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Health Care Report: Creating a Health Care System
Introduction
This paper will analyze the United States, the United Kingdom, and Norway’s health care systems. The analysis will cover topics of the International Standard (IS), the ideal health care model, cost control, roles of private insurance, health care delivery, and insurance principles. Subsequently, an ideal, imaginary health care system will be formulated utilizing aspects from the current health care systems being analyzed. Each of these countries have aspects of their health care systems that are beneficial and detrimental. The creation of the ideal health care system will only incorporate the beneficial attributes from the United States, the United Kingdom, and Norway.
Estraria
The country of Estraria is a small island locate below India and next to Sri Lanka. It has a population of roughly 150,000,000. The demographic makeup of Estraria is roughly 35% White, 15% Black, 25% Hispanic or Latino, 20% Asian, and 5% Other (Pacific Islander, Native American, etc.). The life expectancy in Estraria is 81.1 years and the infant mortality rate is roughly 12 deaths per 1,000 births. Most people in Estaria have graduated college and have completed a Bachelors degree or Masters degree. The health care system in this country is phenomenal and highly regarded by many other countries for its low costs, efficiency, and overall satisfaction.
Estraria and the International Standard (IS)
There is universal coverage in Estraria; this allows citizens to have access to healthcare and a peace of mind. The people who work in the in the health care field are enormously proud of their system and the work they do. The people who receive care are among the most satisfied medical customers on earth. I have chosen to adopt universal coverage for Estraria because I believe health care should be a right not a privilege. I have adopted this thinking from the United Kingdom and Norway because both of these countries have universal coverage. The United States does not have health insurance for everyone and by 2010, approximately 47 million Americans did not have private or public coverage which has deterred Estraria from adopting this ideal (Weiss ; Lonnquist, 2015).

There is no precise scope of what services are covered because of various diseases and severity of illnesses. No people will be left uncovered based on their illness because Estraria believes it is the duty of the physician and healthcare system to treat everyone. Coverage provides or pays for: preventive services, including screening, immunization, and vaccination programs; inpatient and outpatient hospital care; physician services; inpatient and outpatient drugs; clinically necessary dental care; some eye care; mental health care, including some care for those with learning disabilities; palliative care; some long-term care; rehabilitation, including physiotherapy (e.g., after-stroke care); and home visits by community-based nurses. In Estraria, citizens don’t have to worry about their treatment being covered and all necessary treatments will be covered. I have adopted these principles from Norway and the United Kingdom because of how flexible the coverage is for citizens. In Norway and the United Kingdom, Parliament or the government determines what is covered, but there is no defined benefits package.

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The majority of funding in Estraria comes from general taxation which has been adopted from Norway and the United Kingdom. Estraria adopted this method because citizens do not have to directly pay for healthcare, they pay an increased tax on items that then, in turn, pays for healthcare. The sales tax in the UK is 17.5 percent on anything you buy (Reid, 2015). Public spending in Norway on health is financed through general taxation, and accounted for 85.5 percent of total health expenditure in 2013 (Osborn & Anderson, 2015). Estrarias’ sales tax is 18.5 percent on everything. In 2015, the Estraria spent about 10.4 percent of GDP on health care. The government administers the money and the patient never has to think about paying a bill, similar to the health care system in the United Kingdom. The United Kingdom health care system is dedicated to the proposition that nobody should ever have to pay a medical bill (Reid, 2010). Estraria adopted this belief, because they do not want to bankrupt citizens with medical bills. Private health insurance does exist, but many people don’t bother with it because they are covered with the public insurance provided. The government owns the hospitals, pays the doctors, buys the medicine and covers all the bills. There is no profit-making in this health care system, similar to Norway and the United Kingdom, because Estraria does not wish to make money off of citizens that need necessary health care. There are small amounts of costs sharing because people are charged a small fee (about $10) for prescriptions. However, the fee is waived for children, anyone over sixty, pregnant women, and the chronically ill, about 90 percent of all drugs in Estraria are dispensed for free similar to the United Kingdom. Vulnerable populations should not have to worry about paying for prescriptions. These principles have been adopted from Norway and the United Kingdom because there is universal coverage, no profit making, and overall satisfaction amongst citizens.
Estraria and Cost Control
To maintain costs Estraria has a balanced national budget that allows flexibility in addressing rising health costs. Estraria uses cost-effectiveness evaluations to determine which drugs will be reimbursed. The drug pricing scheme aims to encourage use of generic drugs by setting the generic price as a gradually decreasing percentage of the branded price. This thinking has been adopted from Norway because this allows Norway to provide cheaper, generic drugs and determine which drugs are used most often. Estraria is recognized by experts around the world as one of the most cost-efficient health care plans ever devised. There is no-fee funding mechanism based off of the United Kingdom. With no bills, no billing offices, no bureaucracy needed to file or review insurance claims the administrative cost are very low. Also, a general practitioner is paid a fee for each person registered with their practice. Practitioners are also paid more for providing preventative care. Estraria primarily focuses on preventative care to keep their citizens healthy because if preventative care is focused on, hopefully, diseases and illness will be caught early or stopped all together.
Estraria Health Care Model
Estraria employs the Beveridge model which has no medical bills, hospitals are owned by the government, and doctors are government employees (Reid, 2010). The health care in this system is provided and financed by the government, through tax payments. As discussed earlier, citizens of Estraria have a tax rate of 18.5 percent. This system is often referred to as “socialized medicine” by many countries, but for us it works wonderfully. Estraria has low costs per capita, because it has the government as the sole payer, controls what doctors can do and what they can charge. Estraria has adopted this health care model based off of Norway and the United Kingdom because overall citizen satisfaction seems to be higher because of their healthcare model.
Role of Private Insurance in Estraria
Estraria has private insurance, but many people seldom use it. The health care provided by the government is sufficient that many people do not bother with private insurance. Only 4 percent of the population has private insurance. This concept was adopted from the United Kingdom and Norway because both systems seldom use private insurance, but focus on outstanding public insurance.

Estraria and Delivery
Primary care is delivered mainly through general practitioners in Estraria, who act as gatekeepers for secondary care which was adopted from Norway. In Norway, there is the mandatory referral system for specialized services, with the general practitioner as a gatekeeper (Osborn & Anderson, 2015). In 2015, there were 40, 456 general practitioners, with an average of 7,532 patients per practice and 2,043 patients per General practitioner. To decrease wait time and long lines, Estraria has implemented an incentive for the next 8 years. Medical students will receive full reimbursement for their medical school loans. The hope is that many students will flood in to the health care field to decrease wait time. In the past 2 years, medical admissions has increase by 33% so more people are entering medical school due to the new incentive. General practices are normally patients’ first point of contact, and people are required to register with a local practice. Mental health care, long term care, and rehabilitation are integral parts of Estraria, including a full range of services. Estraria puts great emphasis on preventative care, many of the tests in a physical exam are routinely carried out when you go to the doctor.
Financial incentives have also been put in place both to encourage specialized GP certification and for GPs to see more patients per day. Estraria has an emergency phone number patients can call for urgent ambulance services. There are also 24/7 medical advice hotlines. These principles have been adopted from Norway and the United Kingdom.
Estraria Insurance Principal
Estraria exemplifies a social insurance principal. In the social insurance principal everyone should have access to the care they need. In Estraria, there is universal coverage for everyone with no medical bills. They also showcase the social insurance principal because they do not deprive health care of those that need it such as mental health care as discussed earlier. Estraria believes that all citizens should have equal access to health care and no one should ever be denied health care based on their illness. This concept was adopted from Norway and the United Kingdom because they believe health care is a right not a privilege, and that everyone deserves the best healthcare. This concept was also adopted by look at the United States and how their insurance companies can deny citizens because of pre-existing conditions.

The United States Health Care System
The United States health care system is characterized by being extremely expensive, inefficient, and wasteful (Weiss ; Lonnquist, 2015). The health care system is grounded in profit making and has tens of millions of Americans lacking the resources to obtain basic care (Weiss ; Lonnquist, 2015). In a 2006 survey, only 13 percent of American reported that the health care system worked pretty well with minor changes being needed, 49 percent saw the system as needing fundamentally changed, and 37 percent believed that there was so much wrong with the system it needed completely rebuilt (Weiss ; Lonnquist, 2015). Many Americans are dissatisfied with the health care system the United States employs. The U.S. is ranked nineteenth out of nineteen developed countries on their ability to cure people with diseases (Reid, 2010). This is concerning because the United States spends about double what most other developed countries spend on health care (Reid, 2010). The United States has essentially developed the most fragmented health care system in the developed world, with “providers” sending bills to a vast array of different payers (Reid, 2015).
The United State and International Standard (IS)
The International Standard are standards created to guide and provide a basis for requirements of health care. The International Standard can be assessed by analyzing coverage, financing, and cost control. The United States has employed private health insurance. These health insurance policies are sold to individuals, families, and groups (Weiss ; Lonnquist, 2015). In addition to the premium many of these policies also have a deductible provision, coinsurance, and co-payments that characterize cost-sharing (Weiss ; Lonnquist, 2015). This characterizes cost sharing because the insurance company and the insured both pay the bills. Private insurance companies cover whatever the buyer negotiates; this may include basic health benefits, dental care, eye care, drugs, and income replacement during disability (Weiss ; Lonnquist, 2015). There also was the entry of public health insurance which is government sponsored insurance. There are two main groups of public health insurance: Medicare and Medicaid. Medicare is a federal insurance program designed to protect people 65 years of age and older (Weiss ; Lonnquist, 2015). It also protects permanently disabled worker and their dependents (Weiss ; Lonnquist, 2015). Medicare part A covers inpatient hospital services, skilled nursing services, hospice care, and physician services (Weiss ; Lonnquist, 2015). Medicare part B covers physician services, outpatient services and therapy, while part D provides prescription drug benefits (Weiss ; Lonnquist, 2015). Medicaid is a jointly funded federal state program designed to make health care more available to the very poor (Weiss ; Lonnquist, 2015). Medicaid covers family planning services, x-ray services, inpatient and outpatient services, transportation to medical care, nursing services, and dental care (Weiss ; Lonnquist, 2015).). Another government program, Children’s Health Insurance Program (CHIP) was created to reduce the number of children without health insurance. The issue with these programs (Medicare, Medicaid, and CHIP) was that patients typically paid nothing for services, physicians could charge whatever price they wanted and receive full reimbursement, and insurers could pass on higher premiums to those insured (Weiss & Lonnquist, 2015). The United States is also the only developed country that allows insurance companies to refuse coverage to people for fear they might get sick (Reid, 2010).

Cost Control in the United States
Income for health care is gained through taxes or by employers taking a portion of income (Weiss & Lonnquist, 2015). Medicare is financed by a combination of general tax revenues and payroll taxes levied on employers and employees (Weiss & Lonnquist, 2015). Private health insurance can be purchased by individuals, but is usually funded by voluntary, tax-exempt premium contributions shared by employers and employees on an employer-specific basis, sometimes varying by type of employee (Osborn & Anderson, 2015). The health care system represents 18 percent of the Gross Domestic Product (GDP) of the U.S. economy, and about $1 in $6 dollars spent in the United States is on health care (Weiss & Lonnquist, 2015). The government administers the money to Medicare, Medicaid, CHIP and other health insurance programs. The government in 2012, called for expenditures of over 3.8 trillion dollars (Weiss & Lonnquist, 2015). Over half (56.4 percent) of all personal health care services were paid for by private sources (Weiss & Lonnquist, 2015). Private insurance companies compete with each other for sales and were able to raise the price of insurance if a person tried to buy private health insurance without having a job; they set premiums at a level that will allow them to pay out all claims and have money left for profit investors. (Weiss & Lonnquist, 2015).

Cost containment strategies are an effort to give financial incentives to provide only necessary services and to do so in a cost-efficient manner (Weiss & Lonnquist, 2015). Payers have attempted to control cost growth through a combination of selective provider contracting, price negotiations and controls, utilization control practices, risk sharing payment methods, and managed care (Osborn & Anderson, 2015). A second type of containment is High Deductible Health Plans (HDHPs) and managed care like the Affordable Care Act (Weiss & Lonnquist, 2015).
United States Health Care Model
The United States has adopted aspects of all four models; the Bismarck Model, the Beveridge Model, The National Health Insurance Model, and the Out-Of-Pocket Model. The United States is similar to the Bismarck model because both health care providers and payers are private entities and this model uses private health insurance plans (Reid, 2010). The United States characterizes similarities with the Beveridge model because health care is provided and financed by the government just like the United States public health insurance (Reid, 2010). The United States also has the U.S. Department of Veterans Affairs which allows health insurance to veterans with no medical bills (Reid, 2010). The United States employs aspect of the National Health Insurance model because the providers of health care insurance are private, but the payer is a government run insurance program that every citizen pays into through taxes (Reid, 2010). The Out-Of-Pocket model reflects the United States because the United States is the only wealthy country that uses this model for a significant portion of the population (Reid, 2010).

The United States and the Role of Private Insurance
Today there are almost 1,300 private health insurance companies (Weiss & Lonnquist, 2015). These are profit-making companies whose intentions are to set premiums at a level that will allow them to pay out all claims and have money left for profit investors. These health insurance policies are sold to individuals, families, and groups (Weiss & Lonnquist, 2015). Private insurance is characterized by a deductible provision, coinsurance, and co-payment. A deductible provision is where the policy owner pays a set amount of money before the insurance kicks in (Weiss & Lonnquist, 2015). Coinsurance is where the policy owner pays a set percentage of all costs beyond the deductible (Weiss & Lonnquist, 2015). Lastly, co-payments are specific fees paid out of pocket for particular services (Weiss & Lonnquist, 2015). Health insurance became a benefit provided by employers to workers and their families. This provided incentive for many Americans to find a job. Health insurance companies, pharmaceutical companies, medical equipment companies, and some hospitals became part of the private market (Weiss & Lonnquist, 2015). As stated earlier private insurance companies cover whatever the buyer negotiates.
The United States and Delivery
Primary care doctors account for roughly one-third of all U.S. doctors (Osborn & Anderson, 2015). The majority of primary care doctors operate in small self- or group-owned practices with fewer than five full-time-equivalent physicians, although larger practices are becoming increasingly common (Osborn & Anderson, 2015). Primary care doctors have no formal gatekeeping function, except within some managed-care plans (Osborn & Anderson, 2015). Physicians are paid through a combination of methods, including negotiated fees (private insurance), capitation (private insurance), and administratively set fees (public insurance) (Osborn & Anderson, 2015). Specialists are paid through negotiated fees, capitation, and administratively set fees, and are typically not allowed to bill above the fee schedule for services offered in-network (Osborn & Anderson, 2015). Specialist can see patients with both public and private insurance companies. In 2013, 78 percent of office-based physicians used some form of electronic medical record system (Osborn & Anderson, 2015). To provide better delivery of health care and outcomes the United States is experimenting with new payment incentives that reward higher-quality and more efficient care (Osborn & Anderson, 2015). The United States is also trying to fund many initiatives aimed at shifting from a specialist-focused health system to one that is primary care–focused (Osborn & Anderson, 2015).

The United States Insurance Principal
The United States employs both social and casualty insurance principals. The United States embodies a Social insurance principal because they believe that everyone should have the access to care that they need. A good example of the social insurance principal is Medicare and Medicaid. However, the United States embodies casualty insurance because they believe in not subsidizing the health care of people who have riskier lives. This is seen with private insurance companies denying people coverage based on preexisting conditions.
The United Kingdom Health Care System
The United Kingdom is made up of the countries England, Scotland, Wales, and Northern Ireland which all follow the same health care system. The people who work in the British National Health Service (NHS) are enormously proud of their system and the work they do (Reid, 2010). The people who receive care from the NHS are among the most satisfied medical customers on earth (Reid, 2010). Beveridge’s opportunity to reform health care on a national scale came early in the 1940s after the United States and the UK had turned tide in World War II; Britain’s leaders began thinking ahead about what would be required to rebuild the country after the war, and the reformation of the UKs health care system was born (Reid, 2010).

The United Kingdom and the International Standard (IS)
People go their entire lives without ever paying a doctor or hospital bill (Reid, 2010). Coverage is universal. All those “ordinarily resident” in England are automatically entitled to health care, largely free at the point of use, through the NHS (Osborn & Anderson, 2015). There is no precise scope of what services are covered under the NHS. The scope of these services are determined by local-decision making.
The majority of funding comes from general taxation, and a smaller proportion from national insurance (a payroll tax) (Osborn & Anderson, 2015). The UK uses general taxation to earn money. They pay by forgoing treatments and medications the NHS won’t provide, they also pay by waiting in lines for care in a system that is somewhat overstretched (Reid, 2015). In 2012, the U.K. spent about 9.3 percent of GDP on health care (Osborn ; Anderson, 2015). The government administers the money and the patient never has to think about paying a bill (Reid, 2010) Private health insurance does exist, but many people don’t bother with it. The government owns the hospitals, pays the doctors, buys the medicine and covers all the bills (Reid, 2010). There is no profit-making in this health care system. There are small amounts of costs sharing because people are charged a small fee (about $10) for prescriptions. However, the fee is waived for children, anyone over sixty, pregnant women, and the chronically ill, about 85 percent of all drugs in the UK are dispensed for free (Reid, 2010). Many people still have to pay for eyeglasses, contact lenses, false teeth, and some dental bills (Reid, 2010).
Cost Control in the United Kingdom
To keep its service free, the NHS strive mightily to keep its costs low- and is recognized by experts around the world as one of the most cost-efficient health care plans ever devised (Reid, 2015). With no bills, no billing offices, no bureaucracy needed to file or review insurance claims the administrative cost at the NHS are small- about one-fifth of those in the United States (Reid, 2010). NHS budgets are set at the national level, usually on a three-year cycle. They also control cost spending by controlling the range of medications, tests, and procedures the NHS will pay for (Reid, 2010). Every person that wants treatment from the NHS needs need to register with a general practitioner. The most effective cost control tool the United Kingdom uses is the “queue”- the waiting list- it can take weeks or months to get an appointment with a practitioner (Reid, 2010). A general practitioner is paid by a system called capitation- they get a set fee for each person registered with their practice (Reid, 2010). Practitioners are also paid more for providing preventative care. They also get paid for keeping their patients healthy (Reid, 2010).

The United Kingdom Health Care Model
The United Kingdom employs the Beveridge model which is named after William Beveridge who inspired Britain’s National Health Service (Reid, 2010). Health care in this system is provided and financed by the government, through tax payments (Reid, 2010). As discussed earlier, the United Kingdom pays a tax rate of 17.5 percent. There are no medical bills, hospitals are owned by the government, and doctors are government employees (Reid, 2010). This system is often referred to as “socialized medicine” (Reid, 2010). These systems tend to have low costs per capita, because the government as the sole payer, controls what doctors can do and what they can charge (Reid, 2010).

Role of Private Insurance in the United Kingdom
There are private health insurance plans in the United Kingdom, but few people bother with them (Reid, 2010). Most private hospital care—largely for elective conditions—is financed through supplementary private voluntary health insurance, which covered 10.9 percent of the U.K. population in 2012 (Osborn ; Anderson, 2015). Most private expenditure is for over-the-counter drugs and other medical products (which together account for just over half of private spending) and private hospital care, including both insured and uninsured costs (Osborn ; Anderson, 2015). Private insurance in the United Kingdom is not utilized as much as the universal coverage that is provided by the government.
The United Kingdom and Delivery
Primary care is delivered mainly through general practitioners, who act as gatekeepers for secondary care (Osborn ; Anderson, 2015). In 2013, there were 40,236 general practitioners in 7,962 practices, with an average of 7,034 patients per practice and 1,575 patients per General practitioner (Osborn ; Anderson, 2015). General practices are normally patients’ first point of contact, and people are required to register with a local practice (Osborn & Anderson, 2015). Nearly all specialists are salaried employees of NHS hospitals (Osborn & Anderson, 2015). Mental health care is an integral part of the NHS, including a full range of services, with prescription drugs covered under the same terms as other NHS drugs (Osborn & Anderson, 2015). The NHS puts great emphasis on preventative care, many of the tests in a physical exam are routinely carried out when you go to the doctor (Reid, 2010).
The United Kingdom Insurance Principal
The United Kingdom exemplifies a social insurance principal. In the social insurance principal everyone should have access to the care they need. In the United Kingdom, there is universal coverage for everyone with no medical bills. They also showcase the social insurance principal because they do not deprive health care of those that need it such as mental health care as discussed earlier.
Norway Health Care System
Norway and the International Standard (IS)
The nationally managed and financed health system is built on the principle of equal access for all citizens regardless of socioeconomic status, ethnicity, and area of residence (Osborn & Anderson, 2015). There is universal coverage in Norway. Visitors are charged in full. For undocumented immigrants, access is limited to emergency acute care (Osborn & Anderson, 2015) In practice, statutory national health insurance covers primary care, hospital care, ambulatory care, and outpatient prescription drugs on the formulary (the “blue list”) (Osborn & Anderson, 2015). It also covers dental care services for children and other prioritized groups. It does not cover nonmedical eye care or cosmetic surgery (Osborn & Anderson, 2015). All inpatient care in a public hospital, including use of pharmaceuticals, is free of charge for the patients (Osborn & Anderson, 2015). Complementary medicine is not covered (Osborn & Anderson 2015).

Norway has a 9.3 percent GDP for health care (Osborn & Anderson, 2015). Public spending on health is financed through general taxation. The central government proposes an annual health budget in October, which the Parliament debates and passes in December (Osborn & Anderson, 2015). In 2013, out-of-pocket payments accounted for approximately 15 percent of total health care expenditure, reflecting cost-sharing arrangements (Osborn & Anderson, 2015). The government and private insurers administer money. There is no profit-making in this system. There is an annual maximum for many cost-sharing requirements, above which out-of-pocket costs are waived (Osborn & Anderson, 2015). Providers cannot, as long as they are a part of the public system, charge the patient more than the amounts set by Parliament, unless charging for bandages and other disposable materials (Osborn & Anderson, 2015). Out-of-pocket payments account for less than 15 percent of the total health care budget (Osborn & Anderson, 2015). Certain groups are exempt from cost-sharing. Children under the age of 16 receive free physician treatment and access to essential drugs on the blue list, children under the age of 18 receive free psychological and dental care, pregnant women receive free medical examinations during and after pregnancy, and residents eligible for minimum retirement pensions or disability pensions (Osborn & Anderson, 2015).
Cost Control in Norway
A balanced national budget gives Norway flexibility in addressing rising health costs (Osborn & Anderson, 2015). The Norwegian Medicines Agency uses cost-effectiveness evaluations to determine which drugs will be reimbursed (Osborn & Anderson, 2015). The drug pricing scheme aims to encourage use of generic drugs by setting the generic price as a gradually decreasing percentage of the branded price (Osborn & Anderson, 2015).

Norway Health Care Model
Norway employs the Beveridge model. Health care in this system is provided and financed by the government, through tax payments (Osborn & Anderson, 2015). The hospitals are owned by the government, and doctors are government employees (Osborn & Anderson, 2015). These systems tend to have low costs per capita, because the government as the sole payer, controls what doctors can do and what they can charge (Osborn & Anderson, 2015). Norway also has adopt the Bismarck model because they have private insurance plans, don’t make profit, cover everybody, and some doctor’s and offices are privately owned (Reid, 2010). 88 percent receive coverage through their employer (employees are taxed for these benefits) (Osborn & Anderson, 2015).
Role of Private Insurance in Norway
Private health insurance is slowly growing, but only about 7 percent of the population has some sort of insurance coverage (Osborn & Anderson, 2015). Private funds are spent on medicines and general practitioner (GP) services, but also on outpatient specialist services and transportation (Osborn & Anderson, 2015). Voluntary insurance plays a supplementary role, primarily offering shorter waiting times for publicly covered elective services (Osborn & Anderson, 2015). Private insurance is slow growly and not utilized as much as public insurance.
Norway and Delivery
Although the number of physicians has increased in both the general practitioner and the hospital sector, the proportion of physicians working as GPs has fallen dramatically in the past 10 years, indicating faster growth in specialist services and secondary care (Osborn & Anderson, 2015). According to the health personnel registry, there are 2.09 specialists in hospitals or ambulatory care for every practicing primary care physician (Osborn & Anderson, 2015). Financial incentives have, however, been put in place both to encourage specialized GP certification and for GPs to see more patients per day (Osborn & Anderson, 2015). Patients are encouraged to register with a general practitioner. There is an emergency phone number patients can call for urgent ambulance services, but there is no national medical advice telephone service for patients. Patients can always get in touch with health care personnel at their local after-hours care facility (Osborn & Anderson, 2015). In municipalities, mental health care is provided by general practitioners and by other providers (psychologists, psychiatric nurses, social care workers) (Osborn & Anderson, 2015). The municipalities are also responsible for providing long-term care (Osborn & Anderson, 2015).
Norway Insurance Principal
Norway exemplifies a social insurance principal. In the social insurance principal everyone should have access to the care they need. In Norway, there is universal coverage for everyone through the government and employers. They also showcase the social insurance principal because they do not deprive health care of those that need it such as mental health care and long term care as discussed earlier.

Conclusion
In Estraria, we believe that healthcare is a social right, not a privilege, that everyone should have access to healthcare. The main strengths of this healthcare system is that coverage is offered to everyone, no one can be turned away due to any preexisting medical conditions, low costs, effectiveness, low infant mortality rates, high disease cure rates, and no medical bills. Some weaknesses are that it is still a fairly new system, and that the wait times are long to receive care, but action has been taken to correct the problem. Estraria has primarily been modeled after the United Kingdom and Norway for their universal coverage, no medical bills, and overall citizen’s satisfaction. Estraria has not adopted anything from the United States. They believe that the United States health care system needs rebuilt and are appalled that 47 million Americans do not have health insurance (Weiss ; Lonnquist, 2015). Estraria believes in universal coverage and that no one should have to pay to receive necessary medical care. The United States should start by first adopting a simple universal coverage system like Estraria. Another step the United States should take it to cease profit making off of the health care field. By taking these first steps, the United States would insure more people and develop a more cost effective system. Estraria is still a fairly new country, but their healthcare is viewed as one of the best in the world.
References
Osborn, R., ; Anderson C. (2015). International Profiles of Health Care Systems. The Norwegian health care system. Osborn ; Anderson.

Osborn, R., ; Anderson C. (2015). International Profiles of Health Care Systems. The English health care system. Osborn ; Anderson.

Reid, T. R. (2010). The Healing of America: A global quest for better, cheaper, and fairer healthcare. New York, NY: Penguin Group
Weiss, G. L. ; Lonnquist, L. E. (2015). The sociology of health, healing, and illness 8th edition.New York, NY: Pearson.

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