Pre-Writing Assignment: Difference Between United States And ✓ Solved

Pre-writing Assignment: Difference between United States and

Pre-writing Assignment: Difference between United States and Germany Health Care Systems. Compare the two systems focusing on maternal health. Use the provided country overviews: United States (population 322,000,000; national health insurance with private insurers; programs like WIC; Medicaid/CHIP coverage for low-income mothers and children) and Germany (population 81,000,000; Statutory Health Insurance covering >85% of population; mandatory coverage; SHI services include preventive care; long-term benefits reviewed). Write a 1000-word analytical paper that compares coverage, access, maternal services, outcomes, financing, and policy implications. Present a clear thesis about differences in support for low-income families and the role of mandatory/basic coverage. Include in-text citations and a references list of credible sources.

Paper For Above Instructions

Introduction and Thesis

This paper compares the maternal health aspects of the United States and Germany health care systems using the provided country overviews. Both countries offer substantial maternal services, but they organize coverage and financing very differently. Germany relies on a statutory health insurance (SHI) system that mandates coverage and provides broad preventive services, while the United States operates a mixed public–private system in which targeted public programs (Medicaid, CHIP, WIC) supplement employer-based and individual private insurance (Thomson et al., 2011; HRSA, 2018). The working thesis is: although both systems support expecting mothers, Germany’s mandatory SHI ensures more uniform access to preventive maternal services, whereas the United States provides a variety of programs that extend significant resources to low-income families but produce uneven coverage and outcomes; reforms requiring basic coverage have improved access but left gaps across states and populations (Obama, 2016; KFF, 2020).

System Structure and Coverage

Germany’s SHI covers over 85% of the population through sickness funds, and coverage is largely compulsory for employees below certain income thresholds; private insurance is available for higher earners (Thomson et al., 2011; Bundesministerium für Gesundheit, 2018). SHI explicitly includes preventive maternal care—antenatal visits, screenings, immunizations, and standard postpartum services—under its benefit package (BMG, 2018). The system’s universality produces relatively consistent coverage across socio-economic groups.

In contrast, the United States lacks a single national insurance pool. Coverage is a patchwork of employer-sponsored private insurance, Medicare for older adults, and public programs for specific groups. Medicaid and the Children’s Health Insurance Program (CHIP) are the principal public payers for low-income pregnant women and children; additionally, WIC provides nutritional support to pregnant and postpartum women and infants (HRSA, 2018; KFF, 2020). The Affordable Care Act (ACA) increased access by expanding Medicaid in many states and requiring essential health benefits, including maternity care, in most private plans (Obama, 2016). However, non-expansion states and variable eligibility rules leave coverage gaps for some low-income women (KFF, 2020).

Access to Maternal Services and Quality

Germany’s model emphasizes early and routine preventive maternal care delivered through primary care gynecologists and midwives, with standardized screening and follow-up. The SHI funds pregnancy-related preventive services and routine childbirth care, and cost-sharing is limited for essential services, which encourages utilization among expectant mothers (Thomson et al., 2011; OECD, 2019).

The United States has high-quality maternal care available, including advanced obstetric and neonatal services, but access varies by insurance status and geography. Medicaid finances nearly half of U.S. births nationally, making it a critical source of access for low-income mothers; however, reimbursement rates and provider participation can affect continuity of care (KFF, 2020; CDC, 2019). Programs such as WIC improve nutrition and early postpartum outcomes, and targeted federal initiatives address maternal safety (HRSA, 2018). Despite these resources, social determinants and fragmented coverage contribute to disparities in prenatal care initiation and postpartum follow-up (Cheng et al., 2006).

Maternal Outcomes and Disparities

On average, Germany exhibits lower maternal mortality ratios and more uniform maternal health outcomes attributable to universal coverage and integrated preventive systems (OECD, 2019; WHO, 2019). Routine screening and broad access to midwifery and outpatient care support early detection of complications and continuity across pregnancy and postpartum.

The United States has higher maternal mortality and severe maternal morbidity rates relative to many high-income countries, with pronounced racial and socioeconomic disparities (CDC, 2019; Petersen et al., 2019). Medicaid’s coverage of low-income births reduces barriers but does not fully eliminate disparities caused by structural inequities, access to high-quality facilities, and differences in postpartum coverage duration (KFF, 2020). Policy efforts, such as Medicaid postpartum coverage extensions and maternal health safety initiatives, aim to address these gaps (HRSA, 2018; Obama, 2016).

Financing and Policy Implications

Germany finances its SHI through payroll contributions and employer shares, pooling risk across large insured populations and enabling predictable coverage for pregnancy-related services (Thomson et al., 2011; BMG, 2018). This pooled financing reduces out-of-pocket barriers for essential maternal care.

The United States mixes private premiums, employer contributions, and public funding. Medicaid is a federal–state partnership, with states determining eligibility and administration, creating heterogeneity in benefits and access. The ACA’s mandate and benefit requirements improved baseline maternity coverage, but political and policy variability has limited uniformity (Obama, 2016; KFF, 2020). For low-income families, sustained public financing (e.g., Medicaid eligibility expansion and postpartum coverage extensions) is crucial to improving maternal outcomes and reducing disparities.

Recommendations

To strengthen maternal health outcomes, the United States could prioritize: (1) expanding continuous postpartum coverage nationally to reduce care gaps after childbirth, (2) increasing Medicaid reimbursement to improve provider participation, and (3) integrating social determinants into maternal care (KFF, 2020; HRSA, 2018). Germany can continue monitoring long-term benefit reviews to ensure chronic maternal health needs are maintained under SHI and reduce administrative barriers that could restrict care.

Conclusion

Both systems deliver important maternal health services, but their organization affects equity and outcomes. Germany’s mandatory SHI fosters more consistent access to preventive maternal care for most citizens, while the U.S. system—through a mix of public programs and private coverage—provides valuable resources for low-income families but leaves variable coverage and outcome gaps. Policy efforts that expand and stabilize coverage for low-income mothers and align financing with preventive, community-based maternal services can narrow disparities and improve maternal health in both contexts.

References

  • Thomson S., Osborn R., Squires D., Reed S. J. (2011). International Profiles of Health Care Systems. The Commonwealth Fund.
  • Bundesministerium für Gesundheit (BMG). (2018). The German Health Care System. Federal Ministry of Health, Germany.
  • Health Resources & Services Administration (HRSA). (2018). Maternal and Child Health Programs and Services.
  • Kaiser Family Foundation (KFF). (2020). Medicaid’s Role for Women of Reproductive Age.
  • Obama, B. (2016). United States Health Care Reform: Progress to Date and Next Steps. JAMA, 316(5), 525–532.
  • Centers for Disease Control and Prevention (CDC). (2019). Pregnancy Mortality Surveillance and Severe Maternal Morbidity Data.
  • World Health Organization (WHO). (2019). Trends in Maternal Mortality: 2000 to 2017.
  • Organisation for Economic Co-operation and Development (OECD). (2019). Health at a Glance 2019: OECD Indicators.
  • Cheng, C. Y., Fowles, E. R., & Walker, L. O. (2006). Postpartum maternal health care in the United States: a critical review. The Journal of Perinatal Education, 15(3), 34–42.
  • Central Intelligence Agency (CIA). (2018). The World Factbook: Germany.

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