Women and Diabetes:
An Examination of Quality of Care for
In recent years, diabetes has become one of the top 10 causes of death among women. Research has revealed that women 65 years and older account for 40% of the population and numbers are expected to increase exponentially. Vigorous medication management and coordination of care is instrumental in treating diabetes effectively. The patchwork of health insurance that exist today, particularly Medicare Part D, is culpable in allowing unequivocal disparities among race, gender, and socioeconomic status. This paper will examine quality of care among Medicare beneficiaries, particularly ...view middle of the document...
Access to high-quality, groundbreaking health care is considered a critical foundation in combating chronic illness and is a direct correlation to increasing one’s quality and years of life. The elderly population is particularly vulnerable to experiencing gaps in services and poor coordination of care. The writer will explore existing policies and procedures that affect the senior population and its relationship with diabetes, highlight disparities specific to women, and analyze the quality of care among Medicare recipients.
Medicare is public health insurance that is available to persons sixty-five or older, persons with certain disabilities, and persons with end stage renal disease requiring dialysis (Department of Health, 2011). The writer will emphasize on persons sixty-five and older. The senior population is unique in the fact that the potential to capitalize on earning income has diminished while the need for medical care has increased (Fuchs, 2000). Seniors with chronic illnesses such as diabetes are often faced with making the decision between receiving medical care and meeting basic physiological needs. The Medicare Part D drug benefit was introduced in January 2006 and created under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The Medicare Part D drug benefit was designed to help address the needs of seniors with high out-of-pocket costs for medication and to provide continuous access to needed medications for chronic illness (Schmittdiel, Ettner, Fung, Jie, Turk, Quitner, & Mangione, 2009). Prescription drug coverage is voluntary and is offered through private companies contracted with Medicare. As of 2009, fifty-nine percent of Medicare beneficiaries are enrolled in Part D plans. Private companies that offer Part D coverage are allowed to design their own benefit plans. Different plans offer different lists of medicines with varying costs. In creating the 2003 Medicare Modernization Act, the pharmaceutical industry was given free rein to write a program designed more for its profit than for the needs of American seniors and disabled (Cruz & Hickey, 2006).
The standard Part D benefit in 2006 began with partial coverage for the first $2250 of total drug costs, followed by a period of no coverage until patients reached cumulative out-of-pocket costs of $3600. Eighty-nine percent of Part D beneficiaries not receiving a low-income subsidy, such as Medicare, experienced a full coverage gap commonly referred to as a “doughnut hole” (Schmittdiel, Ettner, Fung, Jie, Turk, Quitner, & Mangione, 2009). A senior with approximately $3000 in prescription expenditures would be uncovered for four months and would fall in the “doughnut hole” category. The “doughnut hole” in coverage consists of the first month to meet the initial deductible of $310 dollars, and the last three months after reaching the cap (Stuart, Simoni-Wastila, & Chauncey, 2005). The policy was flawed beyond measure. Understanding Medicaid Part...