Running head: HEALTHCARE FINANCING Organizational Systems and Quality Leadership Task 3 Name 6/10/2020 Western Governors University
HEALTHCARE FINANCING A1. Countries to Compare Since the early 1900’s, countries have developed many approaches for offering their citizens health coverage. The health system in the United States is complex, using both public and private programs based on a citizen’s residential location, age, and employment status. Many developed countries have universal healthcare programs, granting healthcare to all citizens. The idea of universal healthcare makes the inclusion of employment in the healthcare discussion unique to the United States. However, Japan utilizes a country-wide healthcare system in which citizens are characterized using employment. However, there are not many other similarities between the employment-based health care systems of the United States and Japan. A2. Access Japan has a non-profit national health program called the Statutory Health Insurance System (SHIS) and requires employer participation through a payroll tax to fund employer-based insurance plans (covering 60% of citizens), residential plans (covering 27% of citizens), or social/mutual aid insurance plans (covering 13% of citizens). Companies with varying numbers of employees pay tax rates ranging from 5.8-9.5 % to fund these plans (Ruggles, 2019). As universal coverage, the government plays important roles in the SHIS. The national government is responsible for determining provider fee schedules, reviewing provider and insurer regulations, and providing subsidies to local governments, insurers, and providers. In addition to SHIS requiring all citizens to be enrolled in an employment-based or residence-based insurance plan, private insurance is also available for supplemental coverage and approximately 70% of the population hold this coverage (Tikkanen, 2020). Age, employment status, and residence location determines which of the national insurance plans a citizen is enrolled in (HIS, nd).
HEALTHCARE FINANCING If a citizen is unemployed, they typically enroll in the residence-based plans administered through local municipalities (Tikkanen, 2020). Retirees also enroll in residential plans; these residents are also eligible for a federal pension. Children are added to the insurance plan that the parent has, and their parent may apply for a Free medical care certificate to avoid co-payments (JIFC, 2017). Short term visitors to Japan and undocumented immigrants are not covered by the SHIS system and would need to purchase private coverage. The United States does not have a universal health care program, but includes federal- and state-funded plans, commercial/private insurers, as well as self-insurance plans; non- government insurance companies may be profit or non-profit. Federal and state plans, such as Medicaid and Medicare, are funded by payroll taxes from working individuals. Commercial and private insurers may be offered through an employer or, like self-insurance, may be purchased on the marketplace; these plans are funded by those who enroll with those carriers. The marketplace
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