or specialists. Other insurance companies allow the customer to choose a doctor within a hospital system without a referral and others allow the use of outside-the-system medical care and pay 80/20 once the deductible is met (“Health Care U.S. Department of Health & Human Services,” n.d.). The retired (over 65) have access to medical care through Medicare and Medicaid as well as the ability to buy supplemental insurance. Medicare is provided through payments an employee has made while working. Medicaid is a federal-state joint effort to cover those who live at or below the poverty level (“Health Care U.S. Department of Health & Human Services, “n.d.). Children who are of low-income households can access healthcare through Medicaid programs and Children’s Health Insurance Program (CHIPS). Families who do not qualify for Medicaid, unemployed, or unable to pay for the high cost of insurance may qualify for insurance under the Affordable Care Act. This system provides a lower cost insurance program based on income, which is subsidized by the government provided by tax payer money. Even with all these coverages, about 10% of the population remains without medical coverage (“Health Care U.S. Department of Health & Human Services,” n.d.). Most people have access to healthcare.
ORGANIZATIONAL SYSTEMS AND QUALITY LEADERSHIP 4 Compared to China, the United States is inundated with copays, out-of-pocket costs, and deductibles. A2A. Coverage of Medications In Japan, medications are covered by the government 100%. However, this is part of the amount that citizens are required to pay monthly to the government for all healthcare for all citizens (Matsuda, n.d.). In the United States medication coverage varies as well as the prices. Medication can be very high. Some insurance companies require a copay of varying prices depending if it is a generic or brand name medication. Brand names tend to be high in costs. Some insurances pay all, part, or none. Through Medicaid, medication costs are covered completely depending on income. Each state has its own set of regulations concerning the payment of medications. Medicare on the other hand has different tiers for drug costs for the elderly. Others who have no insurance pay out of pocket (“Health Care U.S. Department 0f Health & Human Services,” n.d.). Pharmacies have access to rebates and coupons that can lower the cost. Other independent programs have a medication card that applies discounts for medications. A2B. Referral to See a Specialist In Japan, specialists are chosen by the patient. Most specialist are housed in the outpatient departments located at a hospital. There are very few outpatient clinics who offer specialists. No referral is needed. However, Japan does not have the large number of available primary care physicians and specialists as the United States ( Ikegami, n.d.).
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