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home care, and ensuring safe use of pharmaceuticals are all ways that Japan keeps healthcare costs down. On the other end of the cost spectrum, the out of pocket costs in the USA are double that of otherindustrialized nations (The Commonwealth Fund, 2008). This is mostly due to the costs of insurance premiums, rising healthcare costs, poor medication coverage programs, out of networkcare or high copayments for services. This has created a real challenge for low income citizens toaccess affordable care is they do not qualify for government assistance. These individuals may give half of their paycheck in insurance premiums to have good insurance. Rising healthcare costs have made it impossible for low income families that do not qualify for state benefits, to beinsured. According to The Commonwealth Fund, “A high average of Americans has trouble paying their medical bills, and one quarter of adults in the United States have medical debt.” (The Commonwealth Fund, 2008). Because the system can create such a burden, many in the United States have chosen to live without insurance and pay the annual penalty imposed by the Affordable Care Act. As a result these individuals over utilize the emergency departments and hospitals in lieu of a primary care provider. This impact increases the overall cost of healthcare because this often ends up as unpaid indigent care. This impact coupled with high malpractice insurance premiums and malpractice lawsuits has created a vicious cycle that is continuing to increase healthcare costs which also causes insurance costs to increase.ReferencesInternational Commonwealth Fund. (2017). International profiles of health care systems. Retrieved from ations_fund_report_2017_may_mossialos_intl_profiles_v5.pdfLibrary of Congress Law. (August 2007). Children’s rights: Japan. Retrieved from %20in%20Japan,an%20allowance%20from%20the%20government.&text=The%20government%20provides%20this%20mandatory%20education%20free%20of%20chargeNakagawa, Sari, Kume, Noriaki. (June 30, 2017). Pharmacy practice in Japan. Retrieved fromThe Commonwealth Fund. (June 5, 2020). International healthcare system profiles Japan. Retrieved from countries/japan
Organizational Systems and Quality Leadership – C489Task 3The Commonwealth Fund. (June 5, 2020). International healthcare system profiles United States.Retrieved from countries/united-statesThe Commonwealth Fund. (October 1, 2008). Testimony-rising health care costs: implications for health and financial security of U.S. families. Retrieved from -health-care-costs-implications-health-and