healthpolicych14summary - Ch 14 Summary: 1) All four...

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Ch 14 Summary: 1) All four countries (germany, Japan, Canada, and the United Kingdom) all offer universal coverage guaranteeing medical coverage to everyone. 2) Canada and United Kingdom offer Government-financed system 3) 90% of Germans receive insurance through the mandatory sickness funds. 4) Sickness funds collect money from the members and their employers and pay for the care of their members. The funds cover a broad range of benefits—since the fees used to be proportion to wages and those are getting lower, it is starting to shift towards financing like the tax system. 5) Upon retiring or losing a job, you retain membership in their sickness funds. Health insurance is employer based, but will still remain covered even if they lose their job or retire. 6) People can have private insurance in germany and they pay more than sickness funds, allowing them to receive preferential treatment from physicians. 7) Germany's social insurance concept is slightly different from that of Medicare in the United States: The employer and employee payments in Germany go to quasipublic sickness funds rather than to the government. 8)   German medicine maintains a strict separation of ambulatory care physicians and hospital-based physicians. Most ambulatory care physicians are prohibited from treating patients in hospitals, and most hospital-based physicians do not have private offices for treating outpatients. People often have their own primary care physician (PCP), but are allowed to make appointments to see ambulatory care specialists without referral from the primary care physician. 9)  Rather than paying physicians directly, sickness funds pay a global sum each year to the  physicians' association in their region, which in turn pays physicians on the basis of a detailed fee  schedule. These sums have been based on the number of patients cared for by the physicians in each  regional association, but in 2007, a risk-adjustment factor is being introduced that increases payments 
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This note was uploaded on 09/14/2011 for the course PHARM 1 taught by Professor Staff during the Spring '11 term at UCSD.

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healthpolicych14summary - Ch 14 Summary: 1) All four...

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