Medicare is health care insurance for people aged 65 years and above, people below 65 years but with specific disabilities. It also covers people with any age End Stage Renal Disease (ESRD) or permanent kidney failure that require frequent kidney dialysis or transplant. Individual with Medicare can access home health benefits provided as long as they are under a doctor care or under the medical service plan care established and managed in a doctor (Kronenfeld, 2011). Therefore, in Mrs. Zwick case, she is entitled for a Medicare cover for all expenses incurred in the hospital and those incurred during the home rehabilitation program. In addition, during the 10 days period she was out of the rehabilitation nursing home, she is still entitled for a Medicare cover as longer the doctor certified that she was in need for intermittent skilled nursing care program and needed physical therapy (Kronenfeld, 2011).
The part A of Medicare normally covers services such as doctor visits, lab services and surgeries as well as supply of physical therapy aids such as walkers and wheelchairs. Therefore, Mrs. Zwick is entitled for the Medicare cover because she was admitted for 5 days in the hospital before being transferred to the rehabilitation home. In addition, part A also provided cover for the hospital care and services from a skilled nursing such as nursing home rehabilitation care. In the part B of the Medicare, only services that are essential in diagnosis of a medical condition that meet the set standard criteria are covered in the policy (Kronenfeld, 2011). Therefore, since Mrs. Zwicks condition was not a preventive illness, the Medicare could not cover for any of her service. Mrs. Zwick was also entitled to the part B of Medicare cover such as provision of durable medical equipment. Furthermore, part D of Medicare did not apply to Mrs. Zwicks condition s since she was not entitled to any other insurance cover (Kronenfeld, 2011).
Mrs. Zwick was required to undertake a 40 days skilled nursing home care. However, due to her hospital acquired urinary tract infection she was unable to participate for a period of 10 days. The Medicare cover is still applicable to her case because she was homebound. The doctor certified that she could not leave her home due her condition. In addition, the Medicare policy provides that an individual is covered in the policy as longer as she is homebound due to the condition. The condition must keep the patient from leaving home without the use of any physical aid such as walker, special transportation or getting assistance from an individual. Mrs. Zwick qualified under the above condition.
The Medicare and Medicaid services have a regulation that restrict the payment for various selected conditions that develop during the patient stay in the medical institution. These regulations were enacted on 2008 (Myers & McCahan Foundation, 2008). The hospital acquired infections that are covered in the Medicare and Medicaid new regulation only involves a section of healthcare related infections that are expensive, as well as those with preventable cause of patient mortality and morbidity. According to the new Medicare policy, Urinary tract infection in which Mrs. Zwick suffers is a part of hospital acquired infection that is covered in the Medicare health care plan (Myers & McCahan Foundation, 2008). Therefore, she is entitled for Medicaid cover for the condition. In addition, the same policy has limited the payment to hospitals for medical services provided for avoidable Hospital Acquired Complications that include trauma, falls, pressure ulcers and objects retained during surgery. In her case, urinary tract infection may have resulted from the reaction to an agent and toxins during her period of hospitalization in the hospital. Furthermore, there is significant indication that the infection was not incubating before admission (Myers & McCahan Foundation, 2008).
Hospital acquired contaminations are a substantial cause of injury and deaths. Such contaminations have been connected to unhygienic settings in the medical environment as well as poor medical practices (Silver Lake Publishing, 2011). Medical doctor has a moral responsibility of undertaking measure to prevent the development of hospital acquired condition while the patient is in the hospital. In this case, it would be ethical for the nurse to take responsibility for hospital acquired infection. Mrs. Zwick infection could have resulted from the medications she was taking while being hospitalized. It was ethically essential for nurses and the doctor to notify Mrs. Zwick of the possibility of developing such infections. Furthermore, the medical personnel in the hospital had an ethical responsibility of preventing the occurrence of infections (Silver Lake Publishing, 2011)
COBRA stands for consolidated omnibus budget reconciliation act. This act ensures that an individual remain covered in an insurance policy long after termination of the job. The health insurance cover remains effective for a period of 18 months after the job is terminated. Therefore, Mr Davis, will continue to be covered for a period of 18 months in the group health insurance. However, the policy does not provide protection for employee sacked as a result of incompetency or unethical issues. In the case of Mr. Davis, the protection can be extended up to a period of 29 months since his job was terminated due to prolonged hospitalization.
The health care providers in USA are usually faced in challenges when dealing with uninsured patient like Mr. Davis. The health care provider is usually faced with liability crisis that threatens the ability of a physician to continue providing quality service to all. Long hospitalization is another common challenge that results due to lack of insurance cover (Simmons, 2009). Patient becomes admitted to the hospital for an ailment that could be avoided when a patient was under insurance cover. Therefore, it is essential for development of insurance scheme for everyone, regardless of the ability the insurance status and ability to pay. In addition, the Medicare fund needs to increase in order to cover for the uninsured (Simmons, 2009).
It is advisable for Mr. Davis to relocate to Britain since they have a better insurance coverage for unemployed as compared to USA. In Britain, there is a government funded health service that provides free medical service to resident (Simmons, 2009). The services are provided to the resident without the need of purchasing an insurance cover. This cover is funded through the taxes that are charged from the resident income. This would be a better environment for Mr. Davis since the cost of treatment is usually covered in the employed (Simmons, 2009).