To some extent, the overburdened state of some US emergency rooms can be explained by the failure of our US health care system to assure that all individuals have access to primary care physicians on a timely basis thus placing excess burdens on emergency rooms, since uninsured individuals often are forced to look to emergency rooms as the only place to turn to for medical treatment. One of the major goals of the ACA is to be sure that everyone has access to good quality primary and preventive care in a timely fashion, thus reducing the burden on emergency rooms.
Since nearly all Germans have health insurance coverage, another thing that struck me was that the patients at the emergency room were being provided with care without inquiring about the ability to pay. In the U. In essence, the federal patient-dumping law entitles you to three things: screening, emergency care and appropriate transfers.
Translation of "Reform" - German-English dictionary
A hospital must provide "stabilizing care" for a patient with an emergency medical condition. The hospital must screen for the emergency and provide the care without inquiring about your ability to pay. Some insurance companies refused to pay for emergency room treatment if the medical personnel concluded that no real emergency existed and the patient was seeking care for an illness or injury that they should have brought to a primary care physician. Fortunately, thanks to the ACA, insurance companies are now required to pay for emergency room care if a "prudent layperson, acting reasonably," would have considered the situation a medical emergency.
Both Germany and the U. As our population ages, there will be an increasing need for emergency services, and pre-hospital and hospital-based practices will need to be better integrated and more efficient in the future.
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Based on the health-care presentations, Germany seems to be leading the way in delivering emergency services, especially in the Hesse region. Our two countries have much to learn from each other as we both face the growing demands for more efficient and effective emergency care. Did you find aspects which could help improve the ACA? Borzi: The search for solutions has become global in scope, as the United States looks beyond its borders to examine how other industrialized nations provide and finance health care.
The challenges currently facing the American health care system certainly are not unique; health care systems around the world are buckling under the pressures of aging populations, exploding medical cost increases, and reliance on expensive high-tech solutions and procedures. Industrialized nations all battle to balance the three shared concerns in modern health care: cost, access, and quality. I think there is a lot to learn from each country especially as the U.
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Two of the key goals of the ACA are expanding access to health coverage and increasing consumer protections through market reforms. As a result of the ACA, all Americans are required to have health insurance or to pay a fine, and insurers have to provide medical coverage, despite pre-existing conditions.
More than twenty regulations and more than thirty pieces of sub regulatory guidance have been issued to date to help the regulated community understand their rights and responsibilities under the new law. The provisions that have been implemented to date have focused on improving access to coverage, improving the quality of coverage, strengthening participant protections these provisions are also known as the Market Reform provisions , increasing the disclosures made to individuals, and preventing fraud and abuse.
To learn from one another: Exchange about the different health care systems with the American delegation during the study visit. The ACA has the potential to expand coverage to millions of currently uninsured people through the expansion of Medicaid eligibility and the establishment of Health Insurance Marketplaces, but unfortunately not everyone will be covered.
Category: Medical Administration Policy
Decreasing the number of uninsured is a key goal of the ACA, and my agency is committed to continue to work towards this goal. In Germany, the people that are not covered have chosen to opt-out and purchase private insurance through the private German market, which looked similar to the U. I am glad to say the U. Rising health care costs are one of the most contentious issues and a matter of great concern for policy makers worldwide. Another area where both countries could learn from each other in the international marketplace is the area of increasing pressures of rising health care costs and finding specific techniques to more effectively cut and contain those costs.
No one country seems to have a long-term solution on how best to tackle this problem.
Rising health care costs have triggered cost-containment measures, and this has led certain specialties within the health-care system to become less financially attractive for physicians due to reimbursement schedules, creating a trend among doctors and nurses to choose better paying specialties, and in the end creating a shortage of primary care physicians. Both countries could learn from each other concerning the problem of a shortage of medical personnel, primarily primary care doctors and nurses. Section 6 outlines to what extent the various coalitions that governed between and differed in their approach to health policy.
Gesundheitswesen : German » English | PONS
Finally I take a look forward at future developments in health policy. German health insurance is divided into two systems: statutory health insurance and private health insurance. About 90 percent of the population is covered by statutory insurance generally under compulsory insurance cover , while private insurance--to which only civil servants, the self--employed and high--earning employees have access--covers about 10 percent of the population. Whereas private health insurance is governed by the principles of the insurance market, in the statutory health insurance system the state guarantees members almost universal access to health services, even if these days patients also have to carry considerable charges themselves.
Health service financing is accomplished almost exclusively through contributions representing a fixed percentage of gross wages on the principle of equivalence and borne in almost equal parts by employers and employees. Health service provision is based on the special position of the practicing doctor, generally working in his or her own practice. In the ambulatory sector fund members have the right of free choice of doctor and can consult a specialist directly, but outpatient treatment in hospitals is possible only in exceptional cases.
The almost health insurance funds--between which the insured can choose freely--and their umbrella organizations are of primary importance for regulating the system. Within a given legal framework the insurance funds and their umbrella organizations conclude contracts with service providers doctors, hospitals, pharmaceutical manufacturers, etc. The regulatory system is strongly sectoral differentiated, with each individual sector characterized by its own complex mix of state, corporatist and market management elements.