Essay about Healthcare Models

2530 Words Nov 6th, 2014 11 Pages
Rhonda Smith
America vs. Germany
Sxtytweety566@yahoo.com
October 2, 2013

1a. What model of healthcare does US and your chosen country have? America’s healthcare model is so disorganized that we have a little bit of Beveridge, Bismarck, National Health Insurance, and Out of Pocket models. The working class is considered to be generally in the Beveridge model. Americans who receive Medicare or Medicaid are considered to be on the National insurance model. Americans with no health insurance are on the Out of Pocket model, (Reid, 2008). Germany has the Bismarck model. This model is to ensure that all people have comprehensive coverage. Germany has what they call a sickness fund that both
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They are another choice of healthcare plans that are usually less expensive, (Health Maintenance Organization, 2012). A patient has to chose a primary care physician (PCP) that works within a patients HMO, therefore the PCP takes care of all medical necessities. If a patient needs to see a specialist the patients PCP will then recommend a specialist which works within that patients HMO. HMOs are designed to give coverage to all or part of a certain county. The HMO works for you in your residential or work area unless an emergency arises or the member of the HMO has court ordered medical child support, (Health Maintenance Organization, 2012). Preferred Provider Organizations (PPO) are unlike HMOs because they don’t have to choose a PCP, no referrals for specialists; it is easier to see physicians outside of the networked plan. Physicians and hospitals along with a PPO have consented to a prearranged plan for assuring costs will be low. When using a PPO the patient does not pay for care in advance but only pays when they are treated. Seeing a physician out of the PPO network can cost you more than the discounted rate of the PPO, (Preferred Provider Organization – PPO). Exclusive Provider Organization (EPO) has a grouping of medical care providers which have a contractual arrangement with an insurer to secure health insurance to their members. Medical expenses are only reimbursed if they are from an assigned network of

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