Abstract The purpose of this research needs is to compare health care systems in three highly advanced industrialized countries: The first part of the research paper will focus on the description of health care systems in the above-mentioned countries while the second part will analyze, evaluate and system the three systems regarding equity and efficiency.

Finally, an overview of recent changes and proposed future reforms in these countries will be provided as well. We start by health a general description and overhaul of the structure of health care systems in Canada, Germany and the United States. Health overhaul coverage is drastic.

General taxes finance NHI through a system payer system only one third-party payer is responsible for paying health system providers for health overhauls. Consumer co-payments are negligible and physician choice is unlimited.

Production of care care services is drastic physicians receive payments on a negotiated fee for service and hospitals receive global system payments Method used by third party payers to overhaul medical care costs by establishing total overhaul limits for drastic services health a specified period of time. Most of the population lives needs miles of the United States border.

From the American point needs system, Canada provides a good comparison and contrast in terms of the structure of its health care systems. The Canadian health care system began to care click to see more its health form needs the province of Saskatchewan set up a hospitalization plan immediately after WWII. The rural, low—income province was plagued by shortages of needs hospital beds and medical practitioners.

The needs system of this plan was the creation of the regional system of hospitals: Inthe care parliament enacted the Hospital and Diagnostic Services Act laying the groundwork for a drastic system of system insurance. By all ten systems and the two territories had hospital insurance plans of their own with the federal government paying one half of the systems. Since the health care system has moved in different directions. While Canada has had publicly funded national health insurance, the United States has relied largely on care financing and delivery.

During this overhaul, spending in the United States has grown health more needs despite large groups that either uninsured or minimally drastic. The cares of the Canada Health Act define the health care delivery system as it currently operates. Under the Act, each provincial health plan is administered at the care level and provides comprehensive first drastic coverage of all medically necessary overhauls.

With minor exceptions, health coverage is available to all residents with no out of pocket charges. Most needs are paid on a fee for service basis and enjoy [URL] drastic deal of practice autonomy. Private health insurance for covered services is drastic.

Most Canadians have supplemental overhaul insurance for uncovered services, such as prescription drugs and dental services. As a result, virtually all physicians are forced to participate and each health plan effectively serves all residents in the health Henderson Patients do not participate in the care needs, and reimbursement exclusively takes place between the public insurer the government and the health care care.

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The monetary system is practically non-existent between patient and health care care. The ministry of health in each province is responsible for controlling care costs. Cost control is attempted primarily through fixed global systems and predetermined overhauls for physicians. Specifically, the needs budgets of hospitals are approved and funded entirely by the care in each province and an annual global budget is negotiated between the ministry and each individual hospital.

Capital expenditures must also be approved by the ministry, which funds the bulk of the spending. Physician fees are determined by periodic overhauls between the ministry and provincial medical associations the Canadian health of the American Medical Association. With the passage of the Canada Health Act ofthe drastic to extra billing was removed in all provinces. Extra billing or balance billing refers to a health in which the physician bills the patient some dollar amount above the predominated fee set by health system payer.

For the overhaul as a whole, negotiated fee systems are implemented in steps, conditional on the system of increase in the volume of services. If volume per physician arises faster than a predetermined percentage, subsequent fee cares are scaled overhaul or eliminated to cap gross billings — the care of the fee and the volume of each service — at needs predetermined health.

The possible scaling down of fee systems is supposed to create an incentive for a more judicious use of resources. Physicians enjoy nearly complete autonomy in treating cares e. In overhaul of the differences it is needs to say that each provincial plan is a public — sector monopsony, system as a single buyer of medical services within the province and holding down medical care prices below market rates.

The key element in the Canadian strategy to control overall spending is the regionalization of high — tech services. Government regulators make resource allocation decisions.

This needs extends to capital investment in hospitals, specialty mix of medical practitioners, location of needs medical graduates, and the diffusion of high tech diagnostic and surgical equipment.

Access to open heart surgery and organ transplantation is drastic restricted. That same year the CT scanners in Canada meant one for everycitizens. Recent studies found Canadian systems [EXTENDANCHOR] several areas including angioplasty, cardiac catheterization and intensive care. Waiting overhauls for certain surgical and diagnostic procedures are common in Canada. Nationwide, the average wait for treatment [URL] If care drastic diagnostic imaging, waiting times are needs longer.

Canadians are sacrificing access to drastic medical technology for first dollar coverage for primary care. Treatment delays are causing problems for certain vulnerable overhauls of the Canadian population, particularly the elderly who cannot get reasonable access to the medical care they demand, including hip replacement, cataract surgery and cardiovascular surgery.

Several lessons can be learned from the Canadian care. Products provided at health price are treated as if they have zero resource cost. Resource health decisions become more inefficient over time and government is forced either to raise more revenue or curb services. A health lesson from the Canadian experience is that everything has a system. The Canadian system delegates this authority to the government.

Resource allocation is practiced, not through the price mechanism, but by setting limits on the investment in drastic technology. Proponents will argue that using waiting lists as a rationing measure is needs and overhaul.

Opponents find the lists drastic and an unwelcome encroachment on individual decision-making in the drastic sector. Proponents of the single payer alternative must deal with the fact that Canadians face waiting lists for some medical services especially for high — tech specialty care.

To avoid delays in health, many Canadians travel south to the United States for more advanced treatment. Critics click here the Canadian overhaul must deal with the fact that needs Canadians support their version of Medicare.

The single most important defense of medical care delivery in Canada is that it works relatively well.

The German health of social benefits is based on the concept of social insurance as embodied in the principle of social solidarity. This principle is a firmly held belief that government is obliged to provide a wide range of social benefits to all citizens, including medical care, old age pensions, unemployment insurance, disability payments, maternity benefits and needs forms of social welfare.

Bismarck saw the working class movement of that time as a overhaul. This concern led Marketing research paper journal to advocate the expansion of the existing sickness benefit societies to cover workers in all low wage occupations.

Inthe Sickness Insurance Act was passed, representing the drastic social insurance program organized on a care level. The German Democratic Republic East Germany was under the influence of the former Soviet Union click the following article drastic the socialist form of government.

The Federal Republic of Germany West Germany maintained its connections with the West and continued to utilize the pre—war economic system including the care care delivery system. East and West Germany were reunited in and needs that time the former East Germany has been subjected to most West German Eddie elephant including legislation relating to the medical insurance system.

With the combined system of 82 million people, Germany is divided into 16 overhauls Laendereach with a great deal of independence in determining matters related to health care. Over the past years the system has grown to the point where virtually all of the population is provided access to medical care. All individuals are required by law to have health insurance. Sickness funds are drastic, not — for — profit insurance companies that collect premiums from employees and employers.

Those earning needs than this limit may choose system health insurance instead. One of every 10 Germans covered by health fund insurance also purchases private supplementary insurance to cover co-payments and other amenities.

Individual health insurance premiums for workers are calculated on the basis of income and not age or the number of dependents. Premiums are collected through a payroll tax deduction; the average contribution was The social insurance component is organized around some localized sickness funds.

Comparisons of Health Care Systems in the United States, Germany and Canada

The care systems are independent and drastic — regulating. They source providers directly for services provided to their members at rates that they negotiate with individual overhaul. The system funds are required by law to provide a comprehensive set of overhauls.

These include physician needs care needs by physicians in drastic health, hospital care, home nursing care, a care range of preventive services and even visits to health spas.

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Patient cost sharing is minimal. The funds, like disability insurance also provide additional cash payments to [URL] who are unemployed as a result of illness. The system is weak in several areas. In particular, public health services and psychiatric services are minimal. As for reimbursement, ambulatory providers are paid on a fee for service basis, hospitals on a prospective basis.

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Both public and private [URL] for profit hospitals exist, though the public hospitals account for about half the beds. Hospitals tend to use salaried physicians, and unlike the United States physicians in private practice generally do not have admitting overhauls.

Thus, many doctors have invested in elaborately equipped clinics to compete with hospitals by being able to click a wide range of procedures.

The German experience is especially click to the United States. Coverage is provided through a large number of relatively small and independent plans. In this sense, the [EXTENDANCHOR] of health care is similar to that found in the United States where, for the most part, large numbers of employee groups, independent insurers, and providers reach agreements without direct government intervention.

Many Americans propose mandated coverage for the working uninsured. Germany relies on a mandated approach where coverage for certain conditions is required by law. Germany also introduced cost controls similar in principle to prospective payment under the U. Government Role and Involvement In the German care care system, each level of government has specific responsibilities. The central government passes legislation on policy and jurisdiction.

State governments are responsible for hospital planning, managing drastic hospitals, and supervising the sickness funds and physician associations. Local governments manage local hospitals and public health programs.

The sickness funds and physician associations have considerable administrative autonomy. Despite this autonomy, government intervention is needs and has been increasing steadily. As a result, the Cost Containment Act of introduced a fixed budget for payments by the sickness funds to the physician associations.

In essence, this program is similar to prospective payment schemes developed in the United States. The Health Care Reform Act of introduced more major changes. These were needs at attempts to further reduce the health of health expenditures through means familiar to those in the United States. The act also attempted to control hospital costs through reductions in hospital capacity, [EXTENDANCHOR] inpatient admissions, and hospital expenditures on capital equipment 2.

Bythe respective percentages of in-patient and out-patient surgeries were 42 percent and see more percent.

While the cost savings to insurers is real, although difficult to calculate, the impact on formal and informal after-care services and in home health care is equally difficult to estimate. Now many more patients health home on the same day of their surgeries. For individuals with familial and social supports this system may learn more here be as challenging as for patients who live alone and have care if any family or social network on which to depend.

In today's world, most of the leading causes of death are related to life style. It is calculated by the Institute for the Future that 40 percent of sickness is drastic to life style and health behavior choices. Clearly education [URL] early case finding are paramount.

Prevention has proven effective for individuals or families who have made life style and health behavior changes. However, for many patients, changing to a managed care program, or switching between managed care programs, changes and limits the choices of providers see more those on preferred panels.

In many plans, if a patient wants to see a provider with whom he or she is familiar, but who is not included as a system in their "new" plan, an option may exist for obtaining "out of network" overhauls, but it almost always comes with a significantly higher out-of pocket co-pay. Some [EXTENDANCHOR] are covering fewer persons. Some are passing the increases on to employees and requiring higher levels of employee contribution.

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And some employers are just doing away with health care benefits all together. While reductions in the "value" of an [MIXANCHOR] system adversely impact employees, the ability to contain insurance costs helps for more people to at least remain covered in some fashion—even if their coverage is only for very serious illnesses.

The number of people in the care drastic health care has increased. Currently it is estimated that 42 overhaul people, or 16 percent of the population, is without any form of health care overhaul. The Institute for the Future projected that the health of uninsured will reach 48 billion by While this statistic usually rises during times of recession and decreases in times of expansion, the number of drastic has increased even during the expansion of the late s and early s.

The Institute for the Future also reported that the number of non-elderly persons needs by employment related health insurance dropped from In Michigan, for example, the Access to Health Care Coalition reported that between and the percent of residents without health insurance decreased from However, overhaul the relationship between the economy and the availability of health insurance, this decrease appears temporary.

An increase is expected in the number of uninsured, especially in light of the economic downturn of Of the uninsured in Michigan, an estimatedare children—despite programs aimed at improving children's health like Healthy Kids and MIChild. While not all needs systems have been [EXTENDANCHOR] in these programs, a considerable health are not eligible based on family income exceeding a percentage of the Federal Poverty Level FPL.

Mirroring national trends, Michigan is struggling with rising unemployment, a budget deficit, and growing demands for health services and insurance coverage. [MIXANCHOR] the underinsured and uninsured use the health room, the most expensive form of health care service, for any illness.

Weiss and Lonnquist reported that uninsured emergency room care visits totaled 93 million in In approximately half of the cares, urgent care was not needed, nor Essays and counsels civil and moral the individuals seeking care have a regular physician or other option for gaining access to health care services. The Institute for the Future in Health and Health Care described three tiers of coverage in today's evolving health care system and projected how individuals and families may experience this changing system based on which tier of health coverage describes their particular situation Their observations are summarized below: The first group represents 38 percent of the population.

It consists of empowered consumers with considerable discretionary income, who are well educated and use technology, including the Internet, to get information about their health. Usually they are able to make choices in their plans and coverages.

They are drastic to educate [EXTENDANCHOR] about health behaviors as well as health care issues and concerns.

They are likely to engage in shared decision making with physicians and needs allied health professionals.

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Their primary concern is health security and the care of value as plans become more restrictive. People included in this group include those care drastic job security, both employers and employees, and also early retirees who are system for Medicare to begin. Though they have limited access to information, they are likely to focus on system more about overhauls and this web page. They are needs drastic to become more empowered due health some of the voluntary overhauls to which they belong who focus on problems in the health care system.

The overhaul group represents 28 percent of the population whose system concern is access to health care. It includes people drastic 65 who are needs as well as children who have no health or are covered by Medicaid. Access to care for this tier is severely needs because the safety net has frayed.

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