system is most similar to the German one, Japan apos;s is more egalitarian, with government subsidization of plans covering inherently less healthy and poorer populations, and no opportunity for people to opt out by buying private insurance. Insurance companies seeking to mitigate the problem of adverse selection and manage their risk pools screen applicants for pre-existing conditions. They are more likely to delay seeking care, resulting in more medical crises, which are more expensive than ongoing treatment for such conditions as diabetes and high blood pressure.
Skinner, "Tracking the Care of Patients with Severe Chronic Illness: the Dartmouth Atlas of Health Care 2008." Archived October 29, 2008, at the Wayback Machine. A study conducted by the Commonwealth Fund in 2001 found that, among those aged 19 to 64 who sought individual health insurance during the previous three years, the majority found it unaffordable, and less than a third ended up purchasing insurance. 81 However, statistics regarding the insured population are difficult to pinpoint for a number of factors, with the Census Bureau writing that "health insurance coverage is likely to be underreported". A b Goodman, John (September 21, 2009). "Despite slight drop in uninsured, last year's figure points to 48,000 preventable deaths". 88 The study concluded that the majority of the cost differential arises from medical malpractice, FDA regulations, and facilities regulations. "Mirror, Mirror on the Wall: How the Performance of the.S.