Susan Fay Western Governors University Organizational Systems and Leadership C489 Task 3 – Healthcare Financing A 1. Healthcare Financing In this task I will compare several aspects of the two health care systems between the United States health care system and Germany’s health care system. A 2. Compare access to healthcare systems in both the U.S. and Germany for children, people who are unemployed, and people who are retired. “ Germany has a reputation for having one of the best health care systems in the world.” (Health Insurance, 2019) Germany has more of a socialistic approach to healthcare. Health insurance is mandatory for all citizens. It has three systems in place. There is statutory health insurance which is a system of competing but not for profit, non-governmental insurance funds called “sickness funds” (SHI), substitutive private health insurance (PHI) and a combination of both. (The German Healthcare System, 2016) There is no cost sharing for children under 18 years old, meaning there are no out of pocket expenses. About 70 million German citizens belong to the Governmental Health Insurance System (GKV). “ If your gross salary is less than 60,750 Euros per year, or 5,063 Euros per month in 2019 then membership in the GKV is mandatory .” (Health Insurance, 2019) The GVK must provide coverage for children, those with disabilities, unemployed, maternity and the elderly. Services included are inpatient hospitalization, outpatient doctor visits and dental care. Citizens that earn more than 60,750
euros may choose private health insurance (PKV). Those that are disabled, unemployed, retired or ill are covered by Germany’s social security system. Healthcare access in the United States of America (USA) is quite different. There are different options that require certain eligibility criteria that may be based on income or the person’s contributions into the system. Medicare is a federal program that citizens pay into along with social security from the time they start working. Medicare provides health coverage for citizens once they reach 65 years old if they or their spouse has made contributions into the system. Retired persons generally are covered by Medicare which includes in-patient hospitalization, outpatient doctor visits, diagnostic tests, and other outpatient services as well as drug benefits. If an adult child is considered disabled before the age of 22, they may qualify for Medicare coverage under their parents Medicare benefits. Medicare does not cover dental like Germany’s insurance does. Disabled citizens may be eligible before the age of 65 if they have been declared disabled for 2 years or more. Medicaid is another federal program that is managed individually by each state. This healthcare system is designed to provide coverage for those with low income who meet specific criteria. They do not have had to pay into the system but certain assets may restrict eligibility. There are multiple private insurances that people can pay for out of pocket or are offered through an employer.
- Fall '18