ORGANIZATIONAL SYSTEMS TASK 3 3
Organizational Systems and Quality Leadership
Task 3, SAT1-0517/1217
Donna Danner
Western Governors University
Healthcare Financing
A1. Country to Compare
Comparing the United States healthcare financing system to Switzerland. Both of the healthcare systems of these two countries are very similar but do have some differences.
A1. Access
Health care costs have steadily risen in the United States over a period of decades, leaving the uninsured and underinsured at risk of access to quality health care. Prior to the passage of the Patient Protection and Affordable Care Act (PPACA) in 2010, lack of access to health care primarily reflected a lack of insurance coverage, so access was an issue of financial access (Williamson, 2017). This population usually includes part-time workers, unemployed individuals, children, retired elderly, and the homeless. This population as a whole statistically does not seek out preventative medicine for acute and chronic diseases and are hospitalized more often than individuals who have better access to health care. In turn, the hospital organizations are left with a significant cost burden to pay for this patient population. This causes cost shifting, which refers to unpaid costs being covered by those who do pay for healthcare (Williamson, 2017).
The Swiss people as a whole are wealthier than the country of the United States. They have the ability to choose their healthcare freely and spend more on the cost. However, the Swiss government subsidizes healthcare for their poor on a progressive basis, with their end goal being the prevention of their citizens spending more than 10 percent of their income on insurance (Roy, 2013). Switzerland’s health care system differs wildly from the United States health care system. The government is more highly involved in health care system management in Switzerland. Health coverage is a condition of being a Swiss resident. The Swiss government has three streams of publicly financed insurance, including direct financing for health care providers, mandatory health insurance premiums (MHI), and social insurance contributions.
A2A. Coverage of Medications
In Switzerland, MHI covers most medications. According to International Health Care Systems Profiles, MHI covers most general practitioner (GP) and specialist services, as well as an extensive list of pharmaceuticals and medical devices; home care services; physiotherapy (if prescribed); and some preventive measures, including the costs of selected vaccinations, selected general health examinations, and screenings for early detection of disease among certain risk groups ().
In the United States, most medication prescriptions do go through a patient’s private insurance to cover the cost of the medication. Sometimes the medications are not fully covered, so the patient would need to pay for the rest of the medication out of pocket....
