Medicare may not cover then Medicaid would cover, keeping the cost down for the retired citizen (Mossialos, Wenzl, Osborn, & Sarnak, 2016, p. 153). Citizens in Germany have free choice to choose the specialists (Mossialos, Wenzl, Osborn, & Sarnak, 2016, p. 65). The average wait time to see a specialist is about 3 weeks (Reid, 2008). Specialists in the United States can work both privately and in hospitals. Some insurance plan referrals are required by the primary care doctor (PCP) in order to be covered by the insurance company. Citizens on Medicaid or who are uninsured can have an extremely difficult time seeing a specialist. Some specialists will refuse to see Medicaid or uninsured patients.
United States of America vs Germany 4 Medicaid clients have low reimbursement rates (Mossialos, Wenzl, Osborn, & Sarnak, 2016, p. 155). Germany states all citizens are covered by the SHI. Having a pre-existing medical condition does not disqualify citizens from receiving SHI (Mossialos, Wenzl, Osborn, & Sarnak, 2016, p. 63). Pre-existing medical conditions can disqualify citizens from receiving private health insurance. Citizens with life pre-existing cause can apply for Medicaid, if qualified the citizen can receive Medicaid benefits (Mossialos, Wenzl, Osborn, & Sarnak, 2016, p. 155). In Germany, every procedure, test, and doctor visit have a set code for charging. The government works with the hospital to set up the charges. This keeps health care cost down. All medications, both brand name and generic, are placed into groups with a price serving as a maximum level for reimbursement (Mossialos, Wenzl, Osborn, & Sarnak, 2016, p. 70). A pregnant woman will pay a copay of $15 for the term of her pregnancy. Citizens pay very little
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- Spring '17