixed payment model, unlike traditional Medicare's fee for service model. Fee for service is simple enough to understand. It's basically a la carte. The insurance company, Medicare in this case, pays for whatever services that you use. A fixed payment model, on the other hand, the insurance, Medicare, will give a healthcare organization a set amount of money and say, take care of this person. Any money they don't use is theirs to keep as profit. Also, if they run out of money, they still have to provide coverage for you at their own expense. The idea is that this fixed payment model would encourage the healthcare organization to be more efficient. Um, however, there are some problems with this. I recommend everyone watch John Oliver's Last Week Tonight episode on Medicare Advantage. He goes over essentially how bad Medicare Advantage is and all the problems that it has. We can get into this in a future episode. But there you go, that's 12 questions. How did you do? That's it for today. Tune in next time for more public health trivia. If you think there is an error in the episode, please don't hesitate to let me know by emailing me at everything ispublichealth at gmail.com. If there's a topic that you would like me to write 12 trivia questions on, please let me know by emailing me as well. Check out our website for all updates and bonus material, and remember, public health is for everyone.