Instructions:

This assignment must be done in APA format. It is broken down into 2 questions. A minimum of 1600 words (references is not included) for the overall assignment is required. The minimum reference count is 4 (including in-text citations) for the overall assignment. Also, even though this assignment is done in APA, it must keep the question, answer, and reference format. Please see example below.

Format: Question: XYZ

                Answer: XYZ

                Reference: XYZ

General Instructions

1.  Worldwide spread of disease…..ramifications….implications

1.  Medical tourism………ramifications and implications

1.  Unrealistic expectations of world health system……what are they? Ramifications, implications?

2. Define “responsible role” how would we know it if we saw it? List the steps. Explain how each is actionable

Article for questions:

https://scholarship.law.georgetown.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1013&context=ois_papers&sei-redir=1&referer=http%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3Dglobal%2520health%2520scholarly%2520articles%26source%3Dweb%26cd%3D10%26ved%3D0CGUQFjAJ%26url%3Dhttp%253A%252F%252Fscholarship.law.georgetown.edu%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1013%2526context%253Dois_papers%26ei%3DcLTgT-KkB5CW8gTD1pyCDQ%26usg%3DAFQjCNHzWh5fsUeltajTML61mF-WfkWj8Q#search=%22global%20health%20scholarly%20articles%22

Questions:

  1. The world has become a global economy. Travel advances have minimized the time it takes for an individual to access most of the world. Thus, disease can spread in a matter of hours or days, exposing the world to potentially catastrophic epidemics. Coupled with this is the rising demand for medical tourism, and unrealistic expectation of the worlds health system. Discuss the implications and ramifications of not managing disease from a global perspective.
  • Outline the steps a country can take to play a responsible role in the global health arena?

Part Two: This part of the assignment is simple. The minimum word count for this assignment is 250 words (per response); with one reference each.

Note: Write as if you’re actually talking to the person.

  1.  There are several different types of health care systems around the world with some overlapping. This overlapping is in the type of system but not every alike system is the exact same. When it comes to developed countries there are four system model, The Beveridge Model, The Bismarck Model, The National Health Insurance Model, and The Private Insurance System (Harveston, 2018). The United States primarily uses the private insurance system does cover the majority of the citizens. The rest of the developed countries utilize the three other models.

A universal issue for all countries, no matter what model is used, is the disparities in health, quality of health care, and access to health care. A lot of the disparities are the same from country to country but each of each country deals with them in their own way. In the United States, Medicaid and the Children’s Health Insurance Program (CHIP) were created to help reduce the disparity of low-income populations. The ACA also created requirements to reduce disparities by increasing access to coverage, improving health, shifting the focus of healthcare, and improve the quality of care. One of the provisions of the ACA created reimbursement for federally qualified entities who provide comprehensive primary and preventive care regardless of their patient ability to pay for the services (Commonwealth Fund, n.d.). While these initiatives have helped provide coverage to more individuals there are still millions of individuals without coverage because they either cannot afford it or simply do not want it. And these initiatives do not address access to healthcare which is still a big issue. While in France, which has universal health care, there is a different approach to improve access to care for underserved areas. In France, the nursing association has agreed to limit new practices in overserved areas and the country is offering incentives to physicians to practice in underserved areas (Durand-Zaleski, n.d.). While this is a great idea the incentives must be worth their time or physicians will not serve these areas and if physicians do serve these areas will there be enough, and will they be overcrowded.

The idea of creating incentives for physicians to practice in underserved areas is something that the United States should consider. The United States could also take look at Germany for help and shift its focus to the people and not the money. In Germany, hospitals and providers are not allowed to operate for profit and focus on care (Haverston, 2018). What a great idea, health care focused on people, not the money. This works in Germany because while physicians are paid less there than in the United States, they have little to no debt after completing medical school (Haverston, 2018). This is something the U.S. should look at and may help drive physicians into smaller and underserved areas.

As some countries, including the United States, comes a huge melting pot of culture it will be more difficult for healthcare to adapt. Universal coverage helps with this issue because it does give every coverage and reduces disparities. That being said it is difficult to have the knowledge and be able to provide the correct care for so many different cultures and religions. Each of them is unique and view health and health care differently. Giving them the coverage is only the first of many steps to ensure that the care is correct and of quality.

  • Of the democracies within the Organization for Economic Cooperation and Development (OECD), there are currently 32 out of the 35 countries with Universal Health Coverage (UHC). One of these countries is Australia and the United States of America is not. Australia currently has a 2-tier healthcare system being both public and private. The public healthcare system allows citizens and permanent residents to receive necessary healthcare services at both the inpatient and outpatient care public settings. While some Australians may choose to receive private physician services to expedite the public service availability, it comes with an out of pocket expense. Approximately 57% of Australians choose to seek private sector insurance coverage in order to reduce public waiting times and receive elective procedures not covered in the public plan. A sliding scale subsidy based on income is also provided by the Australian government for applicable families to support the economic drive towards the private insurance companies. In order to achieve this level of public healthcare services, Australians pay a 2% Medicare income tax levy in conjunction with general population taxation for all citizens. For those citizens earning high-income wages and choosing not to take advantage of private insurance coverage, an additional 1% tax is applied. With the Medicare and Medicaid programs in the US, the original design was to offer a financially viable option for healthcare coverage to individuals with low-income earnings and the elderly populations. This has created a large gap of the population to seek private health insurance coverage through their employer. US insurance policies show great variability in coverage criteria and result in co-payments and deductible expenses that patients are subject to paying out of pocket. The Pharmaceutical Benefits Scheme offered in Australia creates a financial cap for medication expenses that would otherwise be incurred out of pocket at a high premium cost (O’Brien, 2017). In 2017, a new compulsory co-payment policy was introduced in the Australian healthcare market that would require $7 co-pay fee for General Practitioner visits, out of pocket pathology and diagnostic testing. This would apply to all adults and children with a cap introduced after ten annual visits. With this policy addition, an estimated $10.5 million would be reduced in government healthcare expenditure. Capturing heavy attention from political parties within Australia by adding such a compulsory co-payment the universal healthcare system began to show the shift in sustainability (Bundey, 2014).

Both the US and Australia have complex healthcare systems with various models of medical practice. The complexity of the Australian healthcare system is funded through state and federal governments, health insurance companies, as well as individual out-of-pocket contributions. Through requiring financial elements from stakeholders, the US in the current economy is faced with healthcare reform in order to increase the quality outcomes while demonstrating cost-effectiveness. They both have elements of providing public healthcare as the US turns to Medicaid which is funded through federal and certain states to financially support low earning families. In Australia, OHS is a large multi-specialty practice that utilizes educational training for medical personnel in a hospital operation. With the goal being providing increased access to timely medical care, improving health delivery outcomes, transparency through data reporting and a patient-centered approach. One of the primary differences seen in the two countries is the General Practitioners role in providing oversight and referring to specialists. In the US patients have the autonomy to self refer to specialty practice physicians while Australia recognizes the General Practitioners role in ensuring proper utilization of necessary services (Jones, Seoane, Deichmann & Kantrow, 2011). 

In 2016, healthcare spending per person in the US was $9,892 representing 17.2% of GDP, whereas Australia was $4,708 at 9.6% of the GDP. The average cost of an average hospitalization in the US is $18,000 which is 3 times higher than the OECD average of other countries. With that, the US life expectancy falls substantially shorter than other developed countries. Higher costs of services, volumes of diagnostic testing, greater administrative costs and poor regulation of the private sector insurance companies are further contributing the high cost of healthcare in the United States (O’Brien, 2017). In early 2017, US president Donald Trump made headlines by stating “Australia has a better healthcare system than we do.” This statement from the current administration comes shortly after the Republican lead repeal of the ACA. Informational data by Peterson-Kaiser Health System Tracker indicates that Australia does, in fact, produce better patient outcomes and lower cost compared to that of the United States (Picchi, 2017). The downside for universal healthcare systems is the financial sustainability that is inevitably created for the responsible governments. Regardless of the mandates taxes that would be imposed, the continuously rising cost of healthcare services in the Unites States would make the implementation of this healthcare system extraordinarily challenging. 

The role that the General Practitioner would potentially play within the US healthcare system would be detrimental to the specialty practices. While it would lead to a more comprehensive oversight approach for patients, it would potentially create a less than superior level of quality for patient care outcomes. From an impactful position, reducing repeat testing would ensure the needed level of communication for patient-centered care. However, the element of medical care that works for Australia does not necessarily mean it will work for the US. The financial sustainability for a universal healthcare system within the US does not appear feasible given the countries economic climate, the volume of patients vs taxpayers and the overall cost of delivering healthcare services. An increased focus on cost-effectiveness measures within healthcare spending can prove to ultimately have an impactful reduction on the GDP. 

  • Canada has a national health insurance program. Health insurance coverage is universal. General taxes finances Canada’s national healthcare system. “Consumer co-payments are negligible and physician choice is unlimited. Production of health care services is private; physicians receive payments on a negotiated fee for service and hospitals receive global budget payments” (Ridic & Gleason, 2012). The United States on the other hand has a multi-payer system private system. Canada is often the model used United States when the discussing healthcare reform. Canada spends far less of its GDP on health care yet performs better than the U.S. on two commonly cited health outcome measures, the infant mortality rate and life expectancy.

Both the United States and Canada ultimate goal is to reduce healthcare costs and increase access. Administrative costs for health care in the U.S. is quite a bit higher than it is in Canada. Nevertheless, these costs account for a large part of both countrys’ budgets, with the United States spending more per capita than Canada does. The Canadian government spent US$2,120 per person in 2004, while the United States government-spent US$2,724 per person in the same period. Canada has achieved access by way of the national health care system and the Canadian government pays for the emergency care costs of any legal Canadian citizen. The Affordable Care Act called for more people to have health insurance by offering subsidies and mandating all Americans have it or face penalties.

The benefits of Canada healthcare system are it is available to everyone that is a citizen. It doesn’t matter what kind of financial status a citizen has, employment status, health or age of the citizen. Canadian Medicare is available for one and all. However, this downside is that increases wait times. People will end up waiting for months to get the necessary treatment or medical attention. In the U.S this is uncommon, due to the fact that is private healthcare and a lower rate for access to care. In Canada health care providers are limited to what they can charge by the government. This limit can cap the earning potential of various providers and make it harder to pay back loans, limit their earning potential, and undermine their overall life. They are considered government workers.

There’s no question that American health care, a mixture of private insurance and public programs, is a mess. Over the last five years, health-insurance premiums have more than doubled. Expensive health care has also hit employers. it’s one of the reasons that median family income fell.  Health spending has surged past 16 percent of GDP. The number of uninsured Americans has risen, and even the insured seem dissatisfied. So it’s not surprising that some Americans think that solving the nation’s health-care woes may require adopting a Canadian-style single-payer system, in which the government finances and provides the care. Canadians, the single-payer tune goes, not only spend less on health care; their health outcomes are better, too—life expectancy is longer, infant mortality lower. Many feel that the government should not be in total control of healthcare. Others feel that for cultural reasons the government should stay out of healthcare.  Private insurance will continue to increase, until the United States comes up with a plan to reduce overall spending

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