- In most of these countries, does universal coverage provide the gold standard of care?
Universal coverage is provided by the state to its residents. In most of the countries, universal health coverage is funded through public and private funds. Also, private insurance and care are available for those who opt to pay. However, universal health care coverage in many countries does not provide the gold standard of care (Basch, 2006). In Canada, universal coverage is financed by both value added and income tax. Nonetheless, many residents have private insurance to allow them access fast and scarce services and pay costs not catered under universal coverage. Further, health care system in Canada experiences a shortness of physicians’ visits and the state regulates the prices of drug prescription. In Australia, residents have problems accessing care especially at night and weekends and paying for paying for prescriptions. In addition, patients spend much longer time in hospitals despite low hospital staffing ratios.
Finally, Japan has few doctors attending the citizens than in other countries. On the other hand, waiting lines for health care services in Japan tend to be managed on first come basis. Although there are few admissions in Japan hospitals, the staying time is much longer. Further, health care facilities in Japan are worn out and have outdated equipment. Mostly, physicians in japan prefer working in large clinics than in public hospitals because the government sets fees schedules below United States rates (Hoffman, 2012). Nonetheless, patients are required to add about 4% gifts to their payments. In addition, physicians in Japan are not client oriented in meeting patient needs.
- Does rationing occur in these countries and how is that different from rationing in the United States?
Rationalization refers to the trend of decentralization of health care services. Rationalization is experienced in most countries such as Canada, United Kingdom, Australia, Germany and Japan. For example, in Canada rationing is not based on the ability to pay but through delays in the elective process. Also, admission time in the hospitals is decreased slowly than the hospitals in the United States (Hoffman, 2012). Further, gross domestic product (GDP) income allocated to the health care has increased slowly than in the United States. In addition, adoption of the new technology such as imaging and surgical capacity is sluggish than in the United States.
In the United Kingdom, rationing is made based on the waiting time for treatments especially for non-acute diseases (Basch, 2006). They include cataract removal, hip replacement and coronary bypass surgery. The number of physicians in the United Kingdom serving many patients or doctor to patient ratio is lower than in the United States. However, professional nurses in the United Kingdom perform many duties than what physicians do in the United States.
In Japan, patients have many and brief visits to the hospitals and more drug prescriptions than in the United States. Secondly, the government of Japan has set fee schedules for physicians below United States rates. Also, there are few doctors per capita in Japan than in the United States. Survey in 2004 revealed that Germany had the highest number of physicians and nurses per 1,000 population compared to the United States. Furthermore, doctor visits are brief and frequent than the United States of America hospitals. In addition, the state of Germany allocates the third highest percentage of their gross domestic product to health care compared to the United States.
- Do revenues used to pay for health care tend to come from a single source or many?
Most governments support universal health care coverage from different sources (Ryan, 2009). In Canada, provincial health plans are funded by both value added and income taxes. Also, hospitals in Canada fund acquisition of new technology and facilities through provincial budgeting system. In the United Kingdom, the government shifted the administration of health care system to the local authorities. In essence, the local authorities determine the tax revenues allocated to the health sector in areas that cover about 500 thousand people.
Also, primary physicians in the United Kingdom are the entrepreneurs of health care (Ryan, 2009). Furthermore, the physicians are grouped primary care fund-holder trusts that negotiate their contracts with local hospitals. The trust receives capital, incentives and allowances to pay physicians and hospitals. National Health Services in United Kingdom adopted a pay for performance system for family physicians (Epstein, 2006). In addition, British consultants are paid salaries by the National Health Services.
In Germany, federal unemployment insurance fund cater the health premiums of the unemployed. Also, hospitals in Germany pay hospital-based physicians’ salaries from their capitation income. Further, ambulatory-care doctors receive salaries from the capitated revenues of the physician associations (Epstein, 2006). In addition, Germany has devoted the highest gross domestic product, GDP to health care.
Moreover, the national health insurance program in Japan is financed by both national and local taxes. Further, clinics dispense their own drugs and patients add about three percent to their payments. In addition, health insurance for retirees in Japan is covered through their employers and community plans.
- Steps do these countries take to assure that payments required of individuals do not become a barrier to access
First, hospital authorities in Canada have a fixed budget. For example, physicians are paid according to a fee standard set by the state. Also, the government has passed regulations that affect drug prescription prices. In addition, rationing in Canada is done through delays in elective services and not based on the ability to pay.
Secondly, primary physicians in the United Kingdom are grouped together into primary care fund-holder trusts. Also, they negotiate contracts between specialist physicians and local hospitals. Further, primary care fund-holders trusts are responsible for community health and quality improvement. Specialists in the United Kingdom are paid their salaries by the Institute of National Health Service (Epstein, 2006). In addition, the National Health Services in UK adopted a pay for performance formula especially for family physicians based on the quality performance.
Thirdly, the national health care system in Australia is funded through Medicare levy based on taxable income (Basch, 2006). The Medicare fund support government to run hospitals and prescription of drugs. In addition, private insurance is used to pay cost sharing fees and provide access to private hospitals, specialist and physicians. Moreover, a system of reinsurance distributes the costs of the claim to insurers to avoid winners and losers of the funds.
In Germany, workers options for health care are linked to the industry and locale. Germany hospitals pay salaries to hospitals based physicians through capacitation income. Also, physicians who prefer ambulatory care are paid their salaries from capitated revenues of the physician associations.
Finally, health premiums in Japan are scaled to family income (Ryan, 2009). For example, retirees in Japan are covered in the health premiums by their employers and community health plans. In japan, the state regulates clinics to dispense their own drugs.
- Patterns of similarities and differences
There are several similarities in the health care system of developed countries such as Canada, the United Kingdom, Australia, Germany and Japan. First, universal health care coverage in developed countries is funded through income taxes. Secondly, every developed state sets health care fee in comparison to the United States rates. Thirdly, every developed nation determines its own rationing rules for health care services. Nonetheless, many themes in developed have borrowed the ideas from the United States regarding health care system. In the developed countries, global hospital budget ids done through hospital budgets and capitation budget for hospitals (Basch, 2006). Moreover, hospital budgets are established either through local authorities or trusts. In addition, many people in the developed countries were compelled to belong to either a public or private health care insurance plan.
On the other hand, different developed countries have various means of accessing their health care system. Developed countries such as Canada, Germany, Australia, Japan and United Kingdom have different rationing measures. For example, rationing of health care services in Canada is not based on the ability to pay. On the other hand, rationing to access health care services in the United Kingdom is based on the waiting period for treatment of non-acute diseases. Also, physicians are paid according to the set standard of every developed state (Epstein, 2006). For example, primary physicians in the United Kingdom, their contracts between local hospitals are negotiated by primary care fund- holder trusts. In addition, per capita spending in health care system differs in developed countries (Ryan, 2009). For example, per capita spending for health care in Canada is low than in the United States. However, Germany devotes third highest percentage of Gross Domestic Income to health care compared to other states such as Japan and United Kingdom. Finally, nurses in the United Kingdom do many things than physicians in comparison to other countries.
Basch, P. (2006). Pay for performance: Too much thing-or too worried about wrong things? Retrieved from http//content.healthaffairs.org/cgi/eletters/25/5/w412
Doran, T., & Roland, M. (2006). Pay-for-Performance Programs in Family Practices in the United Kingdom.
Epstein, A. M. (2006). Paying for Performance in the United States and Abroad. New England Journal of Medicine. doi:10.1056/NEJMe068131
Ryan, A. (2009). Hospital-based pay-for-performance in the United States. Health Economics. doi:10.1002/hec.1532
Hoffman, B. R. (2012). Health care for some: Rights and rationing in the United States since 1930.