Running head: Healthcare system for Utopia 1

Healthcare system for Utopia

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Healthcare system for Utopia 2

Healthcare systems are very important important as they help in defining what is good for

any country to be free from issues that regard good healthcare provision. In that regard, it is

deemed important to have a healthcare system that is keen on having a good approach on the

strategic dispositions for a good healthcare system. Different countries have healthcare systems

that are comparable to other systems, and this is important as it makes it possible to foresee what

is needed to classify a healthcare system as being ideal. The differences that countries have in the

healthcare systems are used to have a definition of which country is the best in such.However

‘best’ cannot be used to offer a basis upon which considerations are done. Instead, analysis on

the workability of the systems, as well as other factors that are important in a country are

considered.It is after this that a country can claim to have a system that has some workability,

with good strategies regarding how the system gets to reach many people, and how the system

relates to the national spending of the countries in question. This paper is a description of a plan

that seeks to have a definition of a healthcare system that is ideal for the growth of Utopia.The

conclusion of the workability is done with the consideration of various countries, looking at their

systems, to show whether the operations that regard healthcare systems are ideal and applicable

in different ways. Therefore, the paper seeks to discuss different countries, their healthcare

systems and a comparison that helps in formulating a good system for Utopia.

Utopia is a country that is based in Asia and is in need in a good healthcare system.The

system that is in operation has some flaws, which is an implication that a system that is better

and workable is needed so that the issues to do with health are looked into with the right strategic

dispositions. The country has had some system for health care, but nothing has proved to be

workable. The country has a devolved government system .Since the devolution of health in the

country started , there has never been a good healthcare system , and this has placed the whole
Healthcare system for Utopia 3

sector at peril.The population of utopia is forty-three million.The population is growing, and

there are anticipations that they may be a five percent increase. The birth rate is high Pertaining

the life expectancy, the country has a life expectancy of 60 years, ffrom the time one is born.

There are many deaths that are caused by injuries, adolescent pregnancies, car accidents, long-

term health conditions, mainly diabetes, and high infant mortality rate. The levels of poverty in

the country are high. Utopia is a developing country, as the levels of education are an average

rate.There has been a good increase in levels of education, since the government has offered free

education, both in primary and secondary level. The improvements on the healthcare are

important, and they should consider factors such as having the system to adopt international

standards, having good control of cost used in healthcare, issues to do with the involvement of

the private sector in healthcare as well as delivery and insurance principles in the system.

Therefore, there are the considerations of different countries, of which there are considerations of

how to have an ideal plan for Utopia.

Healthcare systems in the USA

The healthcare system in use is not an autonomous entity.It has some sectors which are

all aimed at seeing to it that there is good provision for issues to do with health. Firstly, there is

the public sector and the private sector. The working and government of these sectors have one

manner of operation, being guided by a single philosophy. This is a way that sees to it that there

are no varied methods when institutionalizing health institutions. Despite the fact that the system

has some problems, the private and public sector has comparably the same level of providence

effort medical services.

Healthcare system for Utopia 4

The USA uses many systems, regarding the classes of people. There is the use of NHI

model, where insurance money is from a program, employing both Bismarck model and

Beveridge model and out of pocket model where one pays for their medical needs.In USA, there

was an enactment of Affordable Care Act, in the year 2010, with the intent to have the liaise

between the government and other individuals to aid in having affordable health care services.

The spending on healthcare comes from different places, with the inclusion of private funding,

household, private businesses as well as public finance from the government.Most of the people

in the USA are insured in the manner of health, from both the government as well as the private

sectors.There are programs that are aimed at helping people have access to better healthcare,

with the inclusion of Medicare and Medicaid.According to Irvine and Bidgood (2013) “

Medicare is the federal government’s health programme that primarily serves Americans over

the age of 65, whilst Medicaid is a joint federal-state programme principally designed to finance

health care for the poor. Both provide care for the disabled. Together, Medicare and Medicaid

cover approximately 87 million Americans” (p2) Within Medicare and Medicaid; there is the

TRICARE which is a docket that serves those who are in the defense sector. It is still a part of

the Veterans Health Administration (VHA), which is meant to serve those who have retired from

the military.

The system has community health programmes that are used to support medication to

people, without thoughts of making a profit.According to Irvine and Bidgood (2013) “It is

estimated that by reducing costly emergency hospital and specialty care and by reducing inter

and intra community health disparities, these centers and the treatment they offer to save the US

economy approximately $24 billion a year” (p 5). Insurance covers a high percentage of the

population from the private sector.there is also the aspect of managed care, where institutions
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liaise with individuals to have the program fixed in their medical plans, in a bid to cut costs for

medical access. There is also the use of insurance that is employer provided, for those who work

and are on a salary. The health sector also has a docket that advocates for people to have health

saving s accounts.USA also has health care purchasing cooperatives, which are also known as

purchasing pools and alliances.They offer a good basis with which one has less cost for

healthcare. Whenever one is not insured on healthcare, they still receive treatment, and the

government pays the hospitals some amount as a compensation for such.There have been

reforms on healthcare, with the basis of cost, coverage, insurance exchanges, insurance reforms,

subsidies, individual mandate in healthcare, and tax when healthcare is in question. All these are

aimed at seeing to it that healthcare is fit and accessible to all.When the effectiveness of the

system is compared, the country has good provision, but there is no equity in the manner of

healthcare provision, considering that there is uneven care in the population.There are some

barriers for those without insurance coverage.The system also fails to have good usage of

preventive measures to health conditions since there is the existence of problems such as obesity,

higher ch cholesterol rates also and some disease of the heart.

Health care systems in Japan

The healthcare system in Japan has no complexities. The reason for such is that there is

the offering of medical services, with patients taking thirty percent of the cost, and the

government paying for the other seventy percent. All this is in a bid to cut the cost of healthcare

that is incurred by the citizens of that country. There is also a universal insurance policy, where

all the people are required to have insurance cover for their health needs. There is some

legislation for the hospitals in Japan, as they are required to operate without the basis of making

profit.
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Japan uses Bismarck model, where there is the use of health insurance to cater for health

needs. There is some regard in the cost for healthcare in Japan since the government sets into

moderate the cost for healthcare, which is a way that sees to it that there is no manipulation of

people from the medical care providers. Therefore, the medical fee is affordable.Insurance is

given by the age of the person who is being insured, and patients do not pay more than thirty

percent of the medical fee.There are many instances where there is a waiver in the manner of the

cost of healthcare, depending on the income that one has and their age. In such cases, there is

some reimbursement or a waiver. In case a patient has no insurance, they are supposed to pay

100 percent of the medical fee. There is also some subsidized cost for this e who are poor and

without homes. The amount of money that one pays for healthcare is regulated by the

government, by looking at how the economy is and has a definition of how to have the changes

in medical fee. According to Uetssuka (2013), “The medical fee schedule, which sets the prices

for all procedures, drugs, devices, etc., is revised every two years. The revisions are politically

negotiated at the Central Social Insurance Medical Council (CSIMC) consisting of healthcare

payer representatives, healthcare provider representatives, and neutral members representing

public interest” (p 330)

When insurance is considered, the insurance comes in two ways. For those employed,

and for the self-employed.However, there had been problems since it proves to be a heavy

burden when paying for those who are elderly, even if insured.This is because Japan is a country

with the best achievement in the longevity of life, as well as the mortality rates by infants.The

elderly, are many, and this is a problem that threatens the healthcare system in Japan. However,

the system is cost-effective as there are many who can afford to have good medical care. All this

is made even better by the aspect of Japan employing the use of generic drugs. Talking about
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drugs, the drugs that are new in the market fetch more, which opens an avenue for innovation

and improvement in healthcare systems.

Healthcare system in Sweden.

The system of healthcare in Sweden is majorly by the government. However, there are

still private institutions.The healthcare system is managed in three entities, starting from the

national level, regional levels and finally the local levels. There are also private institutions

offering healthcare. The financing is through taxes that are from the counties in the country. The

government sees to it that there is good management of hospitals at all levels.

The country uses Beveridge model, where healthcare is financed by the government,

through taxes levied on citizens. Drugs are not free. However, one pays for some amount per

annum, after which the government seeks in and pays for them.In this manner, the pharmacies

are connected to the internet, which sees to it that there is an automated system for monitoring

consumption and use of drugs. However, there have been concerns.According to Anell (2008),

“Concern for patient safety has been growing. The five most important areas with potential for

improvement are unsafe drug use, particularly among older people; hospital hygiene; falls;

routines to control for fully avoidable patient risks; and communication between healthcare staff

and patients.” (p 11) Therefore, such are some of the issues that the government of Sweden seeks

to deal with.

Health care system that is fit for Utopia

For the provision of good healthcare, Utopia seeks to use the National Health Insurance

model(NHI) This is a method that has the elements of both beverage and Bismarck models.The
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whole nation is insured for health, with the insurance companies which are not profit oriented.

The insurance companies are either public or privately owned, but directions are from the

national government. Therefore, care is not given based on how rich one is.The model is

workable since there are programs that are monitored online, over the internet, when purchasing

medicine from pharmacies.If one is not insured, they should be in a program to help cater for

medical needs. This is a strategy copied from Japanese system. People who have not attained the

age of 18 years are exempted from paying for the medical provisions, but their parents pay caters

to them.

The funding for healthcare is aimed at having equity since this kills the problems such as

those seen in the USA, where there is uneven care for patients. An implementation of an

affordable fee for all citizens is good as it offers flat rates, which are contributions for medical

care. The rates offer a standard system of care, with equalization pool to ensure equity in the

provision of medical services. The services should not be made to be like that in the USA, where

those with insurance coverage from private institutions receive better treatment. The flat rates are

in the form of taxes, like in the case of the USA having the single-payer health care or payments

that are made directly to the national funding for health. Utopia has also employed a strategy

used by Japan, where those who do not have insurance cover enter into a program by the utopian

government, to have the governance at county levels raise strategies with which such people are

given medical care.

There is a subsidy in healthcare, with organizations that are aimed at having improved

care, which is cheap, to some people when they are in some stages such as pregnancy and

childbirth. These organizations are all over and are aimed at having the assurance of equitable

medical care. There are issues with cost control since there is the need to have to pay the doctors.
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However, the use of taxes from all the citizens, with the monitoring that is done on all citizens, is

enough for such. The government has liaised with other nations to have supply if medicine at a

subsidized cost. There is cost sharing in issues to do with different types of surgery, as there is a

lot of expense in such.The patients and the government share the cost. However, when it comes

to cosmetic surgery, the patient pays the full amount, without cost sharing.Doctors receive a

monthly salary, but this is dependent on what they do. Surgeons are the ones who receive the

highest pay.

There have been issues with private sectors offer insurance services to patients, which is

why the government guides private companies on how to offer the service. The private insurance

companies still operate under the government, with flat rates being given by all citizens, despite

who insures them. When offering some improved services, the government has standardized

costs for the private institutions, to ensure they do not overcharge patients.

The delivery of services is maintained at a flat rate, with the ratios of those who go for

specialists being low.The reasons for this is the equitable system. However, there is the

allowance of one to go to a specialist, if they need to be treated with immediacy.If the situation

they are in require special treatment, they receive the treatment, with the government paying for

them.However, if patients visit such institutions without reference from the government

institutions, they pay for the extra costs.The government covers for their needs on the basis of

what it would have paid, on normal accounts.

Conclusion

In conclusion, the healthcare system is fit for all citizens. The system in Utopia views

healthcare as a social right, with equity between all citizens. The system has strengths since there
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is good monitoring on every citizen making their payments, as well as a good record on all

medical treatments.Technology has made this easy. Healthcare is a social right since the

government operates on a philosophy that no one should receive treatment that is not standard.

The weakness of our system is that it is expensive, especially when looking at the aged.Some do

not work, and the government sets in to pay for them. This system could benefit a lot from

USA‘s system of having organizations such as Medicare and Medicaid catering for many needs

by the citizens. The government, as per now, cannot finance such programs since there is a lot of

pressure on maintaining equitable care for all citizens, considering that Utopia is a developing

country, with some groups of citizens that are not employed.

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Comparative Analysis of the US, German, and Italian Healthcare System.

In Globalization and Public Policy (pp. 93-119). Springer, Cham.

Irvine, B., Clarke, E., & Bidgood, E. (2013). Healthcare systems: the USA. London CIVITAS.
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Lameire, N., Joffe, P., & Wiedemann, M. (1999). Healthcare systems—an international review:

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Medical Association journal: JMAJ, 55(4), 330-333.