Foreign Health Care Policy

Foreign Health Care Policy

Over the last several years, issues affecting the U.S. health care system have been increasingly brought to the forefront. This is because rising costs are impacting demand for different services. What has been happening is these increases are forcing insurance companies, employers and providers to pass on more of these fees to the individual. This is problematic, as they are unable to afford these costs and premiums for coverage. When this happens, the total number of people who are uninsured will increase exponentially. Evidence of this can be seen with the fact that there are 48 million Americans who have no form of health care coverage. (Johnson, 2010) (Harrington, 2009)

While in Germany, the costs of care are lower and 90% of the population is insured. This is because they are using a different model. To fully understand which system is better requires comparing the two with each other. This will be accomplished by focusing on: the benefits / limitations of the U.S. system, issues faced by Germany in contrast with the U.S.A., which country has better levels of health and the percentage of GDP spent by each nation. Together, these different elements will provide specific insights as to which health care system is superior. (Johnson, 2010) (Harrington, 2009)

The U.S. Health Care System

Cost of Care

In America the majority of the costs for health care are paid by the individual. This occurs through using their insurance companies, government programs (i.e. Medicare / Medicaid) and personal savings. The below table is highlighting the total amounts of spending by Americans on health care services for 2009.

US Spending on Health Care Service for 2009

Category

Amount

Percentage of GDP Spent on Health Care

16%

Health Care Spending per Capita

$7,290

Out of Pocket Health Care Spending

$890

Per Capita Spending on Health Insurance

$516

Per Capita Spending on Drugs

$878

(Johnson, 2010)

These figures are showing how the U.S. is spending tremendous amounts of money on health care every single year.

Quality of care

If someone has the proper amounts of insurance coverage, they will have access to the highest quality of care. This is because the system is focused on using the most advanced technology to improve quality. This has resulted in a 28% utilization rate for diagnostic equipment and 29% for surgical procedures. Moreover, the average lifespan is 72 years for males and 74 for females. While the infant mortality rate, is 4.5 children out of every 1 thousand that are born. (Greenwald, 2010)

Access to Care

The waiting period to see the doctor is usually from a few days to several weeks. This is based upon their patient load and availability. The individuals who are covered are: the policyholder and their family. This helps to establish a continuum of care (for those who have insurance and can afford the fees). (Greenwald, 2010)

Who pays the Healthcare Provider?

In general, the insurance company or a government entity will pay the provider. While at the same time, the individual must pay a certain percentage of these fees out of their pocket. The system is following a retrospective payment philosophy. As a result, it is utilizing DRG solutions. (Greenwald, 2010)

Germany

Cost of Care

In Germany, the cost of care is covered directly through a pay roll tax. This is used to provide everyone with access to physicians, hospitals and pharmaceuticals. The below table is highlighting the total amounts that were spent for these services in 2009. (Johnson, 2010)

Germany's Spending on Health Care Services in 2009

Category

Amount

Percentage of GDP Spent on Health Care

10.4%

Health Care Spending per Capita

$3,588

Out of Pocket Health Care Spending

$470

Per Capita Spending on Health Insurance

$191

Per Capita Spending on Drugs

$542

(Johnson, 2010)

These figures are showing how Germany spends considerably less on health care in comparison with the U.S. (Johnson, 2010)

Quality of Care

The quality of care is concentrating on using the latest technology to provide different services. This means that they have a higher utilization rate for diagnostic equipment of 43% and surgical procedures are accounting for 37%. The life span is 72.5 years for men and 81.3 for women. The infant mortality rate is 4.10 for every 1 thousand births. These factors are illustrating how Germans have much better quality of care in contrast to America. (Armstrong, 2011)

Access to Care

There is a waiting period from several weeks to months for various procedures. Everyone is covered under this system to include: individuals and their families. This is regardless of determining if they can afford the cost of insurance or health services. (Armstrong, 2011)

Who Pays the Healthcare Provider?

The government pays the health care provider. They are following a prospective payment system. They do utilize select elements of DRG in the process. While at other times, they will use other protocols to increase transparency and accountability. These factors are showing how the German health care system is superior to the United States. (Armstrong, 2011)