Health care Essay

1a. What model of healthcare does the US and your chosen country have (Japan)? Be very specific. The United States has a healthcare system that is different from almost every country in the world. I would call the United States health care system a hybrid type system. I would call our system a hybrid because we fall into almost every type of category possible when it comes to health care; for instance, people who are uninsured have to pay out-of-pocket when they want to see a doctor versus someone who is insured and only has to pay a deductable. Many companies in the United States offer free medical care for employers, or they make health care insurance fairly cheap to afford. Unlike many countries our healthcare system is a little rocky. Insurance companies can drop you for being to high risk leaving you stranded to find another insurance company or leaving you to pay out-of-pocket. Our system has forced many of our fellow citizens homeless, or with masses amount of debt. Japan on the other hand has a Universal healthcare, in which everyone is covered up to 70% of the cost. Japan’s healthcare is much cheaper than hear in America because in Japan, it is accustom to their culture that a family member acts as a nurse, in which they help assist with the patient. In Japan, they have separate hospital beds in the room for a person from the family to sleep in. The family member acts like a nurse by providing food, cleaning, and changing sheet just to name a few. People from Japan who are employed but do not receive health coverage from their company, can participate in a national health insurance program offered and controlled by their government. People in Japan cannot be denied coverage unlike our healthcare in America, and by law Japans hospitals have to be a non-profit hospital which is run by physicians. 1b. In 10 sentences or less [emphasis on less], describe the Beveridge, Bismarck, National Health Insurance and Out-of-Pocket models. The Beveridge model is named after William Beveridge and was designed/implemented in Britain’s National Health Service. This system is funded by the government through tax payments, similar to how a public library works. According to PBS, â€Å"Bismarck-type health insurance plans have to cover everybody, and they don’t make a profit. Doctors and hospitals tend to be private in Bismarck countries†(Health care system–the four basic models, 2008. ). â€Å"Universal health care is a term that refers to a governmental system meant to ensure that every citizen or resident of a region has access to the required medical services†(What is universal health care, 2003-2013). According to TLC, â€Å"An out-of-pocket expense is a no reimbursable expense paid by a patient. This could include any medical benefits that your health plan doesn’t consider â€Å"covered services. † But out-of-pocket expenses can also include covered expenses that you are responsible for before your health-plan benefits kick in at 100 percent coverage. When the insurance company pays all of your expenses and you have to pay only your monthly premium, you have reached the out-of-pocket maximum’’(Jeffries, M. , 2013). 2a. What types of healthcare plans are available in each country? You must discuss each in detail. The US has managed care plans [Health Maintenance Organizations, Preferred Provider Organizations, Exclusive Provider Organizations, Point of Service Plans], and indemnity coverage as well as Medicaid and Medicare and your country’s plan so you need to touch on them all in order to be detailed in your response. The United States has a managed care plan; managed care is used to help control cost. For instance, lets say you are rushed to the hospital, the first thing they EMT’s will ask you regardless how hurt you are â€Å"do you have insurance†. It is sad that the United States has such a terrible health care system. The United States utilizes HMO, which is health maintenance organization, this plans limits the amount of doctors you can see. This is where a person pays a monthly premium in exchange they are covered for hospital visits, pediatric care, x-rays, and many other services our health care has to offer. The person who utilizes this plan generally has to pay co-pay, which the cost varies depending on the type of plan you have. Many people like this type of plan because when you go to the doctor you don’t need to fill out claim forms. Members show a card when they go to the doctor or hospital. The downfall to this plan is that you might have to wait longer in the waiting room. Another plan the United States has is called point-of-service plan. This plan allows the members of the plan to refer themselves to an outside plan and still be able to obtain some coverage. A doctor can also make a referral out of the network and in-turn the health care plan will pay for most if not the entire bill. A preferred provider organization is another type of plan offered by the United States. Just like the health maintenance organization, the preferred provider organization limits you to the number of doctors you can see, but when you do find the right doctor most of your medical bills are covered. The preferred provider organization requires you to choose a primary care physician in order to monitor your health care. If you elect to go to a doctor who is not part of this plan, some of the medical expenses are covered. I deem some people like this plan because if their primary care doctor is not part of the plan, they don’t have to change doctors. According to Health Insurance. Info â€Å"An Exclusive Provider Organization (EPO) is a network of individual medical care providers, or groups of medical care providers, who have entered into written agreements with an insurer to provide health insurance to subscribers. In EPO, medical care providers enter a mutually beneficial relationship with an insurer. The insurer reimburses an insured subscriber only if the medical expenses are derived from the designated network of medical care providers. The established network of medical care providers in turn provide subscribed patients medical services at significantly lower rates than what would have been under normal circumstances. In exchange for reduced rates of medical services, medical care providers get a steady stream of business†(Exclusive provider organization, 2010. ). Japan has a national health insurance plan; this plan for people who are not covered by their employer. You can obtain this health care plan by living in Japan for a year. Japan does have universal health coverage as well, but this plan varies between each individual. Some factors that affect this plan are: visiting, studying, working, your age just to name a few. Your premium that you pay depends on your salary you make for the year, so the cost varies for every individual. In Japan their health care system provides free examinations for specific diseases, infectious diseases and parental care. The government pays up to 70% of the cost for every citizen and foreigners who have lived in the country for a year or longer. Japan has an awesome health care plan compared to the United States, and I deem this is why their economy is flourishing and they have one of the healthiest populations in the world. People in Japan have a longer life expectancy compared to any other county in the world; I deem this is due to the bombing health care, their life style choices, and knowledge. 3a. What alternatives are available if an individual loses their healthcare due to job loss? In the US there is more than one alternative. Please be specific for each country. People in Japan are covered no matter what happens to their job. They have a universal health care system in which their government pays up to 70% of their entire cost for any medical bill. People, who don’t have a job, hardly have to pay any coverage when they are ill no matter how severe their condition is. Unlike Japan, in the United States you generally will loose your health benefits, or you will have till the end of the month to utilize it. Some employers will allow you to have your benefits for 26 weeks, which is ample time to find another job with health benefits. You will have to file a claim through your place of work in order to do this action. 4a. The storage of healthcare records are evolving? Describe what EHR, EMR and the cloud are with respect to this evolving technology. We want to see a minimum of five points per explanation. â€Å"An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization†(What is emr and ehr, 2013. ). EHR’s has some great benefits, one great benefit it has over paper records is that it can notify a doctor or physician that a patient is due for a routine check up. Another benefit is that it makes it almost virtually impossible to loose or misplace someone’s records. I like the fact that you can call your doctor and ask them to just simply print and mail you your medical records with all of your medical history; it makes it much easier for a patient to access. I deem one day that doctors will be able to email, or have an app where a patient can access their medical records electronically just for viewing or printing purposes. According to Healthit. gov â€Å"An electronic medical record (EMR) is a digital version of a paper chart that contains all of a patient’s medical history from one practice. An EMR is mostly used by providers for diagnosis and treatment†(What is an electronic medical record, 2012. ). This is not as beneficial in my opinion as EHR’s are. The reason I feel this way is because EMR’s can only access medical files from one practice. Many people have more than one doctor such as an eye doctor, physician, and even a dentist. All these different practices utilize some sort of medical history that you have compiled over a certain time span. The cloud is a database where every doctor you encounter can access you files. Many people have mixed views about this so called â€Å"cloud†. From a doctors point of view it is great! They can see your medical history for every doctor you have been to. Some people may deem this to be a violation of HIPPA. Many people find it an invasion to their privacy and why would a physician need access to any of my other files. One benefit is doctors can see specific medicines you maybe allergic to that you may have for got to inform them about. 5a. What problems are associated with each country’s healthcare plan(s)? Details please. The United States health care system has many flaws; one is hospitals tend to over price patients. I learned from my Health Law and Ethics class, that some hospitals charge unnecessary charges such as $10. 00 for a cup they carry you medicine in. If you are in the hospital for some time that really adds up quickly! Another flaw our health care system has is over spending on testing. Our country spends more money on test with their patients than any other country. I read an article that a patient was experiencing heart burn constantly and rather than giving a $1,200 stress test (way over priced if you ask me) the doctor charged the patient with a $8,000 CT scan. Many insurance companies will not accept a patient who has had previous records of specific diseases or any chronic condition in fear that they will have to pay too much for their care. If a person who is young and can’t qualify for Medicare, Medicade, and does not have company medical benefits, they have to pay out of pocket. Japan is known for having one of the most superior health care systems in the world. One flaw that it has is a surprisingly high suicide rate. One study showed that these suicides were due to health problems. Japan has a high cancer rate because of the obsessive smoking and drinking in their country.