Instructions
To complete this assignment you will investigate how a country of your choice has dealt with the task of providing health care to its residents. You may choose any country that is not covered in the textbook. That means the United States, Canada, Germany, Great Britain (England, Scotland, and Wales), China, Mexico, and the Democratic Republic of Congo are excluded. Your goal is to become an “expert” in this country’s health care system. In writing the paper, you can use the following or some other outline, so long as you address all the points, or at least describe your attempts to do so, and so long as the paper is well organized and easy to read. Remember that your task is an educational one: you are teaching your readers about the health care system you have adopted. Papers should be 4-5 pages plus references. Each project should include at least four sources, cited using ASA format.
Introduction: First, you will briefly describe how the country developed the system it currently has; that is, you will provide the historical background, including information about the political struggles among different stakeholders (doctors, private insurance companies, pharmaceutical companies, individuals of different political orientations, or anything interesting you might find).
Analysis: It should include all of the following issues, or at least your attempts to find information about them.
1) Coverage
a. Who is covered?
b. What is covered?
2) Financing
a. What rule is used to collect money (income, health status)?
b. Who administers the money (government, mutual funds, or private insurers)?
c. Is there cost-sharing? Of what type? If so, who shares the cost?
d. Role of Private Insurance: You should also find out if, if there is an amount of coverage guaranteed by a national program, whether private insurers are allowed to offer insurance for guaranteed services, and under which conditions.
e. Cost Control: Is “cost sharing” (shifting costs to consumers) used as a mechanism of “cost control” (for the system, or to make “consumers” more “cost conscious,” yet maybe posing financial barriers to at least some individuals)? You may also want to find out how services are paid for, for instance, whether doctors are paid fee-for service, a fixed amount per patient (capitation), a salary, or some mix of all of these; whether there are drug formularies for drugs; and whether hospitals are adjudicated a global budget or an amount per condition or disease they treat (Diagnostic Related Groups or DGR). The ability of a system to use global budgets, fee schedules, capitation or drug formularies reflects the purchasing power of large pools (if payers are divided, they have little bargaining power vis-a-vis providers).
3) Delivery: You will examine questions of delivery; that is, the ratio between primary care doctors and specialists; whether doctors work solo, in group practices, as employees of medical institutions; whether there are “gate-keepers” (i.e. primary doctors who refer patients to specialists, etc.); whether the system uses electronic medical records, etc., and what, in your view, might be the implications of those features of organization of delivery for the efficiency of the system.
Conclusion/Discussion: Strengths and weaknesses, recommendations, commodity vs. social right, further questions
In your conclusion, you will discuss the strengths and weaknesses of the system. You also need to discuss whether, in your view, the country in question considers health care a commodity or a social right, and on what grounds you make the claim.
Final Note: Your main source of information will most likely be the Ministry of Health of the country you choose (the United States does not have one, but most other countries do), but you can also research any public or private institution that produces policy papers. You may also investigate whether the media has anything to say, here or through the media of the country you’re investigating. You can add tables or figures if they help your reader understand some point.
Each project should include at least four sources, cited using ASA format.
