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Task 3: Healthcare Financing
It is essential that nurses understand the issues related to healthcare financing, including local, state, and national healthcare policies and initiatives that affect healthcare delivery. As a patient advocate, the professional nurse is in a position to work with patients and families to access available resources to meet their healthcare needs.
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course
- Compare the U.S. healthcare system with the healthcare system of Great Britain, Japan, Germany, or Switzerland, by doing the following:
- Identify one country from the following list whose healthcare system you will compare to the U.S. healthcare system: Great Britain, Japan, Germany, or Switzerland.
- Compare access between the two healthcare systems for children, people who are unemployed, and people who are retired.
- Discuss coverage for medications in the two healthcare systems.
- Determine the requirements to get a referral to see a specialist in the two healthcare systems.
- Discuss coverage for preexisting conditions in the two healthcare systems.
- Explain two financial implications for patients with regard to the healthcare delivery differences between the two countries (i.e.; how are the patients financially impacted).
- Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
- Demonstrate professional communication in the content and presentation
Comparative Analysis: Healthcare Systems (US and Great Britain)
United State follows a hybrid and non-uniform healthcare system that is majorly based on profitability of the stakeholders. Indeed, profitability takes precedence over the quality of patient care services in more than 50% of the urban hospitals in the United States (Birk, 2016). The non-physician-controlled healthcare organizations in the United States continue to engage multidisciplinary medical professionals for their practice enhancement. This step has considerably stabilized and improved the retirement benefits, regulations, and financial burdens for the young physicians. Contrarily, the Great Britain's healthcare system follows the command-and-control approach with the objective of elevating the pattern of professional and ethical accountability among the healthcare practitioners (Peckham, 2014). The UK healthcare system effectively reinforces centralized healthcare funding and advocates the requirement of establishing common standards of service with the objective of improving equitability and transparency in clinical procedures. This healthcare system facilitates comprehensiveness in h healthcare interventions, promotes free access of services to the health seekers and establishes the universality in the treatment approaches (Peckham, 2014). Contrarily, the US healthcare system is completely governed by the Affordable Care Act that barricades the administration of holistic, person-centred, and comprehensive healthcare interventions to the treated patients (Birk, 2016). The chronically ill patients of various age groups do not acquire universal health coverage in the United States. This leads to serious healthcare disparities that drastically impact the quality of healthcare services and associated patient outcomes (Dalton, et al., 2014). However, the UK (i.e. Great Britain) healthcare system experiences a limited level of healthcare funds in comparison to the US healthcare system (Harding & Pritchard, 2016). This leads to substantial challenges in meeting the medical costs for complex clinical interventions. Despite several efforts to improve the equitability pattern in the healthcare system, funding restraints impact the administration frequency of individualized medical interventions for the target population in the Great Britain. These facts substantiate the need for improvement in both healthcare systems for the effective management of healthcare revenue cycle as well as corresponding patient outcomes.
Healthcare Access Pattern in the Healthcare Systems (US and Great Britain)
Children gain limited healthcare access to the primary healthcare interventions in the United States. This happens because of limited Medicaid reimbursement rate for the child health services. The absence of employer-sponsored healthcare coverage for many individuals minimizes the public health coverage of their children. Private healthcare plans in the United States provide dependent coverage to the children until the age of 26 years. Various children healthcare plans in the United States prohibit the children in terms of acquiring lifetime or annual health coverage because of their pre-existing health conditions (Leininger, 2016). Contrarily, the ECH (Education, Health and Care) plan in Great Britain elevates the healthcare access to the disabled and educationally deprived children (Gov_UK, 2014). However, the increased level of child poverty in Great Britain barricades their overall healthcare access due to the implementation of family income-based healthcare plans (Wickham, Anwar, Barr, Law, & Taylor-Robinson, 2016). The unemployed adults in the United States experience reduced healthcare coverage due to reduced cost-sharing of their healthcare expenses. Eventually, such people experience high risk of acquiring psychosomatic disease conditions as compared to the employed individuals. Contrarily, Work and Health Programme in Great Britain provides healthcare coverage to those unemployed and out of work people who obtained unemployment advantages for a tenure of two years (Gov.UK, 2018). The retiree healthcare coverage norms are periodically altered due to the under-funding of the public-sector pension funds in the United States (Fitzpatrick, 2014). In many scenarios, people seek early retirement to obtain the cost-effective health coverage access and benefits. Health inequality and access disparity for the elderly people result in delayed healthcare interventions and unmet requirements of the elderly people in the United States (Yamada, et al., 2015). Contrarily, the public pension and occupational pension plans in the Great Britain substantially facilitate the equitable access of retired people in the healthcare facilities. The managed care plan advocated by the National Health System assists in enhancing the healthcare access of the retired and elderly people (i.e. Medi-Cal beneficiary) (NHS, n.d.). The part of the basic income of the individuals (during their employment tenure) is utilized to implement the post-retirement health access benefits.