Medicine and healthcare in the United States are one of the most unique and distinct systems in the world. Although one can argue that it has an array of flaws, it is important to put these notions into a perspective in order to have a more precise understanding of the general factors. The given comparison evaluation will primarily focus on the use of point-of-care ultrasound (POCUS) in general practice in nations, such as the United States, Austria, Finland, and the Netherlands. There is major debate whether or not portable POCUS devices improve the patient outcome, because one might consider it as an unnecessary cost.
The United States has a drastically different healthcare system than in most European countries. Countries, such as the UK or Germany, mostly have a budget-based free healthcare system, which is mainly supported by taxes and governmental contributions. However, the US’s privatized healthcare only possesses rudimentarily resembling programs, such as Medicaid. In the case of POCUS and its use in general practice, the selected nations exhibit a different set of approaches in regards to resource allocations. Health insurance and health protection of the population, called in short health, is an essential component of the social policy of European states. From the point of view of organizational and financial characteristics, two main models of health care can be distinguished: insurance and budget. However, due to the fact that over time, each state was forced to improve the existing system, in no country, these models are presented in their pure form.
Austria’s healthcare system focuses on the essential services in regards to patient provision. It is stated that the country’s public service does not provide POCUS, and thus, payment can come from both the patients and insurance companies (Mengel-Jørgensen & Jensen, 2016). In other words, only a number of insurance firms include ultrasound scans as a bonus option for improving the package’s appeal. In the rest of the cases, it is the patients themselves who purchase POCUS in order to enhance and widen the general practice. Therefore, Austrian general practitioners might not be uniformly trained to perform the procedures.
In many regions, payments for medical services and medicines can also be made from the personal funds of patients. This is due to the fact that health insurance does not always cover all the costs of medical care. The structure of patients’ personal expenditures for co-financing health care is not uniform. So, their rather high share in such countries is explained by the prevalence of individual additional payments of citizens for the purchase of drugs and compensation for medical services. In several countries, the bulk of costs are accumulated in the funds of health insurance companies that provide coverage services. This is due to the developed market, a large number of competing private insurance companies, as well as the stability of the financial market. This enables health insurance companies to carry out successful investment activities.
The nation’s approach is partially similar to the United States, where the bulk of the options are provided by insurance companies. Patients proceed with payment options in case of non-coverage, but it is important to note that as a medical practice, American general practitioners have no or limited capability to conduct POCUS. The check is mostly performed by a separate specialist with a different appointment. The main source of funding for health care in most countries is compulsory health insurance contributions, paid on a parity basis by employers and employees (Mengel-Jørgensen & Jensen, 2016). Funds received from voluntary health insurance at the expense of employers or from citizens’ own funds are also allocated to finance health care. It is most widespread in such European countries as Austria and Germany.
It is interesting to note that the example of Finland is drastically different from previous instances. It is stated that public health service pays 15-20 EUR per examination, which might include POCUS if it is needed (Mengel-Jørgensen & Jensen, 2016). The main reason is the presence of a strong and versatile public healthcare system, which mostly provides a fixed set of financial support for medical services. In other words, ultrasound checks are performed solely through the resources of the government and taxes. There are almost no options available from private insurance organizations and patients. Therefore, the country’s general practitioners are fully trained and certified to conduct point-of-care US examinations.
The budgetary model of health care, in contrast to insurance systems, is characterized by greater efficiency, which manifests itself in a lower level of administrative costs. This is due to the fact that the government can contain the growth of health care costs using macroeconomic levers. In addition, with budgetary financing of health care, cost containment incentives and the ability to do so are consolidated in one governing body, which saves funds and eliminates duplication of functions. Therefore, budgetary health care models tend to be cheaper for society than insurance ones. The flip side of government control over the state of health care is the political cost to the authorities in the form of increased public discontent and criticism from health care providers. Therefore, the expenditures allocated to the budgetary health care system often depend on political priorities.
Ghana occupies a unique position in terms of providing POCUS as a part of general practice. Some forms of ultrasound services, such as abdominal scans, are covered by the public health services (Mengel-Jørgensen & Jensen, 2016). However, if a patient wants to get a musculoskeletal POCUS, he or she has to pay for the medical assessment without any support from insurance firms. In other words, general practitioners are not capable of conducting specific types of POCUS evaluations, where some other forms will be made by a separate specialist. In addition, it is important to point out that there are technology and resource limitations within the healthcare system. General practitioners also lack the required training or certification, which renders the practice useless. The overall approach is based on referring to a designated professional in order to utilize the targeted measures.
In conclusion, the medical aspect of the general practice in regards to POCUS differs on the basis of a nation’s healthcare system and its prioritization of the instrument. United States healthcare does not cover the service, but insurance companies might provide it depending on their packages. Austria is similar to the US because the public healthcare system does not include POCUS as the essential component of general practice. However, Finland fully covers and has an ultrasound check as a part of medical examination due to a flat value coverage framework. Ghana does effectively provide due to lack of infrastructure and professional skills, which is why there are separate specialists. Therefore, general practitioners are highly trained in Finland but are less capable in the US, Austria, and Ghana.
Reference
Mengel-Jørgensen, T., & Jensen, M. B. (2016). Variation in the use of point-of-care ultrasound in general practice in various European countries. Results of a survey among experts. European Journal of General Practice, 22(4), 274-277.