Sweden : A Strict Guideline For All Medical Professionals

In 2013, pharmaceutical cost per capita in the US was $1,112 compared to Switzerland’s $730. Private insurance plans widely vary on medication coverage. However, there are programs that are no cost to the individual that can decrease the cost of medications for people without

In Japan, prices for every procedure and drug are negotiated every two years between the physicians and the government. The prices are fixed and the same regardless of where you go in Japan for treatment (Reid, 2008). In the United States, different healthcare plans offer a variety of coverage for medications but some prescriptions can be denied by the insurance company based on your type of insurance plan. Drug companies are very competitive in the United States and prices are expensive. Frequently, insurance companies might cover a similar or generic form of medication rather than the brand name medication and insurance co-pays differ depending on which drug is prescribed.

In the United States, access to health care is largely determined by who has financing to receive insurance (Shi & Singh, 2013, p. 197) Financing for health care comes from many different entities. For most Americans who have health insurance through their employment, the employers pay a part of the insurance premium and employees pay the rest (Shi & Singh, 2013, p.

matter? Because state and private health plans often use Medicare’s exclusion of pharmacists as their reasoning for excluding

This is true for insured, uninsured, and under-insured Americans. These problems are exacerbated by a lack of coordination of care for patients with chronic diseases. The underlying

The cost of health care has been at the forefront of politics for years. It is one of the most talked about topics not just in political venues but also country wide. Every American has an opinion on how our economy can be fixed and they are passionate about health care reform. The price of insurance alone causes many Americans to not have coverage. For those that can afford coverage, the struggle to pay co pays is immensely crippling their bank accounts. Of these burdens on Americans today, the most frightening fact lies in the cost of prescription medications.

Within the formulary the drugs are divided into tiers. Co-payments are based on the tier that the drug is in and range from tier 1, the least expensive drugs, to tier 3 the most expensive drugs. Each insurance company plan is allowed to add or drop drugs from their formularies and move drugs from one tier level to another throughout the year. An insurance company can also drop a drug in the middle of the year, but must continue covering the drug for anyone taking it until the next reenrollment period, at which time a new plan will have to be chosen that covers that drug (Gustaitis, 2007). Although not used a lot there is a fourth tier that is for specialty drugs only. Some plans use a flat-rate or assign a percentage co-pay to the higher tier drugs (Gustaitis, 2007). Other characteristics of the insurance company plans that they have control over are requiring prior authorization for a drug, using step therapy, limiting the quantity, participating at certain pharmacies, and having preferred pharmacies (Gustaitis, 2007).

Under the Act, each provincial health plan is administered at the provincial level and provides comprehensive first dollar coverage of all medically necessary services. With minor exceptions, health coverage is available to most if not all residents with no out of pocket charges. Most physicians are paid on a fee for services and enjoy a great deal of practice autonomy. Private health insurance for covered services are illegal.  Most Canadians have supplemental private insurance for services that are not covered, such as prescription drugs and dental services. Consequently, physicians are forced to participate and each health plan effectively serves all residents in the province (Henderson 487).

pays 86% of the cost of generic drugs during the coverage gap. The patient may get a 50%

Medicare is one of the most widely acknowledged sources of health insurance coverage in the United States. It is often complemented by Medicaid, a similar health welfare program that includes children and the poor. Many Medicare beneficiaries are "dual eligibles" who use Medicaid to extend comprehensive inpatient and outpatient health care coverage, especially for prescription drugs, diagnostic and preventive care, and eyeglasses which fall outside of Medicare. Medicaid can also supplement Medicare deductibles, premiums, and up to 20% of uncovered charges (Goodman, 1991).

First, I must assess Mrs. Jones understanding of her insurance plan. Is she even aware that she doesn 't have prescription drug coverage? According to Cohen and Villarroel (2015), "approximately one fifth (18%) of the $263 billion spent on retail prescription drugs in the United States in 2012

Variability: First, Medicare is more or less the same in every state, but Medicaid rules vary widely state

For Americans, health care coverage depends primarily on whether health insurance is provided by their employer or through two major public programs, Medicaid for the poor and Medicare for the elderly.

The Commonwealth Fund, New York. (2006). US Medicare Prescription Drug Coverage. Retrieved from US Me

Prescription drugs all around are very expensive, but without out them some of us would not be able to say we are alive. We can still see the price of these prescription drugs go through the roof as we speak. Although most of low-income workers can barely afford medicine and drugs, one way or another, we make it work because without it we would be dead. Although having insurance covers a lot of our medical health expenses, such as medical bills, prescription bills, hospital bills and things of this nature. As the cost of prescriptions keep going up, sometimes our insurance companies cannot cover the cost because they have hit their Cap of money able to spend. Some insurance companies have Cap for a person or a cap for a whole family it can be yearly or annually it just depends on the “deal” you worked out with your insurance provider. Most families, like my own make due to cover the cost of having insurance, yet we have to still be able to cover what remains of the prescription cost if we want to live. Money sometimes is very tight and meeting these necessary financial situations get tough.