broken system that does not cover all children. ( Informed Health Online, 2006). Coverage for People who are unemployed In Germany, the SHI covers both the employed and the unemployed. The concept is based on the principle of solidarity. Let those who make more, pay more and those who are healthy also pay so that the sick may benefit. And everyone is entitled to the same level of care without respect for how much you pay or not. Unemployed people pay a minimal sum to SHI, using a fraction of their unemployment entitlements. For the long-term unemployed, government contributes on their behalf. (Health care in Germany, 2016). Unlike the U.S., greater portion of people who are uninsured are those who are poor and unemployed. The Kaiser Family Foundation estimates that 90% of those who don’t have health insurance coverage generate a family income within 400% of the federal poverty level. (The U.S. Health Care System: An International Perspective, 2016). Besides, those without employment are encouraged to seek insurance through the market place for cost savings and some may gain health insurance through Medicaid after meeting certain conditions. Premiums and cost savings are calculated using income and family size. Subsidized coverage could be obtained through tax credits. Through the ACA, some states have also expanded Medicaid to help provide insurance for people with little to no income like the unemployed. Yet disparity exist, and many may not be covered like in Germany.
Organizational Systems and Quality Leadership C489 Task 3 6 Coverage for people who are retired In the U.S., those who retire before they are 65 years and lose their job health insurance may apply for insurance through the marketplace and premium or tax credits will be based on income and household size. Those who retire after 65 years access healthcare through the federal government insurance program called Medicare. If you or your spouse worked for 10 years or more, then Medicare part A is said to be free and if you worked below that years then you pay a monthly premium that may be deducted from your social security. Both part B and D goes with premiums. (How Original Medicare Works). Similarly, Germans who retire are required to apply for both their pension and Pensioner’s Health Insurance. The amount of money they pay depends on how long they have worked and how much they paid to the scheme. A certain amount of money may have to go towards their Pensioner’s Health Insurance. Unlike the U.S., the financial burden may not be as difficult in Germany, considering the cost of healthcare and how much they pay for prescription drugs and other healthcare services. (Pensioners and German public health insurance) 2A. Coverage for medication The nonprofit insurance collective called “the sickness fund” negotiates and pays for prescription drug and medical visits. Drug prices are therefore cheaper in Germany than in the U.S. Just like how the insurances system in the U.S is disjointed so are the negotiations for drug prices. Medicare as a major payer to insurance companies and hospitals is not allowed to negotiate drug prices. The centralized drug price negotiations in Germany are far much effective
You've reached the end of your free preview.
Want to read all 10 pages?
- Winter '20
- Health care in the United States, Universal health care