Question

1. Description of Health Care System
   1. Does it include universal coverage or not?
   2. Different health care services offered
   3. How is the system set up?
   4. What roles do nurses and advanced practice nurses play in the system?
   5. Is the system based on a preventative care model?
   6. Provide a detailed description of the health care system.
2. Costs of Health Care System
   1. How is the health care system paid for?
   2. What is the responsibility of the individual, state, local, and government?
   3. How do patients without insurance or ability to pay access health care?
   4. Are there differences in coverage based on an income?
   5. Is there a private system, public system, or combination of both?
3. Outcomes/Satisfaction of the health care system (minimum three references)
   1. Describe the positive and negative aspects of this health care system as documented in the literature.
   2. What are the strengths and weaknesses of this system?
   3. Are the residents  of this country satisfied with this system?
4. Differences with US Health care System
   1. Describe how this health care system is different than the US health care
   2. Compare and contrast the health care system you have chosen with the US health care system.
   3. Identify the pros and cons of each system as well as similarities and differences

Answer 1

Ans 1

A health system, also sometimes referred to as health care system or as healthcare system, is the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations.

Ans 2

Universal healthcare (also called universal health coverage, universal coverage, or universal care) is a health care system in which all residents of a particular country or region are assured access to health care. It is generally organized around providing either all residents or only those who cannot afford on their own, with either health services or the means to acquire them, with the end goal of improving health outcomes.

Universal healthcare does not imply coverage for all cases and for all people – only that all people have access to healthcare.

Ans 3

Providing health care services
• Health care facilities (rural clinics, health centres) should be within easy walking
distance of the community, particularly for women and children.
• Outreach or primary health care workers, such as health visitors and pro-
moters, can be valuable front-line community health workers if they are provided
with adequate training and support, particularly if they come from the community
itself.
• Other health service providers (pharmacists, medicine sellers, traditional healers)
can provide additional health advice and care if they are given adequate training
and support, and are supervised by medical staff.
• Referral systems between different levels of health care (primary, secondary and
tertiary) should be clear and comprehensible to both users and providers. The
reasons for referrals are often unclear to the users, which can provoke anxiety and
lead to non-attendance. In addition, many primary- and secondary-level health
care workers may not understand how to refer a patient to higher levels of service,
or may not recognize symptoms of more severe illness, which leads to dangerous
delays in referral.

Ans 4 -

Implicitly, nations must design and develop health systems in accordance with their needs and resources, although common elements in virtually all health systems are primary healthcare and public health measures.^[1] In some countries, health system planning is distributed among market participants. In others, there is a concerted effort among governments, trade unions, charities, religious organizations, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve.

Ans 5

The primary role of a nurse is to advocate and care for individuals of all ethnic origins and religious backgrounds and support them through health and illness. However, there are various other responsibilities of a nurse that form a part of the role of a nurse, including to:

• Record medical history and symptoms
• Collaborate with team to plan for patient care
• Advocate for health and wellbeing of patient
• Monitor patient health and record signs
• Administer medications and treatments
• Operate medical equipment
• Perform diagnostic tests
• Educate patients about management of illnesses
• Provide support and advice to patients

The addition of nurses in advanced practice in the emergency settings enabled physicians to pay greater attention to patients of higher complexity and acuity, thereby, improving access to prompt emergency care. Time to treatment is also a priority in emergency care.

Ans 6

It is based on preventive care model

Preventive healthcare, or prophylaxis, consists of measures taken for disease prevention.Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices and are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal,primary, secondary, and tertiary prevention.

Ans 7

U.S. health care spending increased 3.9 percent to reach $3.5 trillion, or $10,739 per person in 2017.

The Government has announced Rs 69,000 crore (US$ 9.87 billion) outlay for the health sector that is inclusive of Rs 6,400 crore (US$ 915.72 million) for PMJAY in Union Budget 2020-21. The Government of India aims to increase healthcare spending to three percent of the Gross Domestic Product (GDP) by 2022.

Ans 8

There are generally five primary methods of funding health systems:^[9]

1. general taxation to the state, county or municipality
2. national health insurance
3. voluntary or private health insurance
4. out-of-pocket payments
5. donations to charities

Most country system is mix of all 5 model.

Ans 9

Everyone shall be obliged to

• refrain from any conduct or activity commonly known to endanger the health of others;
• to provide help, as could be expected of them, and to contact the competent healthcare provider should they become aware of any emergency requiring immediate assistance or any critical conditions endangering health.

Governments play a major role in health care financing by mobilizing the necessary resources through public budgets and other contributive mechanisms, pooling resources allocated to health development, guiding the process of resource allocation and purchasing health services from various providers.

Ans 10

Hospitals receive payments from state and local governments in the form of tax appropriations. The Medicare Payment Advisory Commission (MedPAC) treats these funds as reimbursement for care provided to uninsured patients. In 1999 hospitals received $2.7 billion in tax appropriations from state and local governments.

Free Health Care (FHC) policies aim to reduce the financial barriers that people experience when trying to access health services. ... These services are chosen to protect population groups deemed to be especially vulnerable, and particularly the poor.

Ans 11

Health coverage available at reduced or no cost for people with incomes below certain levels.

Examples of subsidized coverage include Medicaid and the Children’s Health Insurance Program (CHIP). Marketplace insurance plans with premium tax credits are sometimes known as subsidized coverage too.

Ans 12

Public health care is usually provided by the government through national healthcare systems. Private health care can be provided through “for profit” hospitals and self-employed practitioners, and “not for profit” non-government providers, including faith-based organizations

Ans 13

1. Improve the patient experience of care.
2. Improve the health of populations.
3. Reduce the per capita cost of healthcare.
4. Reduce clinician and staff burnout.

Ans 14

Weakness

The prevailing primary healthcare infrastructure and manpower are also very deficient. As on 2017, India's population is approximately 134 crores. There is an immediate need to address inadequate infrastructure and manpower in order to provide better service and delivery of primary healthcare.

Strength

has a strength of at least 15 people, including a Medical officer, a medical health assistant. ... Each Community Health Centre acts as a referral point for 4 Primary Health Centre. Tertiary Level: The tertiary level is the second referral level, and it includes the Hospitals and Medical Colleges

Ans 15

Resident are satisfied to some extent due to spectrum of service and care but still need improvement

Ans 16

Comparing the healthcare systems of two of the world's biggest democracies--the United States and India--highlights changes we can make to improve the access and outcomes in our own country while also bringing to the fore some of our potential strengths.

Difference-

Public health scenario

India lags far behind developed nations in the public health arena, with clean drinking water, adequate nutrition, sanitation and access to healthcare being long-standing challenges. This year's Budget, too, has come under criticism for not addressing systemic problems adequately, emphasizing instead health insurance schemes and public-private partnerships.

The picture is far rosier in the US, where per person healthcare expenditure is the highest in the world. Successive governments have consistently prioritized healthcare reforms.

2. Nature of healthcare

The Indian healthcare system can be described as 'mixed'. While the government provides healthcare at primary, secondary and tertiary levels, there is a burgeoning number of private hospitals with better medical facilities. Unfortunately, most are too expensive for the average citizen. Healthcare is taken far more seriously in the US, as we have already seen.

3.Vast difference in spends as % of GDP

In India the total expenditure on healthcare as percentage of GDP is just 4%, while in the US it is 17%. According to World Health Organization (WHO) data for countries performing best in the healthcare sector, the US ranks 37, while India stands at 112. While the US can still improve and learn more from the top performers, India still has a long way to go.

4. Out of the pocket expenditure

A whopping 70% of the Indian population pays out of their own pocket for medical expenditures. This typically strengthens the financial mechanism of the insurance sector. In the US, the out of the pocket expenditure is much lower at 10-12%.

5. Health insurance is mandatory in the US, unlike India

In the US, it's mandatory to get health insurance and you have to pay a penalty if for some reason you choose not to get it. Employers in the US, as per government guidelines, are supposed to provide health insurance to their employees. None of the above holds true in India, where the provision or purchase of health insurance is up to the discretion of employers or individuals.

6.Scope of coverage

In the US, health insurance cover is generally comprehensive, and includes everything from consultations for, say, a fever to hospitalization. However in India, visits to physicians are not covered under insurance. Only 30 days pre-/60 days post-hospitalization are covered, depending on terms of the policy. The other expenses are to be borne by the individual.

7. Premium charges

Since a larger number of people are covered under health insurance policies, with larger scope and a much higher standard of living, the premium rates are generally higher in the US. In India, since the health insurance policies are taken by a lesser percentage of the population and owing to cut-throat competition amongst various insurance companies, the premiums are much lower.

8. Differentiation in states

The US is a federation of various states, each of which has different regulations. This also has an impact on the health insurance rules and provisions, which differ from state to state. India, on the other hand, is a republic and the same rules apply across all states. Therefore a health insurance policy will have the same rules and regulations across the country.

Similarities

In both india ind usa health care lags far behind in rural area as conpare to urban area. So proper spectrum of service in every area is needed in both system.