Health Care Systems Essay

AbstractThe native objective of any wellness upkeep arranging is to exit adequate and effective aesculapian trouble to the population. health portion out placements whitethorn vary due to political and other factors. Factors may include location, chafe to c atomic number 18, basal of necessity of the populations as well as economic status. However, the primary goal remains the same. Because of the ongoing need for goernance to al togetherocate funds to the medical budget their involvement in health solicitude tail end non be discounted.This paper introduces two major health fearfulness systems. First that of the Netherlands and secondly, the joined States. The pros and cons entrust be plowed, as well as the role and suffice of the government as it relates to health accusation. A comparing and contrast of the differences and similarities of two systems forget be determine. health C are SystemsThe NetherlandsThe health grapple system in the Netherlands is comprised of three distinct compartments and is mandatory for all occupiers and non-resident who digest Dutch income tax. They are required to purchase health damages reporting, except for those with conscious objections and active members of the arm forces. Coverage is mandatory under the health amends act provided by private redress companies and adjust under private law. One share of the Dutch population were uninsured in 2009 and approximately cardinal percent between the ages of twenty and cardinal years. Those who failed to give way premiums for at least six months are to a fault know as defaulters. (Westert & Klazinga, 2011, p. 1) Insurance companies are proscribe to perform risk assessment that deny reporting found on pre-existing conditions, risk factors based on age, gender, or health profile.Tax attribute make the package sustainable for those who receive misfortunate income opus those who have no income receive reportage as part of their social assi stance package. (Daley & Gubb, 2011) The government provides health care allowances in any case known as premium subsidies for low-income families if their premium exceeds five percent of the planetary house income. (Westert & Klazinga, 2011, p. 80) Individuals who do not sign up for health care coverage are subject to a tax fine of unrivalled hundred and thirty percent of the premium. (Daley & Gubb, 2011) The Exceptional medical exam Expenses correspond regulates the first-class honours degree compartment. (Daley & Gubb, 2011) Contributions were taken as a 12.55% salary tax write-off and tho supplemented by a government grant. (Daley & Gubb, 2011) basic indemnity packages include oecumenical practician, Hospital specialisers, Midwives, as well as infirmaryization, dental coverage up to the age of eighteen after(prenominal) which only specialist dental care is cover (dentures e.g) medical netherworld such as home health care and medical equipment pharmaceutical care, mate rnity, ambulance and patient transport services, paramedic care, mental health and limited lifestyle usefulness ( grass cessation programs e.g.). In vetro fertilization is also cover for the first three attempts. (Westert & Klazinga, 2011, p. 1-2) The second compartment deals with basic and inhering needs. These medical needs are first set by a General practician. all resident and non-resident must be registered with a General practician who oversees basic care including, physicals and common illnesses. In the slip specialized care is needed, patients are give earred to a obtain Specialist who is responsible for giving medical treatment.This may include information pertaining to prevention, education, social and psychological support. (Nursing, n.d) For workout if a patient is diagnosed with Diabetes Mellitus their first encounter is with the General practitioner who makes the diagnosis, and puts together a team consisting of the diabetic suckle Specialist and an Endocrino logist. The Endocrinologist supervises the Nurse Specialist who in turn acts as a supervisor or consultant to the General Practitioner. Members of the team must tinct on a regular basis to discuss the patients needs and progress. Based on the severity of the patients illness (which could be deemed as low, moderate or severe) determined by the patients test results one of the three care givers go out in fact manage follow-up care.However, all three practitioners will continue to be involved. The Nurse Specialist acts a liaison between both the Practitioner and the Specialist. (Nursing, n.d) The third is an optional supplemental coverage and is paid for by the individual or as part of an employer/employee contract. Care can include, dental after the age of 18 years, physiotherapy and cosmetic procedures. The counsel on overcoming disparities such as obesity and smoking cessation do not exist in the Netherlands, as it is believed that it is the responsibility of the individual to se ek treatment, which is covered under the basic package. Before the 2006 Reform, there were pine waiting lines to see the General Practitioner. There are 40 Dutch health insurers across the enjoin of matter and individuals are free to choose the company of their choice based on their personal needs and preferences.At the sequence of annual open enrollment, patients are allowed to smorgasbord their insurance policy company to one of their own choosing. (Westert & Klazinga, 2011, p. 84) Every insured individual age 18 and over must carry a deductible ranging from one hundred seventy to 670 referred to as damage sharing. General practitioner care and children health care are exempt from cost sharing. (Westert & Klazinga, 2011, p. 80) How is the health system financed? The first 32,369 are taxed at a rate of 6.9 %. The employer is required to reimburse this parting time the employee must pay taxes on the reimbursement. For those who do not have an employer or do not receive un use of goods and services benefits the contribution is 4.8% while the self-employed is apiece assessed by the Department of Revenue. (Westert & Klazinga, 2011, p. 80)Organization The General Practitioner is the considered to be the gate- keeper. The General Practitioner must refer hospitalization or specialized health care and the only exception is for emergency care. The General Practitioner gets a capitation fee for each registered patient and is further compensated for after hours care on an hourly basis. Consultation fees including phone consults are also accumulated and an additional nub is paid to the General Practitioner for managing the patients care without having to make a referral. Bundled defrayals are make for chronic diseases such as Diabetes Mellitus, Chronic prohibitive Pulmonary disease, Congestive Heart Failure etc. If the General Practitioner hires a private hold back to assist in his practice, the insurance company makes fully reimbursement to the G eneral Practitioner for nurses salary.The population of the Netherlands is 16.7 million pile (One World Nations Online) of which only one percent is uninsured. The reason for this is not due to an inability to pay but rather a default for great than six months. The health care system in the Netherlands is Universal and does not depend on employment status. (Westert & Klazinga, 2011, p. 78) Although the government mandates heathland insurance, private insurance companies are allowed to provide coverage. With five insurance companies that dominate the grocery store the government has created a market environment for sizable aspiration that also benefits the consumer. (Westert & Klazinga, 2011, p. 80)The triangle between the Insurer, the provider and the Insured requires that lineament and efficient care remains consistent. There are five non-governmental entities that regulate care. The health Council advises the government on health care issues (e.g. reality health) The healt h Insurance Board (advises what should be include in the basic health insurance packet). The Medical Evaluation Board is responsible for efficiency, safety and quality are always taken into account The Dutch Health Care sAuthority, which stop ups that the market is functioning while the Dutch Competition Authority ensures there, is fair competition among insurers and providers. (Westert & Klazinga, 2011, p. 83)The coupled StatesIn the United States government is hard intertwined with health care at many a(prenominal) disparate levels. Laws have been created by both the federal official and state legislative bodies. Health care policies have been shaped through a combination of the arenas that make decisions at the local, state and federal levels. The United States health care system is comprised of two separate entities identified as the private and public sectors. First, the private sector is made up of private health insurance companies and employer sponsored insurance cover age. Beginning in 2014, the Affordable Care make of 2010 will require employers who have fifty or more employees to provide health insurance coverage or pay a financial punishment to the federal government. Medicaid program will be expanding and will be required to cover those who fall supra the level of poverty.. (Kaovner & Knicman, 2011, p. 36) This like the health care system in the Netherlands tries to cover a greater amount of the population The public sector is made up of Medicaid and Medicare.Medicaid is a welfare initiative that is not a single national program, but a entreaty of fifty state-administered programs. (Kaovner & Knicman, 2011, p. 29) Medicaid is intentional to cover low-income families. It is jointly funded by the state and federal government. The poorer the state the larger the federal contribution however, each state has specific eligibility rules, benefits and payment schedules. A little known fact active Medicaid is that it can be given free to those who cannot afford it, or it can be given at a low cost depending on ones income. (Social Security) Medicare on the other cut into is a social as well as a federal insurance program designed to cover people aged 65 and quaternth-year as well as the disabled disregarding of age or income. There are four parts to Medicare. get out A also known as hospital insurance covers inpatient hospital stays, care in a skilled breast feeding facilities, hospice and some home health care.Part B also known as medical insurance covers certain doctors services, outpatient care, medical supplies and preventative services. Part C also known as the medical advantage plan is a oddball of medical health care plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits. Part D, also known as the prescription drug coverage, can be added onto the original Medicare plan. The aforementioned plans, are offered by insurance companies and other private companies approved by Medicare. (medicare.gov). The public sector is designed to cover the subdivision of the population that is not covered by employer-sponsored insurance. The United States highest annual health care spending per capita in terms of purchasing power parity is $7,538 is importantly higher than the Netherlands, which spends $4, 063 per capita. This trend has remained constant for the past forty years. (Kaovner & Knicman, 2011, p. 68)It is reported that the United States has the largest proportion of adults who have the hardest time seeing a specialist, however other countries have reported the same difficulties with low-income levels having a greater clog than those with higher income. (Kaovner & Knicman, 2011, p. 69) The life foresight in the United States for male was 75.64 years while women was 80.78 years. In the Netherlands on the other hand, life expectancy for a male is 81.4 years and for female 85.3 years a prodigious difference and is believed to be due to the quality and penetration to health care. The quality of life in the Netherlands is fancied to be much better because of preventative care and education. Patient Protection and Affordable Care Act of 2010, children in the United States will now be covered up to the age of 26. (Kaovner & Knicman, 2011, p. 25) In the Netherlands children are only covered until the age of 18 at which time they are expected to be change members of society.Approximately 16% of the United States population is uninsured, which is a significant disparity between that of the Netherlands. Americans are uninsured primarily because of high out-of-pocket medical expenses and bulky amounts of medical debt. Most of those uninsured are families with full- or part-time jobs or those who are self-employed will not be able to afford or admittance health care. (Kaovner & Knicman, 2011, p. 32-33) Health care supply are adequately satisfied in the Netherlands, which make provision for all Citizens while still release room for healthy competition among insurance carriers. Although guidelines are set up by the government to ensure universal health care it is the responsibility of insurance companies and non-governmental agencies to ensure that these guidelines are followed.On the other hand, while the United States supports those with low income and disabilities there remains the 17% of the population that contribute to the Medicaid and Medicare funds but are still unable to afford health insurance coverage. I believe it is to the detriment of the United States health care system to pull certain aspects from many different health care systems such as the Netherlands and Switzerland that do not always work to our benefit. (Kaovner & Knicman, 2011, p. 79) The absence of a body to oversee making checks and balances in the systems leaves the door open for fraud and fraudulent activities deep down the system.If these aspects were to be imported it must be limited and carefully monitored to ensure there is no mesh with existing programs that have been proven effective. If the average firm income per year is $40,000 of which 30% is spent on heath care it leaves a family with insufficient funds to provide for basic needs. In effect, health care becomes the basic need, creating further health care needs due to the inability to cover food, clothing and shelter. In conclusion, it is my opinion that the health care system in the Netherlands is by far more advanced in terms of organization and effectiveness. The ability for all residents to access health care contributes to the longer life expectancy and overall quality of life which in together ensures that the people will be valuable contributors to society.ReferencesDaley, C., & Gubb, J. (2011). Health Care Systems The Netherlands. Civitas. Retrieved from http//www.civitas.org.uk/nhs/download/netherlands.pdf Kaovner, A., & Knicman, J. (2011). Health Care talking to in the United States (10th ed.). New Yor, NY Springer create Company LLC. Nursing in the Netherlands. (n.d). Retrieved from http//ec.europa.eu/internal_market/qualifications/docs/nurses/2000-study/nurses_nederland_en.pdf Westert, G., & Klazinga, N. (2011). International Profiles of Health Care Systems, 2011 Entire issue. The Common Wealth Fund. Retrieved from http//www.commonwealthfund.org//media/Files/Publications/Fund%20Report/2011/Nov/1562_Squires_Intl_Profiles_2011_11_10.pdf