Comparison of Healthcare Systems in Japan and the United States, Thesis of Cost Accounting

Download Comparison of Healthcare Systems in Japan and the United States and more Thesis Cost Accounting in PDF only on Docsity! Running head: C489 Organizational Systems Task 3 1 C489 Organizational Systems and Quality Leadership Task 3 SAT1 Western Governors University Healthcare Financing A1. Country to Compare Japan. A1. Access The country of Japan has a well thought out health care system with ease of access at the front lines. In summary, every citizen can receive healthcare coverage regardless of age, sex, or employment. The government regulates what is known as the universal Statutory Health Insurance System (SHIS). It is required by law for local and national governments to provide efficient good-quality medical and health care. Individuals are required to enroll in a SHIS plan based on their age, place of residence, and employment status. The only individuals that are not covered are undocumented immigrants and visitors. Unemployed individuals can be covered under a community-based insurance. Japanese parents can apply for a Free Medical Certificate for their children that is provided by the city. The Free Medical Certificate covers about 70 percent of medical expenses until the children turn 15 years old. Vaccinations are not covered under the Free Medical Certificate; however, the parent of the child can apply for cost to be covered under the county. ORGANIZATIONAL SYSTEMS TASK 3 2 In the united states, American children are only covered by health insurance if their parent has insurance through their employment or private insurance, but the child must be added on to the parent’s health insurance plan for a greater expense. If the parent does not have insurance or if they do not add the child on to their insurance plan, all medical expenses for the child must be paid out of pocket. The parent can apply for medical assistance through Medicaid, but individuals are only approved if the entire family falls under a certain median household income. In Japan, unemployed citizens can receive insurance through a community-based insurance plan. In the US, unemployed citizens are not covered with insurance. Americans must apply for Medicaid for coverage but only get approved if they meet the low household income requirement. In Japan, citizens who are retired and under the age of 75 are also covered under a community-based insurance plan. After that citizens reaches 75 and older, their insurance changes to a social insurance plan. This social insurance plan does require a premium, however if the individual cannot afford to pay that premium then it is covered under the city in which the individual lives. In the US, when an American citizen reaches 62, they can become eligible to receive Medicare. However, not everything is covered under Medicare, and is sometimes used as a secondary insurance because of its lower coverage. If an individual has retired from the military and receives benefits, that coverage could be used for the remainder of their lifetime. In the US, healthcare can also be covered by the citizens employer. The individual must still pay for that insurance, and cost of the insurance depends on the company the person works for and who that company uses for insurance. A child can be covered by the parent’s insurance Updated on 2/21/19 ORGANIZATIONAL SYSTEMS TASK 3 5 A2C. Coverage for Preexisting Conditions In Japan, health insurance is available to every citizen regardless of age, sex, or employment. This also includes individuals with preexisting conditions. In the United States, health insurance companies can no longer charge a greater amount, deny coverage, or limit benefits to a citizen or their child because of a preexisting condition. Once an individual has health insurance, they cannot refuse coverage or treatment for that preexisting condition. If a citizen does not have health insurance but does have a preexisting condition, a physician cannot refuse them due to the Affordable Healthcare Act. This does not mean that there is no cost for the treatment. Citizens will have to pay the fees fully instead of having a percent be covered by health insurance. A3. Finance Implications for Healthcare Delivery In Japan, health insurance is mandatory but available to all citizens. The countries healthcare has three categories that it is based in, which is national insurance, employer-based insurance, and insurance for the elderly. These categories of health insurance are financed mostly by the government as well as private employers. In the US, health insurance providers are not allowed to charge extra fees for certain services thanks to the Ministry of Health, Labor, and Welfare (MHLW). These services include experimental treatments, after hours services, hospitalizations of 180 days or more, amenity beds, and outpatient services for large multispecialty hospitals. Safety net: Catastrophic coverage stipulates a monthly out of pocket threshold, which varies according to the enrollee age (International Commonwealth Act, 2017). Updated on 2/21/19 ORGANIZATIONAL SYSTEMS TASK 3 6 Health insurance in America is one of the most complex and largest healthcare systems in the world. The cost of insurance, medications, and procedures depends on the insurance coverage that an individual has. An American who does not have insurance and does not meet criteria for acceptance into assistance programs, are forced to pay out of pocket for the full expense of all health care, medications, procedures, and doctors visits. Health care in Japan is only half the cost of healthcare in the US, and often has better medical outcomes. Japan has a simple and straight forward system and has been known to assist in the longevity of the citizens, overall cost, and well-being of its population. F. Sources References International Commonwealth Fund (2017). International Profiles of Health Care Systems. Retrieved from https:// www.commonwealthfund.org /sites/default/files/ Updated on 2/21/19 ORGANIZATIONAL SYSTEMS TASK 3 7 documents/ ___media_files_publications _fund_report_2017_may_mos sialos_intl_profiles_v5.pdf International Commonwealth Fund (2017). International Profiles of Health Care Systems. Retrieved October 19, 2020, from https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_ fund_report_2017_may_mossialos_intl_profiles_v5.pdf Marylane, K. (2014). Paying for healthcare costs in America: Rising costs and challenges. Retrieved October 19, 2020, from https://wgu.vitalsource.com/#/books/9780323390224/cfi/6/40!/4/2/4/2@0:0:// www.qualityindicators.ahrq.gov/ Updated on 2/21/19