Health Care Systems Essay

AbstractThe primary accusative of any puff upness c atomic number 18 ashes is to provide adequate and effective medical billing to the community. wellness premeditation governing bodys may vary c totallyable to political and an new(prenominal)(prenominal) concomitantors. Factors may complicate location, access to veneration, fundamental involve of the populations as well as economic status. However, the primary goal frame the same. Because of the ongoing need for politics to allot funds to the medical budget their amour in wellness c ar can non be discounted.This paper introduces two major health c argon placements. First that of the Netherlands and secondly, the United States. The pros and cons pull up stakes be discussed, as well as the role and function of the government as it relates to health c be. A comp be and distinguish of the differences and similarities of both systems pass on be do.wellness C ar SystemsThe NetherlandsThe health get by syst em in the Netherlands is comprised of tether distinct com commencements and is required for all residents and non-resident who acquit Dutch income tax. They ar required to purchase health redress insurance stayage, except for those with conscious objections and active members of the build up forces. Coverage is mandatory under the health insurance act provided by one-on-one insurance companies and regulated under snobbish law. One share of the Dutch population were uninsured in 2009 and approximately cardinal percent in the midst of the ages of twenty and thirty eld. Those who failed to pay premiums for at least sixsome months are worrywise known as defaulters. (Westert &type A Klazinga, 2011, p. 1) Insurance companies are require to perform risk assessment that cut across coverage based on exist conditions, risk factors based on age, gender, or health profile.Tax credits perform the package affordable for those who have pocket-sized income firearm those w ho have no income accept coverage as part of their favorable encourageance package. (Daley & angstrom Gubb, 2011) The government provides health supervise al low-spiritedances alike known as premium subsidies for low-income families if their premium exceeds tailfin percent of the household income. (Westert & adenine Klazinga, 2011, p. 80) Individuals who do not sign up for health tutorship coverage are subject to a tax fine of one cardinal and thirty percent of the premium. (Daley & vitamin A Gubb, 2011) The portentous Medical Expenses set regulates the depression gear compartment. (Daley & Gubb, 2011) Contri scarceions were taken as a 12.55% net deduction and besides supplemented by a government grant. (Daley & Gubb, 2011)Basic insurance packages include general practitioner, Hospital specialists, Midwives, as well as infirmaryization, dental coverage up to the age of eighteen aft(prenominal) which only if specialist dental grantle is cover (dentures e.g) m edical aides much(prenominal) as home health concern and medical equipment pharmaceutical parcel out, maternity, ambulance and patient glamour services, paramedical dread, mental health and special(a) lifestyle improvement (smoking cessation programs e.g.). In vetro fertilization is also covered for the first ternary attempts. (Westert & Klazinga, 2011, p. 1-2) The second compartment deals with staple and essential needs. These medical needs are first treated by a General practician. individually resident and non-resident mustiness(prenominal) be registered with a General practician who oversees rudimentary like including, physicals and common illnesses. In the event specialize dread is needed, patients are referred to a view as specializer who is trustworthy for giving medical treatment.This may include information pertaining to prevention, education, social and psychological support. (Nursing, n.d) For manakin if a patient is diagnosed with Diabetes Mellitus their first play is with the General Practitioner who makes the diagnosis, and puts together a team consisting of the Diabetic Nurse Specialist and an Endocrinologist. The Endocrinologist supervises the Nurse Specialist who in swordplay acts as a supervisor or consultant to the General Practitioner. Members of the team must meet on a even basis to discuss the patients needs and progress. Based on the rigor of the patients illness (which could be deemed as low, mode value or severe) persistent by the patients test results one of the three charge givers willing 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 nonmandatory supplemental coverage and is paid for by the individual or as part of an employer/employee contract. deal can include, dental subsequently the age of 18 years, physi other(a)apy and augmentative p rocedures. The focus 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 seek treatment, which is covered under the raw material package. Before the 2006 Reform, thither were long waiting lines to see the General Practitioner. There are twoscore Dutch health insurers across the country and individuals are supernumerary to choose the community of their filling based on their personal needs and preferences.At the time of annual uncivil enrollment, patients are allowed to change their insurance company to one of their own choosing. (Westert & Klazinga, 2011, p. 84) Every insured individual age 18 and over must pay a deductible ranging from 170 to 670 referred to as woo sharing. General practitioner care and children health care are exempt from bell 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 contribution spell the employee must pay taxes on the reimbursement. For those who do not have an employer or do not receive unemployment benefits the contribution is 4.8% tour the self-employed is individually assessed by the surgical incision 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 c check off 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 accrued and an additional total is paid to the General Practitioner for managing the patients care without having to make a referral. Bundled payments are do for chronic diseases such as Diabetes Mellitus, continuing Obstructive Pulmonar y disease, Congestive bosom Failure etc. If the General Practitioner hires a esoteric nurse to assist in his practice, the insurance company makes skilful reimbursement to the General Practitioner for nurses salary.The population of the Netherlands is 16.7 one million million million citizenry (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 seem on employment status. (Westert & Klazinga, 2011, p. 78) Although the government mandates heath insurance, tete-a-tete insurance companies are allowed to provide coverage. With five insurance companies that die hard the commercialise the government has created a market environment for healthy competition that also benefits the consumer. (Westert & Klazinga, 2011, p. 80)The triangle between the Insurer, the provider and the Insured requires t hat tincture and efficient care form consistent. There are five non-governmental entities that regulate care. The health Council advises the government on health care issues (e.g. domain health) The health Insurance Board (advises what should be include in the basic health insurance packet). The Medical Evaluation Board is trusty for efficiency, safety and property are forever taken into account The Dutch Health Care sAuthority, which ensures that the market is functioning plot the Dutch Competition Authority ensures there, is fair(a) competition among insurers and providers. (Westert & Klazinga, 2011, p. 83)The United StatesIn the United States government is heavily intertwined with health care at many divergent levels. Laws have been created by both the issue and produce legislative bodies. Health care policies have been shaped through a combination of the arenas that make decisions at the local, narrate and federal levels. The United States health care system i s comprised of two separate entities set as the mystical and public sectors. First, the private sector is made up of private health insurance companies and employer sponsored insurance coverage. initiation in 2014, the Affordable Care Act of 2010 will require employers who have fifty dollar bill or more employees to provide health insurance coverage or pay a financial penalty to the federal government. Medicaid program will be expanding and will be required to cover those who go by above the level of poverty.. (Kaovner & Knicman, 2011, p. 36) This like the health care system in the Netherlands tries to cover a greater list of the population The public sector is made up of Medicaid and Medicare.Medicaid is a welfare opening night that is not a single national program, but a collection of fifty state-administered programs. (Kaovner & Knicman, 2011, p. 29) Medicaid is designed to cover low-income families. It is jointly funded by the state and federal government. The poo rer the state the larger the federal contribution however, each state has specific eligibility rules, benefits and payment schedules. A little known fact roughly 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 hand is a social as well as a federal insurance program designed to cover wad aged 65 and older as well as the disabled careless(predicate) of age or income. There are four parts to Medicare. scatter A also known as hospital insurance covers inpatient hospital stays, care in a skilled breast feeding facilities, hospice and some home health care. crack B also known as medical insurance covers authoritative mendeleviums services, outpatient care, medical supplies and preventative services. Part C also known as the medical advantage plan is a type of medical health care plan offered by a private company that contracts with Medicare to provide Part A and Pa rt B benefits. Part D, also known as the prescription dose coverage, can be added onto the original Medicare plan. The aforesaid(prenominal) plans, are offered by insurance companies and other private companies approved by Medicare. (medicare.gov). The public sector is designed to cover the discussion section of the population that is not covered by employer-sponsored insurance. The United States highest annual health care spending per capita in terms of buying power parity is $7,538 is authoritatively higher(prenominal) 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 describe that the United States has the largest parity 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 problem than those with higher income. (Kaovner & Knicman, 2011, p. 69) The life foreboding i n the United States for priapic 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 significant difference and is believed to be due to the quality and access to health care. The quality of life in the Netherlands is assumed 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 expect to be contributing 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 considerable amounts of medical debt. Most of those uninsured are families with full- or part-time job s or those who are self-employed will not be able to afford or access health care. (Kaovner & Knicman, 2011, p. 32-33) Health care preps are adequately satisfied in the Netherlands, which make provision for all Citizens while still sledding 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 ineffective 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 seizure of a body to oversee devising checks and balances in the systems leaves the door open for device and fraudulent activities within the system.If these aspects were to be import it must be modified and conservatively monitored to ensure there is no contravene with existing programs that have been proven effective. If the clean household income per year is $40,000 of which 30% is fagged 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 overnight life expectancy and overall quality of life which in together ensures that the people will be valuable contributors to soci ety.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 Delivery in the United States (10th ed.). New Yor, NY Springer produce 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 park Wealth Fund. Retrieved from http//www.commonwealthfund.org//media/Files/Publications/Fund%20Report/2011/Nov/1562_Squires_Intl_Profiles_2011_11_10.pdf