U.S. Health Care Systems Discussion Questions Flashcards

One of the advantages, as listed above, is a more regulated and streamlined healthcare sector. Let’s look at each section individually:
(a) Health care financing: The health care system is financed thru taxes or an employee/employer based contribution. The amount that comes out of your check is commensurate with your salary. Everyone’s dollar goes to a single entity (the government) and the government allocates funds appropriately. In the US, the insurance, NOT the government sets the price of insurance and then negotiates with each employer regarding a specific plan.

(b) Pooling: Again, insurance plans are negotiated are regulated by the government and NOT the insurance companies. For example, France and Germany finance their health care system through voluntary contributions by employers and employees and the risk-pooling occurs at the plan level. However, insurance contributions are a fixed percentage of your income. Also, in most countries (other than US) there is no cost-sharing for services, which means there are no co-payments, co-insurance payments, and/or deductibles.

(c) Provision of Care: The only thing I could really find in the book is that in countries with government involvement, the individual has the freedom to choose any physician they want. Every physician gets paid from the same source: the government. But in America you have to find a physician that is covered by your particular network. I have an employee that has cancer and he needs experimental therapy. The problem is that the doctor that provides this therapy is not covered in our network so if he wants to pursue this opportunity to save his life he’ll have to pay a sky-high fee because it’s out-of-network. In countries like Germany and England every physician is covered so you can go where you please.


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