team 6 germany vs united states

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Compartive Health Care Project

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Comparative Health Care Project Germany VS United States:

Comparative Health Care Project Germany VS United States Team 6: Melissa Wilson, Rhonda Coffman, Elizabeth Hinzmann, & Marcia Plioplis

Population:

Germany United States Size 81,471,834 (16 th Largest) 313, 232,044 (3 rd Largest) Age Distribution 0-14 years 13.3% 15-64 years 66.1% 65+ years 20.6% 0-14 years: 20.1% 15-64 years: 66.8% 65-+ years: 13.1% Gender 0.97 males/females total population .97 males/female total population Age 44.9 years Median Age 36.9 years Median Age Ethnicity: German-91.5%, Turkish-2.4%, other-6.1%. White-79.96%, Black-12.85%, Asian 4.43%, Amerindian & Alaska Native-0.97%, Native Hawaiian & other Pacific Islanders-0.18%, Spanish/Hispanic/Latino-15.1%, two or more races-1.6% (2007 est.) Language: Literacy: German 99% of population age 15 and over can read and write. English 82.1% & Spanish 10.7% & 7.2%-other 99% of Population ag e 15 an older can read and write Immigration: 0.54 migrants/1,000 population (2011 est.) 4.18 migrants/1,000 population (2011 est.) Population

Geography & Climate:

Geography & Climate Germany United States Location Central Europe North America Size 357,022 sq. km 63 rd (Largest) 9,826,675 sq. km 3 rd (Largest) Density/Distribution of population (rural & Urban) Urban-74% of population Rural-28% of population Urban -82% of population Rural-18% of Population Major Population Centers Berlin (capital), Hamburg, Munich, Cologne New York, Los Angeles,, Chicago, Miami, Washington D.C. (capital) Transportation Airports, railways, roadways, waterways. Airports, railways, roadways, and waterways. heliports Petroleum: 244,620 km Natural Gas: 548,665 km Unique features of climate Temperate and marine; cool, cloudy, wet winders and summers Most temperate, tropical in Hawaii & Florida, artic in Alaska.

Historical & Current Socio-Cultural & Economic Features & Issues:

Historical & Current Socio-Cultural & Economic Features & Issues Germany United States Employment by Occupation Services-67.8% Industry-29.7% Agriculture-2.4% Managerial, professional, & technical: 37.3% Sales & Office: 24.2% Manufacturing, extraction, transportation, & crafts: 20.3% Other services: 17.6% Farming, forestry, & fishing: 0.7% Major Industries (Agriculture, service, & Manufacturing) Potatoes , wheat, barley, sugar beets, fruit, cabbages, cattle, pigs, poultry. One of World’s Largest and technologically advanced producers of iron, steel, coal, cement, food and beverages, shipbuilding, textiles. Wheat, corn, fruit, vegetables, cotton, beef, pork , poultry, dairy, fish, & forest products High-technology innovator-petroleum, steel, motor vehicles, aerospace, telecommunications, chemicals, electronics, food processing, consumer goods, lumber, mining. Exports Imports 1,.303 Trillion: Machinery, vehicles, chemicals, and household equipment. 2 nd largest after the U.S. 1.099 Trillion: Fossil fuel, oil, and natural gas. Machinery, vehicles. $ 1.289 Trillion: agricultural , industrial, capital goods, motor vehicle, computers, telecommunications, consumer goods. $ 1.936 Trillion: agricultural, industrial, capital goods, computers, motor vehicle parts, electrical power machinery, consumer goods.

Historical & Current Socio-Cultural & Economic Features & Issues:

Historical & Current Socio-Cultural & Economic Features & Issues Germany United States Per capita income 35,950 46,790 Poverty (Unemployment rate) (population below poverty rate) 7.1% 15.5% 9.6% 12% Major Religions Protestant-34%, Roman Catholic-34%, Muslim-3.7%, unaffiliated or other-28.3% Protestant-53.1%, Roman Catholic-23.9%, Mormon-1.7%, other Christian-1.6%, Jewish-1.7%, Buddist-0.7%, Muslim-0.6%, other or unspecified-2.5%, unaffiliated 12.1%, none-4%. Quality of Life Index (2011 ranking) 9 31

Historical & Current Socio-Cultural & Economic Features & Issues:

Historical & Current Socio-Cultural & Economic Features & Issues Germany Unite d States Educational systems Mandatory 6 to 14 years, public state run school, it’s free. Average years of education: 16 years M/F At age of 10 they attend 1 of 4 schools for track of university, technical field or trade. Kindergarten, Primary, Secondary, Post Secondary prep for university exam. Mandatory 5 or 6 to 16 years. Depends on state. Free public and private paid schooling Average years of education: 15/17 years for M/F Pre-primary, primary, middle, secondary, post-secondary. Lifestyle issues Societal issues middle-class society, universal health care, high education, technology development, and economic production. Oldest social welfare program-1880’s Low birth rates and decrease immigration -illicit drugs, obesity-biggest of European lifestyle. Air pollution, unemployment. Rise of elderly-the baby boomers. Big on Nationalism often expressed through sports. Melting pot-high number of immigrants. Pollution, illicit drugs, middle of health care reform, unemployment, high crime, obesity. Role of family and family members in decision making Nuclear Families with or without children Keep relatives close Retain small town ethos Practice authoritarian or anti-authoritarian personality in child rearing. Mom are more likely to take care of the children and household then men. Nuclear families with children. Both men and women in workforce and participating in child rearing. Women & Men have high status in society. Men-greater societal and economic benefits.

Health Information & Vital Statistics:

Health Information & Vital Statistics Germany United States Birth rate 8.3/1,000 population 13.83/1,000 population Death Rate 10.92/1,000 population 8,38/1,000 population Major causes of death and illness Heart disease, stroke, and cancer Heart Disease, cancer, stroke, Chronic respiratory disease, and accidents. Life expectancy 80.07 total population 78.37 total population Total expenditure on health care as per percent of GDP 11.2% 16.2%

Government:

Government Germany United States Type Federal Republic, parliamentary and democratic constitution. Constitution based federal-republic: democratic based. Organization President: Christian WULFF-elected for 5 year term. Civil law system Branches: executive, chancellor bicameral legislative, and judicial -independent. Federal constitutional court Diplomatic representative in the U.S. President: Barack OBAMA-elected for 4 year term. Common law system Branches: chief of state and head of government, Vice President, congress bicameral legislature, and judicial supreme court. Diplomatic representative in Germany. Role of people 17-23 years M/F voluntary military service. Suffrage: 18 years of age. Democratic 1 8 years M/F voluntary military service 17years need parent consent Suffrage: 18 years of age. Democratic

Organization, Financing, and Delivery:

Organization, Financing, and Delivery Germany VS United States

Organization:

Organization Germany United States Mix of profit and non-profit institutions Insurance Plans Public “social system” Private Insurance Long-term care Accident insurance Mix of profit and non-profit institutions Insurance options Medicare: 65+ and those on disability Medicaid: individuals and families in poverty Private Insurance: Employer based and self-paid. Employer insurance does not generally last into retirement.

Financing:

Financing Germany United States % of GDP – 11.6 in 2009 Social insurance Mandatory contributions per employee and employer to age 65 Cost-sharing for some services Private Insurance Premiums paid per person Continue to pay premiums after retirement % of GDP – 17.4 in 2009 Government programs Medicare, Medicaid, TRICARE, Children’s health insurance program, Veteran’s Health administration Private Insurance Out of pocket- uninsured, copays, deductibles, or non-covered services

Delivery:

Delivery Medical Providers Provider Payment Services Covered Physician Education

Procedure Utilization:

Procedure Utilization 2009 Data: Procedures per 100,000 population. Retrieved from OECD.stat

Cost Control:

Cost Control -The Need for Cost Control -Issues -Measures Used to Control Costs

Cost Control:

Cost Control United States Germany 45% of health care is paid by Government; 16% are paid out of pocket Increase costs ($1.8 trillion) 47 million uninsured Medicare & Medicaid increase debt Health care reform by Obama-Universal Coverage 78% of health care is paid by Government; 13% are paid out of pocket People started having to pay copayments

Quality of Health Care:

Quality of Health Care -How Quality is Evaluated -Outcomes: Mortality, Morbidity, Life Expectancy, Wait Time, Treatments & Procedures, Immunization Rate, & Satisfaction

Quality of Health Care Evaluation:

Quality of Health Care Evaluation United States Germany WHO ranks them 37th in the world in health care WHO ranks them 25 th in world in health care -Both use quality assurance to evaluate their health care.

Outcomes United States:

Outcomes United States Life expectancy: Total-78.1 Men-75.4 Women-80.7 Mortality: Under-5 mortality (per 1,000 live births) Males-8, Females-7; Adult mortality (per 1,000) Males-137, Females-81 Morbidity: (see graph) Wait time: 8.6 days, Specialists: 20.5 days Immunization Rate: Over 90% (examples-HepB3-91.3%, MMR-90%, Polio-92.4%) Satisfaction: 82% believe system needs changed

US Mortality:

US Mortality

Outcomes Germany:

Outcomes Germany Life expectancy: Total-80 Men-77.4 Women-82.67 Mortality: Under-5 mortality (per 1,000 live births) Males-5, Females-5; Adult mortality (per 1,000) Males-112, Females-58 Morbidity: (see graph) Wait time: Government doesn’t keep track of but may wait 4 wks to see specialist Immunization Rate: Over 90% (examples-HepB3 90%, Rubella-96%, Polio-95%) Satisfaction: 78% believe system needs changed

Germany Mortality:

Germany Mortality

Policy Recommendation:

Policy Recommendation The United States is the only developed country without any type of universal healthcare Would the United States benefit from providing universal healthcare to its citizens?

Germany’s Health Care Experience :

Germany’s Health Care Experience *Good: Overall a positive experience WHO ranked 25th in the world in health care 78% of people believe an overhaul is needed *Bad: Start paying copays Lack of funds to pay doctors Possibly not enough money to offer Universal Health system in the future -Germany mandates health insurance to all citizens

United States Health Care Experiences:

United States Health Care Experiences Best modern technology Society “Time is Money” 3.6 days shorter for hospital Length of Stay WHO ranks it as 37th in the world in health care 82% of people believe a overhaul is needed

Possible Consequences :

Possible Consequences *Good: All people will have access to healthcare Health care costs will decrease Health care promotion=Improved patient outcomes *Bad: More money = better health care assess Less offered during hospitalization Insurance Companies will run out of business

Conclusion:

Conclusion No health care is ever perfect! A mixture of public and private insurance would probably help the United States to address the two very important issues faced today: R ising health care costs G rowing number of people without health care insurance

References:

References American Journal, (99)3, p.12. Retrieved September 19, 2011, from eLibrary Around the World. Retrieved September 11, 2011, from The Cato Institute Web site: http://www.cato.org/pub_display.php?pub_id=9272. Bureau of European and Eurasian Affairs. (2011). Background note : Germany . Retrieved from http:// www.state.gov/r/pa/ei/bgn/3997.htm#people Busse, R., Nimptsch, U., Mansky, T. (2009). Measuring, monitoring, and managing quality in Germany’s hospitals. Health Affairs, 28(1), w294-w304. doi: 10.1377/hlthaff.28.2.w294 Busse, R., & Stock, S. (2010). The G erman health care system, 2009. In International profiles of health care systems:  Australia, Canada, Denmark, England, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States (pp. 28-31). Retrieved from www.thecommonwealthfund.org

References:

References Center of Disease ContFriedman, G. (2011, July/August). Universal health care: can we afford anything else? Dollars & Sense, pp. 13-17. Retrieved from http://www.dollarsandsense.org/archives/2011/0711friedman.html Government Accounting Office Report (2008, January 18). Other countries’ experiences provide useful rol. (2011). Leading cause of death in the United States. Retrieved from http://www.cdc.gov/nchs/fastats/lcod.htm CIA. The World Factbook. (2011). Germany and United States Facts . Retrieved from https://www.cia.gov/library/publications/the-world-factbook/ Countries and their Cultures. (2011). Germany and United States lifestyle. Retrieved from http://www.everyculture.com/Ge-It/Germany.html Gunter, L. (2011, May 15). For health care, blended system is best; a combination of public and private is most effective, new study shows. Edmonton Journal, p. A10. Retrieved September 21, 2011, from http://www.edmontonjournal.com/health/health+care+blended+system+best/4786102/ story.html

References:

References Experiences of patients with complex health care needs, in eight countries, 2008.  Health  Affairs, 28(1), w1-w16.  doi:  10.1377/hlthaff.28.1.w1 Epstein, G. (2011, May 2). Grow up, guys! Barron’s, pp. 23-26. Retrieved from http://online.barrons.com/article/SB50001424052970203579804576285360815252024.html Health Care Reform. (2011). The New York Times. Retrieved from   http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html. insights for the United States. Federal Document Clearing House. Retrieved September 19, 2011, from http://www.gao.gov/new.items/d08372.pdf Quality of Life Index. (2011). Germany and United States QLI index. Retrieved from http://nationranking.wordpress.com/2011/03/06/2011-qli/

References:

References Organisation for Economic Co-operation and Development. (2011, April). Statistics. Retrieved  September 21, 2011, from http://stats.oecd.org/index.aspx Pappas, S. H. (2009).  Profits, payers, and patients:  Responding to changes.  Nursing Management, 40(4), 31-35.  Retrieved from www.nursingmanagement.com Quality of Life Index. (2011). Germany and United States QLI index. Retrieved from http://nationranking.wordpress.com/2011/03/06/2011-qli Reinhardt , U. (2011). Not the American way perspective: Germany’s health care system. Health  Affairs. 13(4): 22-24. Schoen , C., Osborn, R., How, S. K., Doty, M. M., & Peugh , J. (2009).  In chronic condition: Tanner , M. (2008). The grass is not always greener: A look at national health care systems Thompson , E. (2009). Wait times to see doctor are getting longer. USA Today.  Retrieved from http://www.usatoday.com/news/health/2009-06-03-waittimes_N.htm inkQuest .(1999). The German school system. Retrieved from http://library.thinkquest.org/26576/schoolpage.htm

References:

References W orld Health Organization (WHO) (2009). Data and Statistics. Retrieved from: http://www.who.int/research/enWorld Health Organization. (WHO) (2006). Mortality Germany country fact sheet 2006. Retrieved from http://www.who.int/whosis/mort/profiles/mort_euro_deu_germany Urban- Klahn , J. (2010, March 1). Health care in the United States versus the rest of the world. Polish . pdf U.S . Census Bureau. (2011). Health Insurance. Retrieved September 14, 2011, from  http://www.census.gov/hhes/www/hlthins/hlthins.html Network for Education Information.(2001). United States of American-education system . Retrieved from http://globaled.us/wwcu/background/United-States.htm

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