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Summary C489 SAT1 task 3.docx C-489 Organizational Systems and Quality Leadership-C489 SAT1-SAT TASK 3: Healthcare Financing Western Governors University A. Compare the U.S. healthcare system with the healthcare system of Great Britain, Japan, Germany, o€6,90
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Summary C489 SAT1 task 3.docx C-489 Organizational Systems and Quality Leadership-C489 SAT1-SAT TASK 3: Healthcare Financing Western Governors University A. Compare the U.S. healthcare system with the healthcare system of Great Britain, Japan, Germany, o
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C489 SAT1 task C-489 Organizational Systems and Quality Leadership-C489 SAT1-SAT TASK 3: Healthcare Financing Western Governors University A. Compare the U.S. healthcare system with the healthcare system of Great Britain, Japan, Germany, or Switzerland. A.1. I will be comparing the U.S. ...
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C-489
Organizational Systems and Quality Leadership-C489
SAT1-SAT TASK 3:
Healthcare Financing
Western Governors University
A. Compare the U.S. healthcare system with the healthcare system of Great Britain, Japan,
Germany, or Switzerland.
A.1. I will be comparing the U.S. healthcare system to Germany’s healthcare system.
A.2. Compare access between two healthcare systems for children, those who are
unemployed, and those who are retired.
Healthcare in Germany is much different than healthcare in the United States. In both the
U.S. and Germany, healthcare is mandatory. In Germany, most of the population is covered by
“sickness funds,” which are non-profit insurance companies (Ridic, Gleason,Ridic, 2012). The
premiums are paid mostly by government funding, and the cost to the insured is very low. All
citizens can be covered by this insurance option, including children, unemployed and those who
are retired. Age does not matter. The coverage is the same for all, as are the providers.
Everyone has access. If a citizen becomes unemployed, their coverage remains the same. A
small percentage of the population that makes more than 35,000 Euros per year may opt for
private insurance. This coverage is dependent on age and health. Only 11% of the population is
covered under private insurance and the other 1% is reserved for government officials and civil
In the United States, the vast majority of insurance coverage is private and offered
primarily by employers. US citizens can also opt for individual coverage through the Federal
Marketplace, which began after the Affordable Care Act (ObamaCare) became law in 2010. This
, individual insurance is more expensive than coverage offered through an employer. This would
be used by individuals who may not like their employer’s coverage, or their employer does not
offer insurance. For children and families who are low income or unemployed, Medicaid is
offered. Medicaid is state based and funded by federal and state taxes. It must be applied for
annually. Edibility varies state to state. Children’s Health Insurance Program (CHIP) is an
insurance program that is public and state funded, and bridges the gap for children whose
families make too much for Medicaid but cannot afford private insurance Lastly, Medicare is
offered for those over the age of 65. Medicare is funded by payroll tax, and shared by employers
and employees. Medicare covers most of retired citizens, and is a fee for service program (at a
discount). Most retired citizens on Medicare cannot afford services with just Medicare
discounts, and must have supplemental coverage (Tikkanen, Osborn, Mossialos, Djordevic,
Wharton, 2020).
A.2.a. Discuss coverage for medications in the two healthcare systems
Germany’s prescription coverage falls under the “sickness fund.” Those insured under
the sickness fund pay a nominal fee (10% of the cost of the drug). Those who have private
insurance must pay up front and then be reimbursed. Although this is somewhat similar to the
United States model, Germany is able to keep the cost of their prescription drugs low by using
collective negotiation between the buyer (sickness funds) and the seller (drug company).
Because the healthcare model really only has one buyer (sickness fund), that covers the vast
majority of the country, it is not in the best interest of the drug company to inflate their prices.
There is “strong political and public pressure to come to reasonable agreement…if none can be
negotiated, the drug’s price is established by and arbitration panel…” (Robinson, Ex, Panteli,
2019). There is no price gouging or charging individuals more than they can afford to pay.
In the United States, medication prescriptions are covered under the individuals’
insurance plan, whether private through the federal marketplace or through their employer, or
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