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© 2018 Laureate Education Inc. 1
Global Health Comparison Grid Template
Use this document to complete the Module 6 Assessment Global Healthcare Comparison Matrix and Narrative Statement
Global Healthcare
Issue
Unaffordable primary healthcare
Description Unaffordable primary healthcare refers to the inability of patients to pay for the cost of services provided in
the Primary care settings. Due to the advancing medical technology, increasing competition among
pharmaceutical companies, and the shortage of healthcare providers, the cost of accessing these services is on
the rise. Consequently, individuals are unable to afford these services. The problem is intensified by lack of
health insurance, due to poor economic status.
Country United States
Switzerland
Describe the policy
in each country
related to the
identified
healthcare issue
The Affordable Care Act was signed in to law in
2010 by the then US President Barrack Obama. The
act aimed at providing healthcare insurance coverage
to vulnerable populations in the US, thus reducing
the problem of uninsured. This would, therefore,
promote the affordability of primary healthcare
services. Through the act, the government introduced
the Medicare insurance program covering the elderly
and disabled, the Medicaid program covering the
The Swiss Federal Law on Compulsory Health Care
(LAMal) was signed in to law in January 1996. The
law mandates every Swiss citizen to purchase a
government-provided health insurance policy. The law
also applies to foreigners who stay in the country for
more than three months. The government pays for the
most significant portion of the premiums while the
citizens pay the other. However, for low-income
earners, the government pays the whole portion. The
Global Health Comparison Grid Template
© 2018 Laureate Education Inc. 2
low-income earners, and the Children Health
Insurance Program (CHIP) covering children from
impoverished backgrounds (Courtemanche, Marton,
Ukert, Yelowitz & Zapata, 2017).
law also allowed citizens to purchase a supplementary
cover from private insurers. It aimed at eradicating the
uninsured problem in the country, thus ensuring every
citizen can afford primary care services (di Bella,
Krejci, Ardu, Leporatti & Montefiori, 2018).
What are the
strengths of this
policy?
Through the policy, the federal government has
introduced insurance programs that help vulnerable
populations access healthcare services at no cost.
Additionally, private insurers are now mandated to
provide at least ten essential health benefits to the
insured. This has increased access and affordability
of a variety of services offered in the primary care
setting. The policy prohibits insurance companies
from abrupt cancellation of insurance cover and
discriminating against individuals with pre-existing
conditions in the access to medical cover.
Additionally, the policy has prolonged the period
children are covered by their parents' insurance to 26
years. As a result, this has promoted health care
access and affordability among unemployed youths
who are in the transition period between graduation
and employment.
The policy is uniform in that it ensures every Swiss
citizen has a health insurance cover; therefore, can
afford healthcare services. The policy allows citizens
to purchase complementary private insurance and
prohibits discrimination on the bases of pre-existing
conditions.
What are the
weaknesses of this
policy?
The policy is biased, thus has resulted in the
ununiformed decreased burden of healthcare costs. It
is only beneficial to populations that qualify for the
The policy promotes universal health insurance,
financed through premiums and taxes. The citizens
© 2018 Laureate Education Inc. 3
government provided programs. These are the
elderly, the low-income earners, and those living
with a disability. The policy imposes a high risk of
financial loss on private insurers. Consequently,
private players are exiting the market, creating a
shortage of insurers across the US. The policy
implementation process is subject to political
influence and the consequent corruption in the
registration of qualified individuals. Consequently,
some members of vulnerable populations end up
missing the opportunities.
bear the highest-burden because both taxes and
premiums are obtained from the citizens.
The policy does not cover clinical trials, therefore
discouraging medical advancement in the country.
Additionally, since citizens are mandated to pay
premiums for the rest of their lives, some may end up
spending more on premiums, than they would have
spent on out of pocket payment of healthcare cost
(Mattig, 2019).
Explain how the
social determinants
of health may
impact the
specified global
health issue. (Be
specific and
provide examples)
The social determinant of health influences the
Unaffordability of primary health care. For instance,
racial discrimination in access to health insurance
hinders members of racial minority groups from
affording healthcare costs. Unequal distribution of
resources and poverty courses competition for basic
needs among individuals. Consequently, they are
forced to prioritize most basic needs like food, and
therefore unable to afford health insurance and out of
pocket healthcare costs.
Social health determinants that contribute to the
unaffordability of health insurance include poor
lifestyle choices like unhealthy diet and exercise,
caused by limited health literacy. Consequently, most
individuals are battling multiple chronic conditions
that exhaust their insurance cover. Therefore, they are
unable to afford primary care services.
© 2018 Laureate Education Inc. 4
How has each
country’
government
addressed cost,
quality, and access
to the selected
global health
issue?
The US government has addressed the cost, quality
and unaffordability of healthcare issues through
policy actions. For instance, through the affordable
care act, vulnerable populations are accorded free
medical cover, and insurance companies are
prohibited from discriminatory actions in the
provision of health insurance. It has promoted
affordability of primary care services and reduced
out of pocket expenditure on healthcare.
Additionally, through the Centre of Medicare
Services, the US government has introduced a value-
based care model and eradicated volume-based care,
thus promoting quality healthcare (Barnes, Brown,
Harris, King & Johnson, 2020).
The Swiss government also controls healthcare cost,
quality and affordability through policy actions.
Through the mandatory insurance act, the government
reduces the out of pocket expenditure on healthcare.
The policy also prohibits private insurers from
charging high premiums on bases of pre-existing
conditions, thus controlling cost. The Swiss healthcare
system allows patients the privilege of seeking
treatment from physicians of their choice and
eradicates barriers to accessing referral to specialists
(Daily-Amir, Albrecher, Bladt & Wagner, 2019).This
promotes quality of care, as well as accessibility.
© 2018 Laureate Education Inc. 5
How has the
identified health
policy impacted
the health of the
global population?
(Be specific and
provide examples)
Through the affordable care act, the US has managed
to create one of the best healthcare systems in the
world. Consequently, other nations are emulating the
US, thus introducing similar policies in their
countries to attain similar benefits. These include
increased access and affordability of healthcare.
The Swiss Federal Law on Compulsory Health Care
(LAMal) has had a global impact because it not only
applies to Switzerland citizens but also foreigners who
have been in the country for more than three months.
Consequently, the global population benefits from
universal health coverage as well.
Describe the
potential impact of
the identified
health policy on
the role of nurse in
each country.
The affordable care act has resulted in increased
access to healthcare among vulnerable populations
like the elderly and those living with a disability.
These populations present with unique health
conditions. This necessitates more nurses to
undertake specialized training in conditions affecting
The Swiss Federal Law on Compulsory Health Care
(LAMal) has also increased access and demand for
healthcare. Consequently, there is an increasing
shortage of physicians. This necessitates nurses to
undertake more advanced roles and practice autonomy
to resolve the problem of the physician shortage
(Schmid, Beck & Kauer, 2018).
© 2018 Laureate Education Inc. 6
special populations like children and elderly
(Kominski, Nonzee & Sorensen, 2017).
Explain how global
health issues
impact local
healthcare
organizations and
policies in both
countries. (Be
specific and
provide examples)
Global health issues are a reflection of local health
problems in nations across the world. Therefore, in
the US, local healthcare organizations bear the same
burden created by global issues as other countries.
Consequently, health policies at organizational levels
are enacted across the US to eradicate global health
issues (Sommers, Maylone, Blendon, Orav &
Epstein, 2017). Such policies include those
promoting equity and standardized quality of care
among all patients regardless of personal differences.
In Switzerland, local healthcare organizations bear a
reduced burden of global issues due to the presence of
a unique healthcare system. The country has the best
healthcare system in the world. However,
organizations also implement organizational level
health policies to eradicate global health issues.
© 2018 Laureate Education Inc. 7
General
Notes/Comments
The affordable care act has significantly reduced the
problem of unaffordability of primary healthcare
among vulnerable populations. However, it has
neglected other citizens.
The mandatory insurance policy has significantly
reduced the problem of uninsured among all citizens
across the country in a uniform manner.
© 2018 Laureate Education Inc. 8
References
Barnes, J. M., Brown, D. S., Harris, J. K., King, A. A., & Johnson, K. J. (2020). Impact of the affordable care act dependent coverage
provision on young adult cancer patient insurance coverage by sociodemographic and economic characteristics. Cancer Causes
& Control, 31(1), 33-42.
© 2018 Laureate Education Inc. 9
Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2017). Early impacts of the Affordable Care Act on health
insurance coverage in Medicaid expansion and non‐ expansion states. Journal of Policy Analysis and Management, 36(1), 178-
210.
Daily-Amir, D., Albrecher, H., Bladt, M., & Wagner, J. (2019). On Market Share Drivers in the Swiss Mandatory Health Insurance
Sector. Risks, 7(4), 114.
di Bella, E., Krejci, I., Ardu, S., Leporatti, L., & Montefiori, M. (2018). What should we expect from Switzerland’s compulsory dental
insurance reform?. BMC health services research, 18(1), 272.
Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act's impacts on access to insurance and health care for
low-income populations. Annual review of public health, 38, 489-505.
© 2018 Laureate Education Inc. 10
Mattig, T. (2019). Coordinating health promotion in a federal state over the course of 30 years: a case report from Switzerland. Health
promotion perspectives, 9(4), 323.
Schmid, C. P., Beck, K., & Kauer, L. (2018). Health plan payment in Switzerland. In Risk Adjustment, Risk Sharing and Premium
Regulation in Health Insurance Markets (pp. 453-489). Academic Press.
Sommers, B. D., Maylone, B., Blendon, R. J., Orav, E. J., & Epstein, A. M. (2017). Three-year impacts of the Affordable Care Act:
improved medical care and health among low-income adults. Health Affairs, 36(6), 1119-1128.