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Organizational Systems and Quality Leadership C489 Task 3 7in lowering prices. Unlike the US, there is a lack of price control strategy, it is left to the freemarket economy where demand and supply will even out the price, coupled with competition. The Germans do more than the U.S. in limiting out of pocket expenditure on prescriptiondrug. There is a relative lack of price control in the U.S., while the German government plays apivotal role in setting drug prices. (Paying for Prescription Drugs Around the World: Why is theU.S. an Outlier. 2017) Some U.S adults reports skipping prescription or not fill one to avoidcopay. 2B. Requirement to get referralBoth the U.S. and Germany uses referral system to see specialists. However, Germanshave the option to see a specialist directly without any referral from their General practitioner(GP) which is like to say in the U.S. your Primary Care Provider (PCP). Unlike the U.S, you willnot be able to schedule an appointment nor been seen by a specialist without such a referral fromyour PCP. Another implication in the U.S. is that even if you are seen by specialists, insurancemay likely decline to pay for such service with referrals from your PCP. 2C. Coverage for Preexisting conditions. In Germany Insurance companies are mandated to provide standard care services to theinsured irrespective of risk, previous or current health condition and without charging them more(Informed Health Online, 2006) Identically, under the new ACA law, insurance companies arebarred from denying anyone coverage because of preexisting condition or charge you morebecause of a previous health condition you had before the coverage begins. It important tomention that the contrary was happening prior to ACA. Insurance companies were denyingcoverage or charge people more because of preexisting condition.
Organizational Systems and Quality Leadership C489 Task 3 83. Financial Implications for patients. The financial impact of U.S. healthcare system to that of Germany greatly differs in twospecific areas. To start with, Americans carry the burden of higher copayments for physicianoffice visits, hospital stay and other hospital services, as well as a higher copayment forprescription drugs. The cost of premiums is higher in U.S. than that of Germany. In Germanycopays ranges from EUR5.00 to EUR10.00 (USD6.36 to USD12.72) per outpatient prescription,EUR10.00 per inpatient day for hospital and rehabilitation stays (for the first 28 days per year),and EUR5.00 to EUR10.00 for prescribed medical devices. In additions, children below age 18years of age are excluded from cost sharing in Germany, while in U.S. children are alsosubjected to cost sharing. (International Healthcare System Profile: The Germany HealthcareSystem)Furthermore, U.S has High-deductible health plans. Cost-sharing for most private plan iscapped at USD7,150 for individuals and USD14,300 for families for 2017, while in Germany outof pocket is capped at 2% of household gross income. The commonwealth foundation estimates