Laurie Turla Medical Anthropology1

Laurie Turla
Medical Anthropology1. In order to fund the National Health Service in Britain, the country uses tax revenue. Tax revenue is the income that is gained by governments that are paid for by their citizens. Because of this, the hospitals are under government control and the employees within them are salaried by the government. General practitioners are considered gate-keepers because they are the only way patients can be referred to specialists. These doctors are also paid a fixed salary but receive bonuses for keeping their patients healthy. For example, Dr. Ahmed Badat receives a $180,000 pay increase for keeping his patients with diabetes and heart disease healthy. (Palfreman, 2008) So far, this is a great way to keep doctors motivated and patients happy when there is no medical debt to worry about and no medical bills period. This is much more attractive than the system in place in the US, especially with Dr. Ahmed’s comment of how ridiculous it was for him to pay $67,000 for his bills when he was admitted to a US hospital on vacation. (Palfreman, 2008)

2. The Japanese do not pay for all their health fund through taxes. Instead, they have to sign up for a health insurance policy through their jobs or with a community-based insurer. (Palfreman, 2008) If individuals are poor, the Japanese government take care of it. Also, unlike the British healthcare system, a patient can walk into any specialty clinic to be seen and don’t need to make an appointment because there are hardly and waiting times. Healthcare in Japan is so low because their health ministry has a regulated price book for all medical procedures. To keep prices low, even technology industries like Toshiba have adapted to making cheaper medical equipment. Because of these set prices, it removes any worry about fluctuating prices in different hospitals around the country. The regulation of health differs for the Japanese than the U.S. in that they don’t lose health insurance when they lose a job. Also, it is not allowed for insurance companies to deny insurance or to increase insurance rates because of preexisting conditions. Japanese insurers don’t make a profit, while U.S. insurers do.
3. The Bismarck model is an idea from the man Otto von Bismarck who invented the concept of healthcare systems. This means that a government has to put different health mechanisms in place for citizens so they can get medical care when they need it. The basics that the German health system covers includes mental health, dental and optical. This system also includes coverage for homeopathic treatments which include visits to a spa, to belly dancing lessons.

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In order to keep medical costs down, Germans have to purchase fixed healthcare premiums that are based off income. It is still expensive but it doesn’t compare to the amount in U.S. standards. The premiums would be split with the employer and the rich would pay for the poor. There are still co-payments but it’s only about $15. The sickness funds that grow means that the management can be better paid. (Palfreman, 2008)
4. Taiwan decided to develop their own health care system by looking at the healthcare systems with other countries all over the world. Instead of trying to make up a system by themselves, they looked into the existing systems and researched the pro and cons for each country and made a comparison amongst them. By doing so they were able to develop a system that would have the best impact to their citizens while trying to avoid the mistakes other countries have made. They chose not to copy the idea from the US healthcare system because the Taiwanese felt that the system was more of a market. The US system was probably seen more as a place to make profit, rather than to address the health care issues for its people. Many people get put into debt because of healthcare costs that can accumulate. With a health system that runs on payments from its’ patients with a fee-per-use, it does not really entice people to go to the doctor frequently to address health problems because they are worried about the costs first. Taiwan is struggling with balancing the hopes of patients, the needs of doctors and the cost of treatment because they spend too little for healthcare which has caused them to borrow from banks. The government knows the solution to solve this problem is as simple as increasing the premiums, but they are afraid of what the citizens will say about it and would rather ignore it. (Palfreman, 2008)

5. Why did Switzerland make the change in 1995 to a new healthcare system called LAMal?
Switzerland made the change to a new healthcare system in 1995 called LAMal because they took on healthcare reform. They made the change because in the past, when some people lost their job, they lost their healthcare coverage. The LAMal required everyone to buy premiums so that everyone could be covered and the government would pay the difference for the poor.
What was different about LAMal is that it was founded on the belief that healthcare coverage is a basic human right. By doing this, citizens were able to visualize what it means to have this entitlement which is why LAMal has gained the support of its people. The Swiss system is doing well today even though it is still relatively expensive. (Palfreman, 2008) The Swiss system and the Affordable Care Act have similarities in that they both require everyone to purchase healthcare insurance but come at a higher cost. The German system does not discriminate as much against preexisting chronic conditions much like the Swiss and US system where they can deny coverage. Instead, the Germans charged based on a patients’ age. (Carroll, A. E., & Frakt, A., 2017)
6. The differences in healthcare systems between France and Australia is that France has a more extensive list of services compared to Australia, while Australia manages expenses better. France costs more overall but with the option of having voluntary health insurance, this system decreases the amount of money that patients have to pay out of pocket. Australia has two different tiers within their system, public and private, but have a low GDP. The information provided by the Newsweek article says differently. The charts show that Australia has a higher performance compared to France which is low on the list near the US. When it comes to spending, France is still significantly lower than the US when it comes to spending. With that, France is clearly still a better healthcare system than the US. The best system out of these two is the French system. The fact that France has a longer list of services that are covered makes it an easy choice. Even though Australia is good at keeping their GDP costs down, it’s not likely going to reflect if the US used this system. Both systems are really good, but the amount of services that are available is more important for the patient population. The two-tiered system in France would also appeal to the rich. (Carroll, A. E., ; Frakt, A., 2017)
7. Some of the current problems with the healthcare system in the U.S. is that it is more expensive for its citizens and costlier to run overall. It causes too much financial burden on its patients because of high copays and not all services are covered. According to Newsweek, the U.S. is the only high-income nation that lacks universal healthcare. In order to improve, measures need to be considered to organize and help with the delivery process of insurance claims and maybe a way to just make the overall process smoother and more efficient. The charts in this article also show how isolated the U.S. is compared to the other rich nations of the world. Newsweek spotlights a report by the Commonwealth Fund that states “strengthening primary care, supporting organizations that excel at care, and moving away from fee-for-service payment” are some options that would be greatly beneficial for the U.S. and the health of its citizens.
Bibliography
Palfreman, J. (Writer). (2008, April 15). Sick Around the World Television      episode. In J. Palfreman (Producer), Frontline. San Diego, CA: KPBS Public      Broadcasting Service.
Carroll, A. E., ; Frakt, A. (2017, September 18). The best health care system in      the world: Which one would you pick? Retrieved September 16, 2018, from      www.nytimes.com website: https://www.nytimes.com/interactive/2017/09/18/      upshot/best-health-care-system-country-bracket.html
Bort, R. (2017, July 14). How bad is US healthcare? Among high income nations,      it’s the worst, study says. Retrieved September 16, 2018, from Newsweek      website: https://www.newsweek.com/      united-states-health-care-rated-worst-637114

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