Organizational Systems and Quality Leadership Discussion Paper
Country of Comparison
The United States is made up of 331,127,805 individuals (Waldometers, 2020). On the other hand, Switzerland is made up of 8,658,711 individuals (Worldometers, 2020). Switzerland and the United States demonstrate two distinct healthcare forms, as both frameworks have its own collection of rules and regulations that they follow.
Access
United States
Individuals residing in the US are not covered by a universal health care program but need to own a healthcare insurance coverage, as recently mandated by an enacted legislation. Citizens may opt to get one insurance policy provided whether from their employer, individually or from the government that assists them to offset the costs of healthcare. When necessary, the government can help the children in covering their healthcare costs and guarantee that they get proper healthcare. There exist various health facilities, primary care providers, and speciality care providers who may provide children with healthcare. Nevertheless, some may not be within the system for that individual's health coverage Organizational Systems and Quality Leadership Discussion Paper.
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Every state has its own unemployment benefits insurance laws, but the federal government also governs them. The most significant difficulties in obtaining healthcare are with the unemployed individuals of the United States. The most prevalent factor is typically job loss because, with that, healthcare benefits are lost. Through funding, state legislation offers help to community health facilities that utilize a variable scale on income-based fees. To be entitled to such benefits, individuals must fulfil the state standards for income earned or "base period" which is defined as time spent working over a duration of time (United States Department of Labor, 2015).
The children from low-income families are more advantaged, as they can put in for coverage through the Medicaid or Children's Health Insurance Plan (CHIP). In the United States, the retirement age is 65 years. When an individual hits this age, they can begin obtaining benefits from Medicare. This assists in covering hospitalization expenses, doctor services, and prescription medications. The system also covers end-of-life hospice services and post-acute care but not lifelong care (Commonwealth Fund, 2015). An individual can also benefit from a Medicare supplement program Organizational Systems and Quality Leadership Discussion Paper.
Switzerland
All citizens that reside in Switzerland are insured and governed by the Swiss federal law health insurance (De Pietro et al., 2015). Due to the integration of public, supported corporate and full organizational healthcare models, this healthcare program is considered to be an exemplary healthcare system. The integration then establishes a system of exceptionally qualified physicians and health facilities in Switzerland (Expatica 2017). Each family member in all families must be covered separately, but infants are covered from birth and should have a medical cover obtained by the age of three months. Children are typically presented to a pediatric physician who will care for the child during their years of childhood. Families are entitled to pick whatever physician they prefer since all physicians are insured by the Federal Health Insurance (Expatica, 2017). There are several healthcare facilities offering speciality and pediatric services where the physicians are qualified to perform extremely advanced study and treatment of severe, unusual diseases Organizational Systems and Quality Leadership Discussion Paper.
All individuals residing in Switzerland are contributors to the Swiss insurance plans that involve the social security program. The program is split into many fields including pensions, family and maternity allowances income compensation, unemployment coverage, work-related sickness and accident cover, and public insurance and healthcare (Expatica, 2017). Both an individual and employer contribute half of the payments each, translating to around 2% of the earnings of an individual. Unemployment benefits may take hold for anybody when they go through lack of employment as a result of environmental problems, job loss, cut down of hours, and several other matters. An individual can request 70% of the standard income for the past six months to a year after five days of working (Expatica, 2017). To claim, an individual ought to possess the following: Swiss citizenship, job visa, reimbursement of one year’s contributions in the two years prior to obtaining coverage, and registering with the employment service on the first day at work in addition to consistently searching jobs (Expatica, 2017).
The age of retirement is 64 for women and 65 for men, and they still earn a salary once they retire, and after an individual retires, they are also insured by the Swiss Health Insurance scheme. They have to pay monthly contributions when their coverage specifies the yearly deductible amount, which is the sum that an individual spends for healthcare expenses (Expatica, 2017). Every individual also needs to pay a maintenance charge in which they pay 10% towards the cost of the insurance provider, which for adults is limited at CHF 700. Along with the deductible and maintenance costs, the person also needs to compensate for hospital expenses valued at CHF 15 a day. An individual can decide to buy extra health insurance to cover services not added in the standard health insurance, and also have to obtain accident insurance to top up (Expatica, 2017) Organizational Systems and Quality Leadership Discussion Paper.
Coverage of Medications
United States
Although there is no one-time charge to establish a pharmacy record in the US, certain pharmacies are not protected by some insurance plans. An individual has to select a pharmacy inside the system that will manage the prescriptions via insurance. Several of the drugs have a deductible a client has to compensate for.
Switzerland
Once an individual acquires drugs from a pharmacy for the first time, they will incur a one-time charge to create a file with the pharmacy. Around 20% acts as a deductible on branded drugs and 10% deductible on generic drugs. All drugs which are not included in a prescription are not insured by insurance; therefore, the individual will reimburse it out of the pocket Organizational Systems and Quality Leadership Discussion Paper.
Referral to See a Specialist
United States
All individuals living in the US ought to contact their primary care provider to be referred to a professional (The Commonwealth Fund, 2018).
Switzerland
All individuals living in Switzerland are able to see a professional without being referred, except if they have successfully registered for private health insurance which demands that they first consult a primary care physician. The primary care doctor then serves as the "facilitator" and will first examine the individual prior to a referral to an advanced care standard (The Commonwealth Fund, 2018) Organizational Systems and Quality Leadership Discussion Paper.
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Coverage for Pre-existing Conditions
United States
Since the enactment of the Affordable Care Act in the US, care regarding all pre-existing conditions cannot be withheld to an individual (The Commonwealth Fund, 2018).
Switzerland
Within the obligatory health insurance act, all persons should receive health benefits irrespective of their health condition (The Commonwealth Fund, 2018). It implies the treatment is not withheld with respect to pre-existing health issues.
Finance Implications for Healthcare Delivery
United States
For those residing in the US, a significant financial consequence is that they spend considerably more out of pocket than anyone in Switzerland. US residents have to spend more resources on private insurance providers and have more diagnostics, specialized treatments, and tests performed than the citizens of Switzerland do, thus rendering healthcare more costly than in Switzerland.
Switzerland
Much of healthcare financing is obtained from compulsory Swiss health insurance contributions. Those are the monthly out-of-pocket expenses that households have to pay that cost about 500 EUR per month, indicating that this country does not offer "free" healthcare (Expatica, 2017). Although each individual pays to the healthcare program on a monthly basis, they may still spend more to a fixed amount for their own medical appointments and procedures Organizational Systems and Quality Leadership Discussion Paper.
References
De Pietro, C., Camenzind, P., Sturny, I., Crivelli, L., Edwards-Garavoglia, S., Spranger, A., ... & Quentin, W. (2015). Switzerland: health system review.
Expatica. (2017). Social security in switzerland- and claiming your benefits. Retrieved from https://www.expatica.com/ch/about/Social-security-in-Switzerland_104573.html
The Commonwealth Fund. (2018). The u.s. health care system. Retrieved from http://international.commonwealthfund.org/countries/united_states/
The Commonwealth Fund. (2018). The swiss health care system. Retrieved from http://international.commonwealthfund.org/countries/switzerland/
The United States Department of Labor. (2015). State unemployment insurance benefits. Retrieved from http://workforcesecurity.doleta.gov/unemploy/uifactsheet.asp
Worldometers. (2020). Switzerland population. Retrieved from http://www.worldometers.info/world-population/switzerland-population/
World o meters. (2020). US population. Retrieved from http://www.worldometers.info/world-population/us-population Organizational Systems and Quality Leadership Discussion Paper
PLEASE DO NOT ASSIGN TO Writer ID: 1609 PLEASE FOLLOW INSTRUCTIONS CAREFULLY FOLLOW RUBRIC TO AVOID REVISION DELAYS AS THIS IS TIME SENSITIVE A. Compare the U.S. healthcare system with the healthcare system of Great Britain, Japan, Germany, or Switzerland, by doing the following: 1. Identify one country from the following list whose healthcare system you will compare to the U.S. healthcare system: Great Britain, Japan, Germany, or Switzerland. 2. Compare access between the two healthcare systems for children, people who are unemployed, and people who are retired. a. Discuss coverage for medications in the two healthcare systems. b. Determine the requirements to get a referral to see a specialist in the two healthcare systems. c. Discuss coverage for preexisting conditions in the two healthcare systems. 3. Explain two financial implications for patients with regard to the healthcare delivery differences between the two countries (i.e.; how are the patients financially impacted). B. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized. C. Demonstrate professional communication in the content and presentation of your submission.