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International Health Systems

Ashley Bryan

School of Health Professions and Wellness, Jacksonville State University

NU710: Healthcare Policy and Finance

June 1, 2020
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INTERNATIONAL HEALTH SYSTEMS

International Health Systems

The purpose of this paper is to discuss the different healthcare systems in

the United States, Germany, Canada, United Kingdom, and Japan. The paper

will describe the most effective healthcare system based on the lowest cost, most

extended living, lowest infant mortality rates, and how it is most useful for that

specific country. Three recommendations will be provided to help improve patient

outcomes in the United States healthcare system after comparing data from

other international healthcare systems.

Criteria United Germany Canada United Japan

to States Kingdom
Evaluate
Healthcar The United Germany has a Canada has a National Japan's
e States has a self- publicly health governme
Philosop hybrid health administering funded service nt
hy system. health care healthcare (NSH) regulates
There is not system, and system with provides the
a uniform everyone must fundamental comprehen universal
health have values of sive care in Statutory
system, no insurance, fairness and the United Health
universal funding equity Kingdom. Insurance
health care through demonstrated Patients are System
coverage, premiums paid by shared referred to a (SHIS). It
and only by employees, resources hospital by is publicly
recently uses the and their financed
enacted principle of responsibilitie general health
legislation self- s. practitioner. insurance,
mandating governance, Treatment and
healthcare and solidarity. is free to everyone
coverage for the patient is
almost and is mandated
everyone. funded by to enroll.
government The
revenues. majority
holds
private
health
insurance
but is only
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INTERNATIONAL HEALTH SYSTEMS

beneficial
as a
suppleme
ntary role.
Access Primary care Outpatient care Primary Individuals SHIS
to Care providers consists of self- healthcare can register plans all
Model-- can refer to employed services are with an provide
(How a specialist, doctors and the first step, NHS the same
does a offer other health including general benefits
citizen of preventative care prevention, practitioner package,
this care, and professionals. treatment, who which is
country illness The doctors essential provides determine
get into treatment. can refer you emergency care d by the
the Emergency to a specialist. services, and through governme
healthcar medical Inpatient care referrals. primary nt.
e services treats all Secondary care, Hospital,
system? provide patients functions are hospitals, primary,
How do basic and regardless of hospitals and and specialty,
they gain advanced private long-term community mental
access to life support. statutory health care facilities. health care. health
personal Uninsured insurance. Supplementar Dentistry, care,
health patients may Rehabilitation y services are pharmaceut prescriptio
services not have the facilities are for children, ical, and n drugs,
to same help available for low-income ophthalmic home
achieve as insured after surgery, residents, or services services,
the best patients to recovering seniors. have hospice,
health gain entry from illness, or charges and most
outcome into the for mental that are dental
s?) healthcare illness and below the care is
system. addiction. full cost of covered.
services. Preventati
ve
measures
are
included,
and
cancer
screening
s are by
municipali
ties.
Cost to Health care Health care Health care Health care Health
Consume spending per spending per spending per spending care
rs capita by the capita by the capita by the per capita spending
source of source of source of by the per capita
funding in funding in funding in source of is $4,152,
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INTERNATIONAL HEALTH SYSTEMS

the United Germany is Canada is funding in $126 out-

States is $5,056 of $3,466 of the United of-pocket,
$4,993 of public public Kingdom is All
public spending, $192 spending, $3,107 of enrollees
spending, for private $759 for public have to
$4,092 of spending, and private spending, pay 30%
private $738 for out-of- spending, $207 of coinsuran
spending, pocket and $749 for private ce for
and 1,122 of spending. out-of-pocket spending, services
out-of-pocket spending. and $629 or goods
spending. for out-of- received.
pocket
spending.
Average The average The average The average The The
Age of age of death age of death age of death average average
Death for the for Germany is for Canada is age of age of
United 81.1 years of 84 years of death in the death in
States is age. age for United Japan is
78.6 years of females and Kingdom is 87.2 years
age. 79.9 years of 82.7 years of age for
age for of age for females
males. females and and 81.1
79.2 years years of
of age for age for
males. males.
Infant 5.80 deaths 3.40 deaths 4.50 deaths 4.30 deaths 2.0 deaths
Mortality per 100,000 per 100,000 per 100,000 per 100,000 per
Rate live births. live births. live births. live births. 100,000
live births.
Obesity The obesity The obesity The obesity The obesity The
percenta percentage percentage for percentage percentage obesity
ge for the Germany is for Canada is for the percentag
United 24%. 26%. United e for
States is Kingdom is Japan is
40%. 29%. 4%.
Major  Ischemic  Ischemic  Ischemic  Ischemic  Alzhei
Diseases heart heart heart heart mer's
Affecting disease disease disease disease diseas
the  Lung  Alzheimer's  Alzheimer'  Alzheim e
Populatio
cancer disease s disease er's  Ische
n
 Self-harm  Stroke  Lung disease mic
 Cirrhosis  Lung cancer  Stroke heart
 Alzheime cancer  Stroke  COPD diseas
r's  COPD  COPD  Lung e
disease  Colorectal  Colorectal
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INTERNATIONAL HEALTH SYSTEMS

 Colorecta cancer cancer cancer  Stroke

l cancer  Chronic  Lower  Lower  Lower
 Congenit kidney respiratory respirato respira
al defects disease infection ry tory
 Lower  Lower  Diabetes infection infectio
respirator respiratory  Chronic  Colorect n
y tract kidney al  Lung
infection infection disease cancer cancer
 Hypertensiv  Breast  Breast  Colore
e heart cancer cancer ctal
disease  Prostate cancer
 Breast cancer  Stoma
cancer  Pancrea ch
 Cirrhosis tic cancer
cancer

Most Effective International Health Plan

Japan's health care system is considered one of the best in the world (Zhang &

Oyama, 2016). Japan is the most effective healthcare system out of the United States,

Germany, Canada, Japan, and the United Kingdom. Japan was chosen based upon the

access to healthcare, the cost of individual healthcare, the population's average age of

death, the percentage of obesity, and major diseases affecting the society. Japan's

healthcare philosophy provides health care services based on what is necessary and

adequate by the universal health care system (Zhang & Oyama, 2016). The citizens of

Japan are mandated to enroll in the Statutory Health Insurance System (SHIS) based

on employment status, age, and place of residence (Matsuda, n.d.). The majority of the

population holds private health insurance but usually only acts as supplementary or

complementary (Matsuda, n.d.). A form with name, address, and monthly income

should be completed at the National Health Insurance Department to enroll in the

program (Matsuda, n.d.). Hospital, primary, specialty, mental health care, approved
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prescription drugs, home care services, hospice, physiotherapy, and most dental care is

covered under the package (Matsuda, n.d.).

The leading causes of death in Japan is Alzheimer's disease, ischemic heart

disease, stroke, lower respiratory infection, lung cancer, and colorectal cancer (Institute

for Health Metrics and Evaluation, 2019). Healthcare spending per capita is 4,152 and

$126 out-of-pocket in 2014 (Matsuda, n.d.). The prevalence of obesity is 4% in the

population of Japan (Matsuda, n.d.). The infant mortality rate is 2.0 deaths per 100,000

live births (Central Intelligence Agency, 2019).

Recommendations

Stanford University's Graduate School of Business provided three

recommendations to transform American Health Care. The article offers popular

business strategies that hospitals should adopt (Pearl, 2015). A model of inefficiency is

the U.S. health care system (Pearl, 2015). Consolidate services for better quality and

lower costs by closing hospitals that have low volumes and idle capacity (Pearl, 2015).

The second recommendation is to eliminate the fee-for-service payment system (Pearl,

2015). This model reimburses physicians and hospitals based on the volume of services

performed, instead of the quality of outcomes achieved and appropriateness of services

(Pearl, 2015). Embracing technology is the third recommendation provided in the article

(Pearl, 2015). A comprehensive electronic health record connecting physicians and

hospitals in the community that gives information about every point of contact should be

utilized (Pearl, 2015). When the provider is aware of the medications a patient takes,

preventive screenings required, and other tests, physicians have ordered the
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opportunity for best outcomes and reduce costs are optimized due to a decrease in

inefficiency and redundancy (Pearl, 2015).

Conclusion

In conclusion, Japan is the most effective health care system when compared to

the United States, the United Kingdom, Canada, and Germany. Japan has ease of

access to healthcare, low cost of individual healthcare, high life expectancy, low

percentage of obesity, and the different major diseases affecting the society are

presented to review. The United States has room for improvement in the health care

system. The Stanford Graduate School of Business provides a detailed article on

improving healthcare with the first three recommendations discussed. Consolidating

services for better quality, lower costs, eliminating the fee-for-service payment system,

and embracing technology are all steps towards transforming the American health care

system (Pearl, 2015).

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References

Britannica. (2020). Health and welfare, The national health service.

https://www.britannica.com/place/United-Kingdom/Health-and-welfare

Central Intelligence Agency. (2019). Country comparison: Infant mortality rate.

https://www.cia.gov/library/publications/the-world-factbook/rankorder/

2091rank.html

Department for Professional Employees. (2026). The U.S. health care system: an

international perspective. https://www.dpeaflcio.org/factsheets/the-us-health-

care-system-an-international-perspective

Government of Canada. (2019). Canada's health care system.

https://www.canada.ca/en/health-canada/services/health-care-system/reports-

publications/health-care-system/canada.html

Healthy People 2020. (2020). Access to health services.

https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-

Services

Institute for Health Metrics and Evaluation. (2019). Canada.

http://www.healthdata.org/canada%20

Institute for Health Metrics and Evaluation. (2019). Germany.

http://www.healthdata.org/germany

Institute for Health Metrics and Evaluation. (2019). Japan.

http://www.healthdata.org/japan

Institute for Health Metrics and Evaluation. (2019). The United Kingdom.

http://www.healthdata.org/united-kingdom
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INTERNATIONAL HEALTH SYSTEMS

Matsuda, R., (n.d.) The Japanese health care system. The Commonwealth Fund.

https://international.commonwealthfund.org/countries/japan/

National Center for Biotechnology Information. (2018). Health care in Germany: The

German health care system. https://www.ncbi.nlm.nih.gov/books/NBK298834/

Pearl, R., (2015). Three ways to transform American health care.

https://www.gsb.stanford.edu/insights/three-ways-transform-american-healthcare

Tikkanen, R., (2020). Multinational comparisons of health systems data, 2019. The

Commonwealth Fund.

https://www.commonwealthfund.org/sites/default/files/2020-01/Tikkanen_multinat

ional_comparisons_hlt_sys_data_2019_01-30-2020.pdf

Zhang, X., Oyama, T. (2016). Japan and reviewing the local public hospital reform.

https://pubmed.ncbi.nlm.nih.gov/27051323/