Health in four nations Flashcards
how much does US spend of GDP on health care
17.1%
four mechanisms for reimbursement
out of pocket
individual private insurance
employment based private insurance (germany)
government financing (uk and canada)
japan lies between 3 and 4
germany
1st nation to enact compulsory health insurance legislation
howmuch of GDP germany spend on health care
11.3%
germany sick funds
90 % os citizens covered through mandatory sick funds. May not exclude anyone based on illness
Germany employement
technically coverage is employment based
germany physicians
separation between ambulatory and inpatient MDS
51% are generalists
germany cost controls
body of health care providers, sickness funds, employers
establish guidelines for MD fees, hospital rates, and drug/ supply prices
cap to MD reimbursement
Canadia
tax financed public single payer health care system
prohibits private health insurance for coverage of services provided by govt funded insurance
who pays providers in canada
each provinces govt is the payer.
canada medical care
50 % generalists.
some high tech procedures are available at limited, regional locations
waiting time for elective procedures is longer
reimbursement in canada
MDS reimbursed by fee for service. caps on reimbursement
hospitals usually private and non private
uk
National health service
majority tax funded
allows private insurance, but cant use private and public health insurance at the same time
uk medical care
must have a general practitioner and need to be referred for a specialist
paid for performance
uk cost controls
govt single payer can limit budgets and mode of payment
not a lot of MRI scanners
Japan
spends 10.3 % of GDP ON health care
how to be covered in japan
if employer has >700 employees
operate self inured plans specific to an employer
if employers <700
enroll in single national health insurance plan operated by national government
community based insurance plan
japan medical care
no restrictions on choice of hospital or MD
LTC funding in japan
funded by general tax revenues and earmarked income tax
japan reimbursement
previously FFS for MDs and hospitals
strict govt regulation of fees
physicians can sell rx
