Organizational Systems and Quality Leadership
Task 3, SAT 3
WGU C489 Task 3
Healthcare financing
A1. Country to Compare
Comparison of the United States healthcare system with the healthcare system of Japan.
A1. Access
In the United States, private and public health insurance programs are all different, offering a lot of options for coverage; however, most people with health insurance get it through an employer. If the job doesn't provide health insurance choosing the right health insurance plan can be a difficult task. Fortunately, the Affordable Care Act introduced more standardization to insurance benefits that required all plans to offer essential health benefits.
On the other hand, Japan has a universal health care insurance system that gives everyone who lives there (except undocumented immigrants and visitors) access to affordable and adequate medical care. It is required by law for their citizens to be covered by some form of insurance. The two most common insurance types are employment-based health insurance and National Health Insurance.
In the U.S., if an employer offers health insurance, they also must provide coverage to an employee's children. Children from low-income families are eligible for health coverage through Medicaid, which is a program that is funded by the state and federal government. Children's Health Insurance Program (CHIP) is a program that provides low-cost health coverage to children up to age 18 that do not qualify for Medicaid. Each state has different CHIP benefits, but they all provide comprehensive coverage, including immunizations, regular doctor check-ups, and prescriptions. (Scott, 2016).
Similarly, in Japan, children before the age of 6 pay reduced coinsurance for treatments or products received. There are no deductibles, and frequently copayments for children's health care are subsidized by local governments (Matsuda, 2017).
In the U.S., unemployed citizens have several options for health insurance coverage. If an employee is laid off, some companies might allow them to stay on the company's health plan through the federal law COBRA. Others can find health insurance through the government's Health Insurance Marketplace. Unemployed individuals can also be qualified for free or low-income coverage through Medicaid. Family size and income, not employment status, determine eligibility for the type of health coverage and the amount of financial assistance for coverage (Doyle, 2019).
In the event a Japanese citizen loses their job and becomes unemployed, he or she would not lose health coverage but will change to community-based insurance. Unemployed, self-employed, and retirees with low incomes pay reduced premium payments (Matsuda, 2017).
Americans, after the age of 65, become Medicare health insurance beneficiaries, a national health insurance program under Social Security Administration. Medicare offers different types of coverage, and retirees choose one based on their speci...
