Health Care Systems

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Health Care Systems
Tamara Leung
Florida Hospital College of Health Science
DADI494

Professor Slockett
January 20, 2013

Abstract

The primary objective of any health care system is to provide adequate and effective medical care to the population. Health care systems may vary due to political and other factors. Factors may include location, access to care, basic needs of the populations as well as economic status. However, the primary goal remains the same. Because of the ongoing need for government to allocate funds to the medical budget their involvement in health care cannot be discounted.

This paper introduces two major health care systems. First that of the Netherlands and secondly, the United States. The pros and cons will be discussed, as well as the role and function of the government as it relates to health care. A compare and contrast of the differences and similarities of both systems will be made. Health Care Systems

The Netherlands
The health care system in the Netherlands is comprised of three distinct compartments and is mandatory for all residents and non-resident who pay Dutch income tax. They are required to purchase health insurance coverage, except for those with conscious objections and active members of the armed forces. Coverage is mandatory under the health insurance act provided by private insurance companies and regulated under private law. One percent of the Dutch population were uninsured in 2009 and approximately sixteen percent between the ages of twenty and thirty years. Those who failed to pay premiums for at least six months are also known as defaulters. (Westert & Klazinga, 2011, p. 1) Insurance companies are forbidden to perform “risk assessment” that deny coverage based on pre-existing conditions, risk factors based on age, gender, or health profile. Tax credits make the package affordable for those who have low income while those who have no income receive coverage as part of their social assistance package. (Daley & Gubb, 2011) The government provides health care allowances also known as premium subsidies for low-income families if their premium exceeds five percent of the household income. (Westert & Klazinga, 2011, p. 80) Individuals who do not sign up for health care coverage are subject to a tax fine of one hundred and thirty percent of the premium. (Daley & Gubb, 2011) The Exceptional Medical Expenses Act regulates the first compartment. (Daley & Gubb, 2011) Contributions were taken as a 12.55% salary deduction and further supplemented by a government grant. (Daley & Gubb, 2011) Basic insurance packages include General Practitioner, Hospital specialists, Midwives, as well as hospitalization, dental coverage up to the age of eighteen after which only specialist dental care is covered (dentures e.g); medical aides such as home health care and medical equipment pharmaceutical care, maternity, ambulance and patient transport services, paramedical care, mental health and limited lifestyle improvement (smoking cessation programs e.g.). In vetro fertilization is also covered for the first three attempts. (Westert & Klazinga, 2011, p. 1-2) The second compartment deals with basic and essential needs. These medical needs are first treated by a General Practitioner. Every resident and non-resident must be registered with a General Practitioner who oversees basic care including, physicals and common illnesses. In the event specialized care is needed, patients are referred to a Nurse Specialist who is responsible for giving medical treatment. This may include information pertaining to prevention, education, social and psychological support. ("Nursing," n.d) For example if a patient is diagnosed with Diabetes Mellitus their first encounter is with the General Practitioner who makes the diagnosis, and puts together a team consisting of the Diabetic Nurse Specialist and an Endocrinologist. The Endocrinologist supervises the Nurse Specialist who in turn...
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