Healthcare Financing

Task 3: Healthcare Financing

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. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

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.

A. Compare the U.S. healthcare system with the healthcare system of Great Britain, Japan, Germany, or Switzerland, by doing the following:

1. Identify one country from the following list whose healthcare system you will compare to the U.S. healthcare system: Great Britain, Japan, Germany, or Switzerland.

2. Compare access between the two healthcare systems for children, people who are unemployed, and people who are retired.

a. Discuss coverage for medications in the two healthcare systems.

b. Determine the requirements to get a referral to see a specialist in the two healthcare systems.

c. Discuss coverage for preexisting conditions in the two healthcare systems.

3. 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).

B. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

C. Demonstrate professional communication in the content and presentation of your submission.

Introduction

                The United States of America (U.S.) and Great Britain have fundamental differences in their respective healthcare systems. The U.S., for instance, allocates an annual budgetary provision of 15% of its Gross Domestic Product (GDP) to provide for its healthcare issues and systems while the United Kingdom budgetary expenditure stands at about 8%. According to research studies, the US has substantially achieved several healthcare objectives compared to the United Kingdom. There are several organizational differences between these two countries in relation to the healthcare system, which involves healthcare financing, healthcare policy, and initiatives that affect healthcare delivery (Marshall et al, 2016).

A Comparison of The U.S. and Great Britain’s Healthcare Systems

               Research studies indicate that about 45 million of Americans under the age of 65 years lack insurance citing the cost of healthcare as a barrier to access of healthcare services while the comparative percentage is significantly lower in Great Britain. In the US, healthcare is more of a privilege than a basic service provided by the government. All citizens are expected to meet the full or partial costs of healthcare services. The US has the highest rate of amenable mortality compared to the UK as well as the lowest improvement rate. Comparatively, the US offers more high-tech healthcare than the UK. Increased and enhanced access to primary healthcare substantially reduces the susceptibility to avoidable hospital conditions. The UK is significantly better in providing access to primary care than the US.

Great Britain’s health care share of the GDP stands at about 10% while the US has its budgetary share at 18%. It is noteworthy that Great Britain has the least financial barriers to primary care compared to the US as well as the tightest access barriers to specialty services underscored by the role played by primary care trusts. Great Britain has substantially recorded significant successes in eliminating financial barriers to health care access compared to the US.

Whereas, mortality rates for acute myocardial infarction (AMI) are about 20% higher in England than in the US, the hospital discharge rates for AMI cases are 40% lower compared to the US rates. Additionally, the avoidable hospital conditions discharge rates are lowest in England compared to the US meaning that access to primary healthcare is more timely and effective in England than in the US. The rates for revascularization are about 70% higher in the US than in England. The rates of revascularization for patients of ages 65+ in England is more limited than in the US. Financial barriers to primary health care in the US is much higher than in the UK. England’s NHS evidently provides greater and lower-cost access to primary health care than her equivalent in the US. (Gusmano et al, 2014).

Healthcare Systems for All: Comparison

Health care system in the UK is considered free but in essence it is paid for through income taxation of approximately 9% of an individual’s gross income. The UK’s NHS target is to have all patients attended to in 4 hours. However, the shortage of general practitioners has occasioned significant delays. The UK’s paradigm of its healthcare system is that health care is a right, while in the US, it appears to be a privilege and largely private. In the US, healthcare practitioners are privately employed while in the UK, all practitioners are public workers (Roe et al, 2007).

The National Institute for Health Care and Excellence (NICE), a U.K. Center, sets out standards and guidelines for various ailments. The center has, additionally, set goals, which enable 95% of the patience to be seen within four hours by a healthcare specialist. In the U.S., the average waiting time for a patient in the emergency and accident care unit is approximately 58 minutes. However, patients have to wait for significantly longer periods to see a primary healthcare specialist (Marshall et al, 2016).

Coverage for Preexisting Conditions in the US and UK Healthcare Systems

Comparatively, US citizens are inclined to use prescription drugs compared to UK citizens who have the benefit of walking into any hospital regardless of age, income levels, and medical condition (Roe et al, 2007). US citizens who suffer from pre-existing conditions lack protection from the health insurance companies who charge unaffordable premiums or deductibles for people with these conditions. The health insurance company policies in the US sometimes do not cater for these pre-existing conditions. This makes the healthcare acquisition more expensive for those with these conditions in the US. On the other hand, in the UK the National Healthcare Service caters to its citizens for pre-existing conditions hence they are fully covered for any medical conditions they may suffer from. This makes healthcare acquisition easier and cheaper for them (Gusmano et al, 2014).

Financial Implications for Patients in the U.S. and Great Britain

With regard to equity of access to medication, income variation levels in the US apparently make no difference in the use of prescription medicine compared to the UK where an individual’s level of income matters. However, US citizens are more likely (by about 23%) to skip dosages due to financial barriers than in the UK (by about 5.5%) regardless of the income groups. About 14% of US citizens are reportedly out-of-pocket spenders compared to UK’s 3% owing to its comprehensive drug benefit programs (Roe et al, 2007).

The US citizens pay for their own medical bills which means a huge amount of their income is directed to their healthcare providers while in the UK their financial bills are catered for indirectly through taxation. This significantly reduces the living standards of people in the US compared to those in the UK as they invest hugely in their healthcare providers. Also in the US the time taken to see a specialist is much longer compared to that of the UK, hence hits into the time, which would have used to generate some income (Marshall et al, 2016).

Conclusion

UK healthcare system is comparatively more robust and superior to that of the U.S. since their medical bills are catered for through government taxes and are fully covered by the U.K. National Health Service (NHS). In the U.K., it takes patients a comparatively shorter time to see a primary specialist as compared to the U.S. Effectively, the U.S. should seek to develop and facilitate her healthcare systems in order to make healthcare provision affordable and reasonably easier access by citizens.

References

Gusmano, M., Rodwin, V., Weisz, D., (2014). Using Comparative Analysis to Address Health

System Caricatures.

Marshall, M., Bindman, A., (2016, January). The Role of Government in Health Care Reform in

The United States and England. Retrieved from JAMA Intern Med. 2016

Roe, A., Liberman, A., (2007). A Comparative Analysis of the United Kingdom and the United

States Health Care Systems

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