Organizational Systems and Quality LeadershipOrganizational Systems Task 3 Nicole JacobsWestern Governors University
ORGANIZATIONAL SYSTEMS TASK 3 2Healthcare FinancingA1. Country to CompareThe identified country I am comparing to the U.S healthcare system is Japan.A1. AccessJapan’s government regulates access to healthcare by the universal Statutory Health Insurance System (SHIS). The local and national government is required to have efficient, and good quality medical care for all of Japan’s population including children, unemployed, and the retired. Japan’s citizens are mandated to enroll in one of the many SHIS plans based on employment status, place of residence, and age. Majority of enrollees pay a thirty percent coinsurance, but children up to the age of six only pay twenty percentand copayments for children’s access to health care are usually subsidized by the local governments. Adults within retirement ages of seventy to seventy-four with low income pay twenty percent coinsurance, and seventy-five and older with low income only pay ten percent. Unemployed and retirees in Japan are enrolled in the Citizens Health Insurance, and due to their income reduction are eligible for reduced premium payments (The Common Wealth Fund, n.d. a). In the United States healthcare access is done through The Affordable Care Act (ACA), which was enacted in 2010. The ACA established a shared responsibility between employers, government, and individuals for ensuring that Americans have access to quality health insurance. Even with the ACA, coverage for citizensin the united states is fragmented with private and public sources of health insurance, creating wide gaps in rates with those that are insured in the United States. The Centers for Medicare and Medicaid Services (CMS) has a federal Medicare program for retirement aged adults sixty-five and older. For children there is the Children’s Health Insurance Program (CHIP), a federal–state program for certain low-income populations. CHIP, which can be an extension of Medicaid in
ORGANIZATIONAL SYSTEMS TASK 3 3some states but separate in other states has covered more than 8.1 million children that are in low-income situations in 2015 (The Common Wealth Fund, n.d. b). Undocumented immigrants are not eligible for coverage, but some local governments will provide additional coverage for undocumented children and pregnant women. A mix of programs and organizations such as public hospitals, local health departments, free clinics, Medicaid, and CHIP deliver care for unemployed/uninsured and the vulnerable patients of the United States.