Coverage of Medications

Running head: COMPARING THE US HEALTHCARE SYSTEM TO JAPAN Revision Comparison of the US healthcare system with that of Japan Western Governors University July 13, 2016 1 COMPARING THE US HEALTHCARE SYSTEM TO JAPAN 2 Part I The accessibility of the healthcare system in the US by children, unemployed people and the elderly is varied in the US. Americans who are over 65 years of age are provided with a medical cover. Medicare also provides a cover to the young people who have some disabling conditions or illness. For those who are poor or unemployed and cannot afford to pay for the insurance cover, they are usually covered by Medicaid after applying and qualifying for the service (Kumar, 2010). In Japan, however, the poor, elderly people used to have no access to better healthcare system facilities. The government of Japan launched an insurance plan in the year 2008 to cover the elderly who were over 75 years old to reduce their medical expenses. More children in Japan visit hospital-based outpatient clinics and community physicians unlike in the US. Besides, Japan has a universal health care system that allows access to free health care to everyone including children and those who are not employed unlike the US is where the poor and unemployed have to apply for the Medicaid services. Part II: Coverage for medication In the US, there has been an increase in drugs copayments by about 34 percent and co-insurance fees compared to the pre-reform market. However, medication coverage continues to improve especially with the recent adoption of Obama care services. In the plan, individuals can compare the insurance plans in the marketplaces and select the most viable based on cost, coverage benefits, and protection. Cost assistance is also available for the individuals and small businesses in the market. Coverage of Medications, assignment help

COMPARING THE US HEALTHCARE SYSTEM TO JAPAN 3 Unlike in the USA, Japan healthcare facilities provides services which include screening examinations, infectious diseases control, and prenatal care. The government incurs 70% of the patient’s cost which the patient pays the rest of the 30 percent. The universal health care insurance system is used by the government as a channel for the payment of personal medical services. The system provides relative equality of access, with fees set by a government committee. Every patient is free to select the kind of facilities or physicians of their choice, and there is no coverage denial. By law, hospitals must be managed by doctors and run as non-profits. Any profit corporations are not allowed own or hospitals. Referral to see a specialist More than a third of the patients in the US are referred to specialists each year. These visits include more than half of outpatient visits. The specialty referral process is being improved through strategies such as using referral guidelines and gatekeepers. More so, transfer information lack in many of the referrals, either to the specialists or from the specialist. Referrals are approved by the plan and valid for the indicated diagnosis. Additionally, referrals have expiry dates and are usually limited in the number of visits a patient can be referred. In Tokyo, the local medical facilities including the family doctors refer patients with exceptional emergency cases to metropolitan hospitals. The family doctors offer referrals to hospitals that have specialized or advanced capabilities when he or she finds out that an advance treatment or a more thorough examination is needed. The doctor usually writes a referral letter stating the diagnosis to be carried by the patient to the hospital. The patient COMPARING THE US HEALTHCARE SYSTEM TO JAPAN 4 makes an appointment to the designated hospital where he or she takes the referral letter with them when visiting the hospital.

This is how the referral-based system works in Japan (Miyata, 2011). Part III: Coverage of pre-existing conditions In the US, pre-existing medical conditions are covered by the insurance systems without making any extra charges on the patient and without denial of the insurance benefits. Once a person is enrolled, the plan cannot raise the rates based on the health or deny the coverage. In Japan, the starters’ health insurance system is mandatory and under the regulation of the government. The plan covers all dental, medical, and prescription drug needs that may arise. Besides, the patient cannot be denied coverage by the plan due to the pre-existing condition. The Japanese are sure of treatment when they go to the hospital, and they can choose the doctor of their choice. Part IV: Financial implications for the patient concerning healthcare delivery Japan is egalitarian without any known medical bankruptcy. Also, out-of-pocket costs and premiums are minor concerns for most. Indeed, the low-income earners and the elderly receive subsidies to afford care. In this country, the income of an individual has little influence on the quality and quantity of medical care accorded to that person than in the United States. Coverage of Medications, assignment help

In the US, however, the poor and unemployed people must apply for the Medicaid insurance which covers their medication entirely or partly based on the individual’s state. More so, the increase in the health costs is making the employers drop coverage or increase cost sharing. The number of uninsured people is also rising particularly among those with COMPARING THE US HEALTHCARE SYSTEM TO JAPAN low financial income. The number of adults with low financial incomes is also increasing with the low financial income due to the increase in the medical costs. 5 COMPARING THE US HEALTHCARE SYSTEM TO JAPAN 6 References: Kumar, S., & Aldrich, K. (2010). Overcoming barriers to electronic medical record (EMR) implementation in the US healthcare system: A comparative study. Health informatics journal, 16(4), 306-318. Miyata, H., Motomura, N., Kondo, J., Takamoto, S., & Hasegawa, T. (2011). Improving the quality of healthcare in Japan: a systematic review of procedural volume and outcome literature. Bioscience trends, 1(2), 81-89. http://www.eastasiaforum.org/2014/02/22/farewell-to-free-access-japans-universalhealth-coverage/ http://obamacarefacts.com/benefitsofobamacare/ http://www.byouin.metro.tokyo.jp/english/reservation_system.html http://www.usfhpnw.org/index.cfm/members/referral-guidelines/ … Coverage of Medications, assignment help