Organizational Systems and Quality Leadership
Task 3
Sandy Yi Holmes
Western Governors University
ORGANIZATIONAL SYSTEMS TASK 3
2
Healthcare Financing
A1. Country to Compare
Japan
A2. Access- children, unemployed, retired
In Japan there is universal coverage through the Statutory Health Insurance System
(SHIS) and it is mandated that everyone enroll in one of the SHIS plans. These plans are based
on age, employment status, and/or place of residence (International Commonwealth Fund, 2017).
The national and local government regulates this system to ensure fair pricing and good-quality
medical treatment (International Commonwealth Fund, 2017). People in Japan either sign up
through their employer or a community-based insurer. If a person is unemployed and/or unable
to afford insurance, he or she is able to receive insurance through a community-based coverage.
This type of system is known as social insurance (Palfreman, 2008). All enrollees have a 30%
coinsurance for healthcare expenses with the exception of children and older adults. Children up
to age six have a coinsurance of 20% but are often subsidized by local governments. For older
adults ages 70 to 74 who are low income also have a coinsurance of 20% and those older than 75
with lower incomes have a coinsurance of 10% (International Commonwealth Fund, 2017).
Furthermore, retirees under the age of 75 are covered under the community-based insurance,
after the age of 75 there is a premium that these citizens have to pay.
In the United States, healthcare insurance is provided through employers, directly
purchased coverage, and public programs (Medicare, Medicaid, and military) (International
Commonwealth Fund, 2017). The majority of the population hold insurance through their
employer-provided insurance. Most companies will cover a portion of the monthly premium and
employees are able to provide coverage to dependents at an additional cost. In addition to
Updated on 2/21/19
ORGANIZATIONAL SYSTEMS TASK 3
3
Medicare and Medicaid, the Children’s Health Insurance Program (CHIP) is a program available
to provide health coverage for eligible children. Medicaid and CHIP provide public health
