••••9 Summary Obamacare Changing American Health Carethe medical institution. Thus, in Japan, you can visit a medical institution without an appointment and receive your medicine immediately after visiting the pharmacy. Billing is also completed on the same day.In contrast, there are a limited number of medical facilities in the U.S. where patients can be seen without an appointment. An appointment is required to see a doctor, except for certain clinics (such as Walk-in Clinics, Urgent Care, and Emergency Rooms), where it can take months to schedule an appointment. At Urgent Care, minor fractures, nausea, vomiting, diarrhea, flu, and other conditions can be treated without an appointment. General hospitals in the U.S. have emergency rooms where patients can be treated without prior notice. Emergency rooms are used for more urgent cases such as breathing difficulties, extremely high fever, heart attack/stroke, etc.When you go to a hospital in the U.S., you must first present your health insurance card and fill out the necessary forms at the reception desk. Depending on your insurance, you may be required to pay a copayment (Copayment, Copay) for each medical examination. In the U.S., if an abnormality is suspected during the initial examination, the patient tends to be immediately referred to a specialist or ordered to undergo advanced (and expensive) tests. (This is due to the current situation where the specialist system is well-established and medical malpractice lawsuits are commonplace.) As a result, medical care becomes increasingly expensive. Appointments are generally required, except for emergencies. In my case, I had to see an otolaryngologist, but it took about three weeks for the first visit, and then I had to wait one month after the initial visit for the examination.In March 2010, the Affordable Care Act (commonly known as Obamacare), a major health care reform law, was passed in the United States under the Obama administration.The background of Obamacare was the increasing number of uninsured people in the U.S. Unlike Japan, the U.S. does not have a universal health insurance system, and as of 2011, the number of uninsured had reached 15.7% of the approximately 48.61 million people in the country.Prior to the introduction of Obamacare, 60% of the U.S. population was covered by private health insurance provided by their employers, and public health insurance was limited to Medicare (for the elderly over 65 and disabled persons), Medicaid (for low-income people), and the Children's Health Insurance Program (for children in low-income families).What has changed with Obamacare• Medicaid eligibility was expanded.and at least one employee is exempt from paying the premium tax credit.Allows individuals and businesses to purchase insurancethrough the Health Insurance Exchange at affordable pricesand with their own choice.These Obamacare changes aimed to reduce the number of uninsured by 32 million over a 10-year period and increase the percentage of uninsured under age 65 from 83% to 94%. The new fine measures and stricter regulations on insurance companies established by this health care reform law have reduced the uninsured to a certain extent.However, some challenges remain with Obamacare. Because Obamacare does not change the health care system, which is centered on private insurance, the challenge remains that approximately 22-23 million people will be left uninsured as of 2019, even after reform. The United States remains the only advanced democracy that will continue to have a large number of uninsured people.I hope you have enjoyed this comparison of the U.S. and Japanese health care and insurance systems. As described above, the medical systems in the U.S. and Japan are very different. In Japan, medical treatment is readily available and relatively inexpensive, so people are more likely to visit a hospital when they feel unwell. However, living in the U.S., I feel that people tend not to visit medical facilities unless it is an emergency, because in the U.S., many steps must be taken to receive medical care, which can be time-consuming and expensive. Therefore, self-medication is more developed in the United States. I believe that the existence of medical institutions is crucial for maintaining health, and that it is essential for all people to have easy access to reliable medical facilities.U.S. citizens and legal immigrants were required to purchaseindividual health insurance.A tax credit for premiums was introduced for households at orbelow 400% of the federally defined poverty level.Businesses with 50 or more employees are required to pay afine if they do not offer health insurance to their employees,
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