In the United States the need for a referral to see a specialist is dependent

In the united states the need for a referral to see a

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In the United States, the need for a referral to see a specialist is dependent on your insurance provider and plan. For most Health Maintenance Organization (HMO) plans,a referralfrom your primary care physician is necessary beforeyou cansee a specialist, unless it isan emergency. If you see a specialist without getting a referral it is possible that your insurance provider will not cover the cost. If you have a Preferred Provider Organization (PPO), you can go to any health care professional within your network that you want without getting a referral first.A2C. Coverage for Preexisting ConditionsIn Germany, everyone who has SHI receives the same treatment if they get sick. This is regardless of their premium. How much tax/premium you pay depends on your income. The tax is a percentage of your income up to a ceiling amount. This means people with a greater income pay more than people making less. Healthy and sick people pay the same amount. Pre-existing
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ORGANIZATIONAL SYSTEMS TASK 3 5conditions do not affect your coverage. Also because SHI is based on solidarity, when people getsick, the costs and loss of income are shared by everyone with that insurance. In the United States, The new health care law gives specific protections to children and adults who are in danger of being denied. Since 2014, no one with a preexisting medical condition can be denied health insurance coverage [Gog19].A3. Finance Implications for Healthcare DeliveryGermany’s healthcare system results in much less spending than in the United States. Financial implications reside with the fact that you are forced to pay a mandatory tax since healthcare services are funded by progressive taxation. Of late, Germany had a policy passed that will increase tax again for long term care, and if you don’t have children, you pay more! Another financial implication within Germany’s healthcare system is the fact that healthcare workers make much less money. Hospitals are given budgets for spending which means most doctors aresalaried. Often times this means healthcare workers, especially doctors, work far more than whatthey are fairly paid. This makes it hard for Germany to keep their healthcare workers from moving outside of the country.
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