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Task 3, C489
 Identification of Countries

For the purpose of this task and to demonstrate an understanding of the issues related to

healthcare financing, including local, state, and national healthcare policies and initiatives that

affect healthcare delivery, the healthcare system of the United States of America will be

compared with that of Great Britain.

Comparison of Access for Children, the Unemployed, and the Retired

United States

Medicaid in the United States is a federal and state program that helps with medical costs for

some people with limited income and resources. Medicaid also offers benefits not normally

covered by Medicare, including nursing home care and personal care services. The Health

Insurance Association of America describes Medicaid as "a government insurance program for

persons of all ages whose income and resources are insufficient to pay for health care."[1]

Medicaid is the largest source of funding for medical and health-related services for people with

low income in the United States, providing free health insurance to 74 million low-income and

disabled people (23% of Americans) as of 2017.[2][3][4] It is a means-tested program that is

jointly funded by the state and federal governments and managed by the states,[5] with each state

currently having broad leeway to determine who is eligible for its implementation of the

program. States are not required to participate in the program, although all have since 1982.

Medicaid recipients must be U.S. citizens or qualified non-citizens, and may include low-income

adults, their children, and people with certain disabilities.[6] Poverty alone does not necessarily

qualify someone for Medicaid.

 Germany

Requirements for a Referral

In the United States, the type of health insurance coverage or arrangement a person possesses

which could be a Preferred Provider Organization plan or a Health Maintenance Organization

will determine if the person needs a referral before being attended to by specialist doctor. The

health system of Great Britain requires that patients obtain a referral before they can be attended

to by a specialist doctor ("Outcomes in EHCI 2015"). The waiting time to consult a specialist

doctor in Great Britain ranges from two to three months and this is the same for elective

surgeries. In the united states however, there is no waiting time besides the office schedule and

equally no waiting time for elective surgeries.

Financial Implications for Patients

Citizens of the United Sates are required to obtain private insurance if no provision of health

insurance coverage is made by their employer. Employees in the United States are still

responsible for some payments for healthcare services which can come in firm of insurance

premium, coinsurances deductibles, and other out of pocket costs. When an individual

possesses a private health insurance coverage, most of the financial burden of such coverage

rests on the individual and can come in form high monthly fees for insurance premiums,

coinsurances, high deductibles, and high out of pocket costs. Majority of the cases of bankruptcy

in the United States can be attributed to tremendous cost of health care costs (O'Bringer &

Jefferies, 2019). Most of the times, the exorbitance of these payments deter individuals from
obtaining medical treatment in a bid to avoid the high out of pocket costs. In the Great Britain

however, citizens never get to see a medical bill in their entire lifetime because government

covers all cost through the tax system.

Coverage for Preexisting Conditions

In years past, the health insurance companies have the rights to decline the health insurance

coverage of an individual as a result of preexisting conditions. The Obama administration of

governance introduced a new healthcare insurance policy which started in 2010 and made the

landmark achievement of preventing companies from declining coverage due to preexisting

conditions ("Outcomes in EHCI 2015"). In Great Britain where citizen are covered by a

universal health insurance, this kind of issue does not come up.

References

O'Bringer, L., & Jefferies, M. (2006, January 29). Health. Retrieved from

https://health.howstuffworks.com/ on October 15, 2019.

"Outcomes in EHCI 2015" (PDF). Health Consumer Powerhouse. 26 January 2016. Archived

from the original (PDF) on 6 June 2017. Retrieved 27 January 2016.