Health Care Comparison Amanda Rekoutis

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Health Care Comparison

Amanda Rekoutis

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USA Healthcare

Medicare is an important role in the American healthcare system. It serves more than 40 million beneficiaries in the United States. Medicare is health insurance for people 65 or older, people under 65 with certain disabilities, and people of any age with permanent kidney failure requiring dialysis or a kidney transplant. There are three main parts to Medicare; part A- hospital insurance, part B- medical insurance, and part D- Medicare prescription drug coverage. Part A Medicare helps cover inpatient care in hospitals and skilled nursing facilities, hospices, and home healthcare services. Part B Medicare helps cover doctor’s services, hospital outpatient care, and home health care. It also helps cover some preventive services to help maintain your health and keep illnesses from getting worse. Part D Medicare is an option run by Medicare-approved private insurance companies for prescription drugs. It helps cover the cost of prescription drugs and it might lower the cost of prescription drugs and prevent higher costs in the future. There is one more part to Medicare that you may have noticed is missing; part C. Part C Medicare is an advantage plan, like an HMO or a PPO, this includes parts A and B and sometimes for an extra cost it will include part D.

According to, Medicare is our most successful healthcare program but is under attack when access to healthcare in the United States is already a major crisis. This is because in 2003, the Bush Administration passed a Medicare prescription drug bill through congress that moves Medicare more toward privatization. It also forced 32.5 million seniors and people with disabilities to pay higher premiums and other medical expenses. The bill dropped coverage for out of pocket expenses between $2,250 and $5,100. It prevents lower drug costs and doesn’t do anything about how much they increase.

Medicare isn’t the only part of the US healthcare system. Another part of it is Medicaid. Medicaid and CHIP cover more than 31 million children in the US. It provides coverage for 11 million non-elderly adults including maternal health by covering 40% of all births in the US. This includes prenatal care, labor, delivery, and a 60 day postpartum period. Medicaid covers 8.8 million adults with disabilities and 4.6 low-income seniors. Medicaid is different from Medicare because it is provided by the state government instead of the federal government. It also covers a lot more people than Medicare does.

Even with these two aids at our fingertips, 47 million Americans don’t have health insurance. This is because we are struggling to pay higher premiums and deductibles and co-payments even when we can’t afford it. Prices for prescriptions are skyrocketing and there are more out of pocket doctor’s visits that can’t be paid for. Health care costs are rising at five times the rate of inflation causing families to decline coverage for individuals and the family as a whole. The main problem is that employers are not paying their fair share and are therefore forcing the healthcare costs onto employees.

I feel like Medicare and Medicaid are both great plans but we need to go back and revise them because they seem to not be working anymore. I think the problem is that we have spent so much that now we can’t cover all of the costs and we are increasing the rates people pay so that the government can pay their own costs. I don’t think we have the greatest healthcare system. A hospital visit can rack up a serious bill that people can’t afford to pay so they either enter into debt or they don’t get the care they need and suffer from something that is curable. This can result in debt as well because an individual could become too sick to work and they have to support a family with no job but they can’t afford to get better and it is a vicious cycle that results in debt either way. We also have a limited number of sick days which is ridiculous because there is no way for us to know when we will be sick or for how long. If we have a limited number of sick days, do our employers want us to come back to work when we are still contagious? I feel like after I watched “Sicko” I am biased towards our healthcare system because it seems so horrible. It isn’t ideal and there are other options that we have for healthcare that we should probably consider since things are so bad here. I wouldn’t recommend anyone to have American healthcare.

Italian Healthcare

Even though most Italians would disagree, Italy has an affordable healthcare system with a high standard of medical assistance that puts Italy at number two on the World Health Organization’s list of the country with the best healthcare. It’s the decentralized version of the British NHS. The medical staff is well trained and hospitals are comparable to anywhere in the world. Even if in some southern parts of the country the hospitals aren’t top notch. The national health system of Italy is called the Servizio Sanitario Nazioanale and it offers inexpensive healthcare to all of European citizens. It offers in-patient treatments that include tests, medications, surgeries during a hospital stay, family doctor visits, and medical assistance provided by medical specialists. It also covers drugs and medicines, out-patient treatments, and dental treatments.

If you are an employee in Italy, your employer is obligated to pay for your health insurance. You visit the local health authority, visit with your doctor, get issued a health card and a health number and then you can take that to your doctor for free visits. The doctor can then give you your prescriptions and drugs when you need them. Your family physician can issue prescriptions that you take to the pharmacy. The pharmacies are small establishments that deal only with medical related items. If you have state health coverage you qualify for a subsidized rate that reduces your cost of medicine. If you aren’t covered by the state, you have to pay in full for the medication.

Most Italians prefer private health insurance over state insurance because you can freely choose your own doctor and be treated to a private hospital, avoiding the long lines that you would run into to make an appointment with a medical specialist. The private hospitals have accommodations that are comparable to five star hotels but have a staff that is similar to public hospitals. Also, private hospitals are very expensive. Additional offers include free counseling for family and relationship problems where you can make an appointment without a doctor’s referral.

Italians are dissatisfied with their care because they believe that more patient choice will improve the quality but that doesn’t look likely anytime soon. Funding is based on the regressive payroll tax that starts at 10.6% of income for the first €20,666 and drops to 4.6% of income between €20,510 and €77,480. The completion of the funding also comes from federal and regional general taxation. Italians have a limited choice of physicians but they do have more choices than the UK or Spain. They must register with a general practitioner, GP, and for a specialist they must get a referral from their GP.

Inpatient and primary care are free however for tests, diagnostic procedures, and prescription drugs, the copayment is as high as 30%. This excludes the 40% of the population that are exempt from these copayments. The technology in Italy doesn’t compare to the technology in the US. The US has twice as many MRI machines per million than Italy and 25% more CT scanners. Also, the waiting times for diagnostic tests are fairly long. The average wait for a mammogram is 70 days and the average wait for a colonoscopy is 74 days. The sad thing is that the hospitals in northern Italy with the better equipment have longer waiting lists because of the high quality equipment.

I don’t understand much about the healthcare system in Italy, I mean I understand it obviously, but I don’t think I understand how it’s any better than the US’s healthcare system. Obviously they are charging people out of their behinds to pay for health insurance but it doesn’t seem that great either. If I were to compare it to the UK where you walk into a hospital and come out check free, it doesn’t seem very special. Sometimes in the UK, you even leave with money if you had to pay for transportation on your way to the hospital. It sounds to me like Italians still have to pay for hospital visits and medication where in the UK they only have to pay if they can afford it but if you do have to pay, all medications are only £6.65. Now I’m comparing Italy and the UK. But the point is, I don’t think there is anything extraordinary about the Italian system. It does sound a lot better than the US though. If I were to advise someone on where to live based on health insurance, I would tell them to move to Italy, the number two spot on the WHO’s list of top health care countries, or to France who holds the number one spot on the WHO’s list. Even if the Italians are unsatisfied with their healthcare system, it seems to work out just fine.

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