Paper Example on Healthcare System for Utopia

Introduction

Healthcare systems are very important as they help in making a country have a good disposition in the manner of how healthcare is provided to its citizens, and also growth even in other aspects. "health care companies can play critical roles not only in improving access to medicines and quality care for citizens of developing countries but also in expanding economic opportunities in those countries" (Mahmud & Parkhurst, 2007, p 6) Different countries have healthcare systems that are comparable to other systems, and this is important as it makes it possible to foresee what is needed to classify a healthcare system as being ideal. The differences that countries have in the healthcare systems are used show countries that have good planning on healthcare. It is from these differences that a country may be regarded as having the best health systems. However, 'best' cannot be used to offer a basis upon which considerations are done. Instead, analyses on the workability of the systems, as well as other factors that are important in a country are considered. It is after this that a country can claim to have a system that has some workability, with good strategies regarding how the system gets to reach many people, and how the system relates to the national spending of the countries in question. This paper is an investigation of the healthcare systems of USA, Japan, and Mexico, and using the analysis of the three systems to have an ideal system for Utopia. The workability of a system defines whether it is a good system, or whether it is using strategies that are not fit. Therefore, the paper seeks to discuss USA, Japan and Mexico, their healthcare systems and a comparison that helps in formulating a good healthcare system for Utopia.

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Utopia

Utopia is a country that is based in Asia and is in need of a good healthcare system. The system that is in operation has some flaws, which is an implication that a system that is better and workable is needed so that health-related issues are looked into with the right strategic dispositions. The country has a devolved government system. Since the devolution of health in the country started, there has never been a good healthcare system, and this has placed the whole sector at peril. The population of utopia is forty-three million. The birth rate is high. When it comes life expectancy, the country has a life expectancy of 60 years. Many deaths are caused by injuries, adolescent pregnancies, car accidents, long-term health conditions, mainly diabetes, and high infant mortality rate. The level of poverty in the country is high. Utopia is a developing country. There has been an increase in levels of education since the government has offered free education, both at the primary and secondary level. The improvement of the healthcare sector is important. For improvement in healthcare, Utopia has considered adopting international standards, ensuring control of healthcare-related costs, involving the private sector in healthcare as well as having insurance in healthcare.

Healthcare System in the USA

The healthcare system in use is not an autonomous entity. It has some sectors which are all aimed at seeing to it that there is good provision for issues to do with health. Firstly, there is the public sector and the private sector. According to Chua (2006), "there are both private and public insurers in the U.S. health care system. What is unique about the U.S. system in the world is the dominance of the private element over the public element." (p 6) The working and government of these sectors have one manner of operation, being guided by a single philosophy. This way sees to it that there are no varied methods when institutionalizing health institutions. Despite the fact that the system has some problems, the private and public sector has comparably the same level of providence effort medical services.

The USA uses many systems, regarding the classes of people. There is the use of NHI model, where insurance money is from a program, employing both Bismarck model and Beveridge model and out of pocket model where one pays for their medical needs. In the USA, there was an enactment of Affordable Care Act, in the year 2010, with the intent to liaisewith the government and other individuals to aid in having affordable health care services. The spending on healthcare comes from different places, with the inclusion of private funding, household, private businesses as well as public finance from the government. According to Chua (2006) "The financing of health care centers around two streams of money: the collection of money for health care (money going in), and the reimbursement of health service providers for health care (money going out). In the United States, the responsibility for these two functions is shared by private insurance companies as well as the government, both of which are known in policy terms as "payers." As such, the United States can be thought of as a "multi-payer" system." (p 3) Most of the people in the USA are insured in the manner of health, from both the government as well as the private are programs that are aimed at helping people have access to better healthcare, with the inclusion of Medicare and Medicaid. According to Irvine and Bid good (2013) " Medicare is the federal government's health program that primarily serves Americans over the age of 65, while Medicaid is a joint federal-state program principally designed to finance health care for the poor. Both provide care for the disabled. Together, Medicare and Medicaid cover approximately 87 million Americans" (p. 2) Within Medicare and Medicaid, there is the TRICARE which is a docket that serves those who are in the defense sector. It is still a part of the Veterans Health Administration (VHA), which is meant to serve those who have retired from the military. (Irvine and Bidgood (2013)

The system has community health programmers that are used to support medication to people, without thoughts of making a profit. According to Irvine and Bidgood (2013) "It is estimated that by reducing costly emergency hospital and specialty care and by reducing inter and intra-community health disparities, these centers and the treatment they offer to save the US economy approximately $24 billion a year" (p. 5). Insurance covers a high percentage of the population from the private sector. There is also the aspect of managed care, where institutions liaise with individuals to have the program fixed in their medical plans, in a bid to cut costs for medical access. Chua (2006) states that "in 2003, 62% of non-elderly Americans received private employer-sponsored insurance, and 5% purchased insurance on the private nongroup (individual) market. 15%were enrolled in public insurance programs like Medicaid, and 18% were uninsured. Elderly individuals aged 65 or over are almost uniformly enrolled in Medicare" (p 1) there is also the use of insurance that is employer provided, for those who work and are on a salary. The health sector also has a docket that advocates for people to have health saving s accounts. The USA also has health care purchasing cooperatives, which are also known as purchasing pools and alliances. According to Irvine and Bidgood (2013) "Envisioned by Alain Enthoven, healthcare purchasing co-operatives (also known as purchasing pools and alliances) are public or private organizations which secure health insurance coverage for the workers of all member employers. The goal of these organizations is to consolidate purchasing responsibilities to obtain greater bargaining clout with health insurers, plans,and providers, to reduce the administrative costs of buying, selling and managing insurance policies" (p 7)They offer a good basis with which one has less cost for healthcare. Whenever one is not insured on healthcare, they still receive treatment, and the government pays the hospitals some amount as a compensation for such. When the effectiveness of the system is compared, the country has good provision, but there are some weaknesses. According to Irvine and Bidgood (2013)

"Although the USA performs well regarding cancer outcomes and research prizes, it does less well on performance indications such as life expectancy and infant mortality. Although this can partly be attributed to the failure of its healthcare system, there are other factors which are less directly linked. For example, the US suffers from high levels of obesity, which can only partly be blamed on a failure in the healthcare system to provide adequate preventive medicine that encourages healthier lifestyles. The school drop-out rate is also high, which makes it more likely that people will be unable to afford insurance in future.65 Car accidents and homicides are also more common in America than elsewhere in the developed world, and income inequality, often noted to correlate with lower public health, is very high." (p 13)

Healthcare System in Japan

The healthcare system in Japan has no complexities. The reason for such is that there is the offering of medical services, with patients taking thirty percent of the cost, and the government paying for the other seventy percent.Mossialos (2017) states that "All enrollees have to pay a 30 percent coinsurance for services and goods received, except for children up to around age 6 (20%), adults ages 70 to 74 with lower incomes (20%), and those age 75 and older with lower incomes (10%). There are no deductibles. Copayments for children's health care are often subsidized by local governments" (p 106). According to Fukawa (2002), "Most health services in Japan are provided through the public health insurance system, which covers the entire population. Although the private sector has established an important infrastructure that delivers health services and maintains public health, its role is relatively small regarding health service financing." (p 1). There is also a universal insurance policy, where all the people are required to have insurance cover for their health needs. There is some legislation for the hospitals in Japan, as they are required to operate without the basis of making a profit.

Japan uses Bismarck model, where there is the use of health insurance to cater for health needs. According to Mossialos et al. (2017), "Citizens are mandated to enroll in one of the SHIS plans based on age, employment status, and place of residence as are resident non-citizens; undocumented immigrants and visitors are not covered. Insurance premiums vary between types of insurance funds and municipalities. Government employees are covered by their insurers (known as Mutual Aid Societies) as are some groups of professionals (e.g., doctors in private practice)." (p 105) There is some regard in the cost for healthcare in Japan since the government sets into moderate the cost for healthcare, which is a way that sees to it that there is no manipulation of people from the medical care providers. Therefore, the medical fee is affordable. Insurance is given by the age of the person who is being insured, and patients do not pay more than thirty percent of the medical fee. There are many instances where there is a waiver in the manner of the cost of healthcare, depending on the income that one has and their age. In such cases, there is some reimbursement or a waiver. In case a patient has no insurance, they are supposed to pay 100 percent of the medical fee. There is also some subsidized cost for this e who are poor and without homes. The amount of money that one pays for healthcare is regulated by the government, by looking at how the economy is and has a definition of how to have the changes in medical fee. According to Uetsuka (201), "The medical fee schedule, which sets the prices for all procedures, drugs, devices, etc., is revised every two years. The revisions are polit...