Organizational Systems and Quality Leadership C489 Task 3 7 in lowering prices. Unlike the US, there is a lack of price control strategy, it is left to the free market 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 prescription drug. There is a relative lack of price control in the U.S., while the German government plays a pivotal role in setting drug prices. ( Paying for Prescription Drugs Around the World: Why is the U.S. an Outlier. 2017) Some U.S adults reports skipping prescription or not fill one to avoid copay. 2B. Requirement to get referral Both the U.S. and Germany uses referral system to see specialists. However, Germans have 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 will not be able to schedule an appointment nor been seen by a specialist without such a referral from your PCP. Another implication in the U.S. is that even if you are seen by specialists, insurance may 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 the insured 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 are barred from denying anyone coverage because of preexisting condition or charge you more because of a previous health condition you had before the coverage begins. It important to mention that the contrary was happening prior to ACA. Insurance companies were denying coverage or charge people more because of preexisting condition.

Organizational Systems and Quality Leadership C489 Task 3 8 3. Financial Implications for patients. The financial impact of U.S. healthcare system to that of Germany greatly differs in two specific areas. To start with, Americans carry the burden of higher copayments for physician office visits, hospital stay and other hospital services, as well as a higher copayment for prescription drugs. The cost of premiums is higher in U.S. than that of Germany. In Germany copays 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 18 years of age are excluded from cost sharing in Germany, while in U.S. children are also subjected to cost sharing. (International Healthcare System Profile: The Germany Healthcare System) Furthermore, U.S has High-deductible health plans. Cost-sharing for most private plan is capped at USD7,150 for individuals and USD14,300 for families for 2017, while in Germany out of pocket is capped at 2% of household gross income. The commonwealth foundation estimates