In the article, “A “Customary and Necessary” Program-Medicaid and Health Care Reform,” the author, Sara Rosenbaum describes the basics of health care finance contained in the recently passed U.S health care reform act while focusing on its main ideas including the respective targets, which congress is bent on achieving in the program implementation. The decision to pass this new legislation comes at a time when the United States health care program has undergone challenges in ensuring health care provision to the entire population. Sara objects that a health care system is essentially composed of four main elements, which are health plans sponsored by the employer, coverage purchased through state-based exchanges, Medicare, and Medicaid, all of which face challenges in their implementation with Medicaid bearing the brunt of it (Sara). The article strives to portray emerging concerns in the recent health care reforms by expressing the fundamentals regarding the emerging difficulties that one of the programs in the reforms, Medicaid is bound to experience in a bid to achieve its objectives.
Rosenbaumsimulates a situation whereby state functions will have to adjust to numerous barriers in order for the new proposed health care reforms to be effective with regard to coverage.She progressively identifies the various barriers that exists and that may fundamentally hamper the successful implementation of the mentioned components of the reform and specifically focusing upon theMedicaid program. To support this, Sara states in her thesis statement, “Numerous issues confront the “new” Medicaid. Will states be able to achieve full coverage for eligible persons and align their operations smoothly with those of other coverage sources?” (Rosebaum)
The article gives admirable level of credence to the authority of the writer in the respective field. In this context, Sara goes ahead to give her contribution to the argumentative aspects regarding the implementation of the Medicaid arm in consideration of the overall Health Care Reform legislation. This she does providing a factual analytical perspective of the respective background of the emerging issues. She objects, “Medicare plays a starring role in the health care reform” (Sara). This article is therefore basically intended for analysts and critics of the recently proposed health care forum in various dimensions, especially with regard to its classification in the emerging health forum. This is because it gives a critical analysis on the applicability of Medicaid using valuable evidence.
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In the article, “A “Customary and Necessary” Program-Medicaid and Health Care Reform,” Sara elementally gives an economic based critique on the functionality of the health reform in the present economic circumstances. Her arguments probe the validity of the reform in various instances in a bid to convince her audience of the emerging issues relative to their respective implementation. For instance, “Will providers participate, and will the safety net be sustained? And perhaps above all, will states continue to operate Medicaid programs and share in their costs?” (Sara). Special reference is made based on scenario analysis of the present American population fundamentals. She infers, “Of the 32 million people gaining benefits, half–16 million people–ares expected to derive their coverage through Medicaid and the Children’s Health Insurance Program-CHIP” (Sara). She goes ahead to justify, the ground for her various arguments in the manner in which she strives to empower the reader with her ideas by building a scenario situation, which her readers can easily relate to without much difficulty while taking account of the contextual variable. She supports, “This change is not merely a matter of basic fairness; it also reflects the fact that using a program that is jointly financed by the federal and state governments to expand health care coverage considerably reduces the federal cost of expansion” (Sara).
Sara appeals to the logos of her readers by making reference to relevant statistical data to support her various arguments as seen in, “...and the CBO estimates that the actual threshold will be 138% of the poverty level, once new income calculation methods are applied” (Sara). Logos essentially implies making an appeal to the reader using basic logic and reasoning. She further supports this through making reference of previous statistical records: “In its final cost estimates, the Congressional Budget Office (CBO) projected that 94% of the U.S population will have health care coverage by 2019, up from 83% under current policy” (Sara). This essentially provides a critical supportive element for her argumentative mechanism as it provides adequate information to the reader on the recurring trends, which is important in building a logical image of the accompanying events.
Moreover, she captures the pathos of her readers by using strategic quotes like, “They also exclude millions of poor parents of minor children in states whose income eligibility ceiling for such individuals can dip as low as 17%...” (Sara). This elementally builds an image to the reader that she actually cares about the needs of society, which appeals emotionally to her readers as it touches on their basic needs.
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She also captures her reader’s ethos by portraying her comfort in the subject. She exclaims, “Regardless of the course of the states’ litigation, the case underscores the long-term need to reconceptualise Medicaid’s financing and administration for the sake of the country’s populations” (Sara). Here she strives at establishing a connection point with the writing through giving her assessment of some of the issues, which emphasizes her character in regard to the article. In addition, the writer strives to competently and coherently apply language elements and structures. She strives to bring out her ideas through the incorporation of speech elements, narrative and expression elements of language. These further expound on her character.
The article places its major focus upon the elements of ethos, logos, and pathos while identifying some of the emerging challenges of Medicaid. In addition, the article sites all of the relevant sources and quotes the respective authorities providing relevant statistics of the facts contained in the article. The fact that Medicaid forms a key element due to its connection with funding issues indicates that there is indeed need to inculcate better strategies. The article therefore strives to portray emerging concerns in the recent health care reforms by expressing the fundamentals regarding the emerging difficulties that one of the programs in the reforms, Medicaid is bound to experience in a bid to achieve its objectives.
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