Health Care Systems of Developed Countries, Research Paper Example

United States

The United States health care system has been the subject of many debates. One side argues that health care is the best in the United States due to its technology, innovation and facilities while the other side point out that the USA is the highest spending nation on health care compared to other industrialized nations all over the world (WHO, 2011) and was also ranked last in terms of quality and the cost of health care by the Commonwealth Fund (Roehr, 2008).

Facilities in the United States are primarily owned and operated privately while insurance is provided by the US government for public sector employees. Two health programs dominate the public sector, namely: Medicare and Medicaid. These programs are both run by the US Department of Health and Human Services. Medicare is primarily for individuals over the age of 65 while Medicaid is designed to help the poor. By 2003, 62% of Americans have employer-sponsored insurance within the private sector, 5% have individual private insurance, 15% have insurance within the public sector and 18% remain uninsured. People without any form of health insurance therefore have limited health care access and this lack has become a national problem without a clear solution up to now.

Obama’s election into the presidential seat in 2008 saw the advent of healthcare reform. At this time, costs associated with healthcare were steadfastly rising and it was even estimated that the costs of healthcare for a family of four will double in 10 years and will continue to rise. In addition, 50% of personal bankruptcies resulted from medical expenses. On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act along with the Health Care and Education Reconciliation Act of 2010. This includes certain provisions including the expansion of eligibility criteria in Medicaid, subsidizing insurance, provision of incentives for businesses providing healthcare benefits and prohibition of denial in claims and coverage to name a few.

Canada

In Canada, each province is responsible for the administration and delivery of healthcare. Canadian citizens often receive health care services at no cost, including fees for hospitalization and physician services. Health care is funded by the public sector with the government ensuring the quality of care through a set of standards at the federal level. Healthcare coverage does not have any limits or excluding factors for pre-existing conditions. Furthermore, employment does not play a significant factor in getting healthcare coverage. Since 1971, all Canadian citizens have access to health care, irrespective of income, health status, or employment status. Compared to the United States, Canada provides healthcare coverage at a fraction of a cost. In terms of supplementary care such as elective surgeries, these can be paid through private insurance or out-of-pocket. Supplemental insurance also cover vision and dental care, usually provided by employers. The financing for health care system is split between Medicare (70%), which is funded publicly and supplemental care (30%) (Evans, 2000).

Disparities within Canada’s healthcare system occur between the rural and urban areas, with the rural areas having a lower status. This can be attributed to accessibility and delivery of healthcare within the rural areas (PHAC, 2003). Physicians working in rural areas are fewer in numbers and those practicing in remote areas, in particular, are overworked. There are also variations between provinces in terms of insurance plans. This is particularly evident between French speaking areas and non-French speaking provinces. Some provinces may provide full insurance coverage while others may not even cover an individual’s basic needs. Another criticism in Canada’s healthcare system is the long waiting times for individuals with non-threatening conditions. Waiting times for diagnostic procedures can take as long as several weeks. This problem has been recognized by the government, however, and wait time guarantees are now in place to ensure efficiency.

Great Britain

In a report by the Commonwealth Fund, the United Kingdom has been ranked second overall in a survey of the seven first-world healthcare systems. The United Kingdom also took the first place in the sub-categories of efficiency and effective care (Davis et. al., 2010). Healthcare in Great Britain is regionalized within each country. Each country, comprising of Northern Ireland, Scotland, Wales and England each have their own system, with varying policies. A common feature among these countries is the provision of public healthcare to all permanent residents, funded from general taxes. The National Health Service (NHS) is the primary body responsible for public health. All taxpayers contribute to the cost of healthcare, thus ensuring that treatment and care is provided to those who need it. The NHS utilizes General Practitioners in the provision of primary healthcare along with referral services. Hospitals serve as providers of specialist services and acute care. Free ambulance services are also available in emergent cases. Private dental services are available, with rates regulated by the NHS. Amidst this, private healthcare is also available to those who opt through private health care insurance.

The NHS also has a twenty-four telephone advisory. Though it has different names for each country, it has the same function of addressing medical concerns from residents. The service was also initiated to decrease waiting times at offices of general practitioners and to provide care during out-of-hours. Walk-in centers are also available for non-urgent care and to quickly access medical information and advice. Medication prescriptions have a fee of 7.65 GBP per item in England. Exemptions apply for those under 16 years of age or over 59 years, certain medical conditions and those on the low-income threshold. However, these charges have been totally abolished in Northern Ireland, Scotland and Wales.

Germany

In a Commonwealth Fund report, Germany obtained a second ranking among developed nations in the category of adults receiving healthcare either on the same day or the next day (Commonwealth Fund, 2005). Germany has two major kinds of health insurance, namely: Private health insurance and Law-enforced health insurance (DiPiero, 2004). Obligatory insurance are enforced to individuals who do not meet a certain income level. This is paid for with contributions from employees and employers. Individuals whose incomes are above the compulsory insurance level may decide to join the sickness fund system or they may also obtain a private insurance. In the case of state workers, the government pays a share of medical costs and private insurance covering the rest.

Coverage offered by sickness funds is very broad and extensive and includes dentists, prescriptions, end-of-life care and may even include spa treatment if it is prescribed. German citizens also have the freedom to choose a fund of their liking and can freely switch between them. Unemployment does not cause forfeiture of insurance coverage and the option for supplemental coverage is available.

Works Cited

Davis, K. et. al. Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally, 2010 Update. [Web] 29 March 2013

DiPiero, A. Universal Problems & Universal Healthcare: 6 countries – 6 systems. 2004. [Web] 29 March 2013

Keckle, P. 2011 Survey of Health Care Consumers Global Report: Key Findings, Strategic Implications. 2011. Produced by the Deloitte Center for Health Solutions

Public Health Agency of Canada. Rural health in rural hands: Strategic directions for rural, remote, northern and aboriginal communities. 2003. [Web] 29 March 2013

Roehr, B. Health care in US ranks lowest among developed countries. BMJ 337. 2008.

The Commonwealth Fund. Waiting Time to See Doctor when Sick or Need Medical Attention–Sicker Adults in Six Countries. 2005. [Web] 29 March 2013

World Health Organization. World health statistics 2011. Geneva: World Health Organization. 2011. [Web] 29 March 2013