Health Systems

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Japan has a universal public health insurance system that ismandatory for all citizens. Health expenditures represent 10% of thecountry’s GDP (Niles, 2015). Although most of the healthcarefacilities are privately owned, the government regulates medicalfees. However, the U.S. government does not control the fees chargedby practitioners. Japan treats chronic diseases in over 4,000comprehensive support centers (Niles, 2015). France has a socializedhealth insurance program funded mostly by payroll taxes, nationalincome tax, and tobacco taxes. 99% of French citizens benefit fromuniversal healthcare coverage. Health expenditures comprise 11% ofthe country’s GDP while American expenditures amount to 17.6% ofthe GDP (Niles, 2015). In the U.S., insurance companies withholdcoverage due to preexisting conditions. However, the Frenchgovernment limits such occurrences.

The American healthcare system exposes individuals with chronicillnesses to bankruptcy due to cost sharing. On the other hand, theFrench healthcare system provides increased care to patients withsevere illnesses (Niles, 2015). Practitioners in France pay lowermalpractice insurance premiums than American physicians since theformer country has fewer lawsuits. It is mandatory for all thecitizens in Switzerland to buy health insurance. Hence, 99.5% ofSwiss citizens have mandatory health insurance (Niles, 2015). BothSwitzerland and the U.S. allow patients to choose their preferredhealthcare providers. Individuals in the U.S. rely on insurancecompanies to cater for healthcare expenses (Niles, 2015).Nonetheless, Swiss citizens must bear the full cost of coverage.

The American healthcare system can learn various lessons from thehealthcare systems of the three countries. In Japan, large healthcareinstitutions are required to collaborate with local communityproviders. Local governments are also responsible for implementingcommunity-based initiatives (Niles, 2015). France makes extensive useof electronic health records across 6,000 institutions and 550,000patients. The French government has established a standardized systemfor patient reimbursement and physician billing using electronicfunds. Practitioners are also restricted from setting their ownmedical fees (Niles, 2015). The Swiss healthcare system hasestablished a national e-health service that allows all providers tobenefit from electronic platforms.


Niles, N.J. (2015). Analysis of the U.S Healthcare System. In Basicsof the U.S. Health Care System (pp. 368-378). Burlington, MA:Jones and Bartlett Publishers.