INTRODUCTION
It is essential that nurses understand the issues related to healthcare financing, including local, state, and national healthcare policies and initiatives that affect healthcare delivery. As a patient advocate, the professional nurse is in a position to work with patients and families to access available resources to meet their healthcare needs.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
- Compare the U.S. healthcare system with the healthcare system of England, Japan, Germany, or Switzerland, by doing the following:
- Identify one country from the following list whose healthcare system you will compare to the U.S. healthcare system: England, Japan, Germany, or Switzerland.
- Compare access between the two healthcare systems for children, people who are unemployed, and people who are retired.
- Discuss coverage for medications in the two healthcare systems.
- Determine the requirements to get a referral to see a specialist in the two healthcare systems.
- Discuss coverage for preexisting conditions in the two healthcare systems.
- Explain two financial implications for patients with regard to the healthcare delivery differences between the two countries (i.e.; how are the patients financially impacted).
- Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
- Demonstrate professional communication in the content and presentation of your submission.
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SOLUTION
Comparison between the United States of America and Japan
A1. Access
The healthcare system in Japan focuses on providing equal access to essential medical services for all people regardless of social status, at a significantly low cost. According to Ikegami and Anderson (2012) the universal health insurance in Japan was set up in 1961, and it has remained relatively affordable and accessible to the entire population including foreigners who have stayed in the country for more than a year. Individuals who work in corporations can get the medical coverage via social insurance while the self employed can access the cover through national medical insurance. Children in Japan are covered by the universal healthcare insurance hence enabling them to access free and quality medical care. Watanabe and Hashimoto (2012) add that an individual’s income has little or no influence on the level of healthcare one can access in Japan since the medical fee is uniform across the country. This measure allows the disadvantaged and the low-income population in the society to access essential and adequate medical care that the country’s universal health provides. The unemployed and the elderly receive government subsidies which enables them to effectively pay for their medical insurance.
The health system in the United States on the other realm, faces numerous challenges as a huge number of citizens lack health insurance, with approximately 13.7% of adults being uninsured as of the year 2018. The country does not have a universal health system, and instead the population accesses medical care through private health insurance or public care, such as Medicare and Medicaid (Rosen et al., 2018). The high costs of medical care have been attributed as the main reason American citizens face challenges accessing proper health care. According to Schlichting et al (2017), the vulnerable population, for instance children from low-income families are encouraged to access healthcare at a low cost from Medicaid or freely from Children Health Insurance Program (CHIP). Unlike Japan, the household income level plays a major role in determining the level of medical care an individual has access to. A study conducted in 2013 revealed that approximately 25% of the senior citizens who declared bankruptcy was because of medical expenses. The retired can use Medicare insurance to access medical care, and incase they retired before the age of 65 years, they can purchase an insurance plan through health insurance marketplace system. Additionally, some of the insured individuals may be underinsured in such a way that they may not have access to some costly medical services. However, Leung et al., (2017) assert that the initiation of Affordable Care Act (ACA) in 2014 has greatly contributed to easier access to healthcare for the underprivileged through the health insurance marketplace system.
A2A. Coverage of Medications
Japan has a statutory health insurance program that is mainly funded by taxes and individual contributions to cover for all approved medications. The Japanese citizens are required to pay 30% co insurance for medication fees, but the senior citizens and children are exempted. Considering that everyone is universally covered, there are no cases of low-income households being unable to access medications. The health insurance is subdivided into three subsections, with the first covering the employed individuals whereby the employer deducts the healthcare insurance premiums from the employees’ salaries. The second health insurance covers the self-employed individuals, and various factors such as income level, number of dependents and assets determined the premiums paid. The third health insurance consists of pooling fund, whereby premiums derived from the previous two caters for individuals aged 70 and above. Please click the purchase button to access the entire copy at $10