Healthcare in the United States vs. Europe, Essay Example

A Comparison of the Healthcare Systems of the United States and Europe

The people of the United States have often boasted that the country has the “best healthcare system on earth.” Yet European critics have denounced America’s system as backwards. Indeed, when American President Barak Obama recently signed new healthcare reform legislation into law, Europeans said that they were happy Americans had finally joined the 20^th century ­ (not even the 21^st). (Walt, 2010) But how different is the American system from the European? How do the two systems compare in terms of cost, access, quality, demographics and socioeconomic consideration? The United States has reason to boast in some of these areas, but in other areas, it is inferior to the systems run by its European allies.

Perhaps the most widely discussed differences between the American and European systems are the issue of cost. Europeans claim that Americans pay a great deal more for medical premiums and still, sometimes receive low quality care. From a certain perspective, they are right. American John Econopouly found that he needed to have an operation because of a hernia. His insurance paid for some of his bills, but he was still left with a 2,000 tab. (Leonhardt, 2006) To add insult to injury, his wound opened, leaving him in a “pool of blood.” Not long after, he traveled to Greece and during his visit he discovered that he needed surgery for another Hernia. Although, he says, the hospital was far dirtier and the staff laughed at him when he asked for more privacy (and even offered to pay for it), the surgery was far cheaper. Although he had no Greek insurance, his bill was only 700. Econopouly also mentions that he believes the care he was given in Greece was more thorough than the care he received in the American hospital.

Yet there are hidden costs of healthcare. The true cost of healthcare is often tucked away in taxation. The European countries that spend he most on healthcare, including Norway, France and the United Kingdom, also tax their laborers significantly more than the United States currently taxes its. Indeed, According to the Brussels Journal (Adair, 2005), Norway, which spends nearly $3,000 USD per capita on healthcare also taxes its workforce, has a 37% tax wedge. France which spends just over $2,000 per capita on healthcare has a 48% tax wedge. Germany has a staggering 52 % tax wedge and spends $2,212 per capita on healthcare. The tax wedge of the United States is relatively small at 29%. It spends $2,364 on care – more than France and Germany, whose taxes are significantly higher. (Adair, 2005) America, then, seems to tax its people less than many of its European counterparts, while sometimes spending more on healthcare than they do.

Private spending should also be taken into account. When one adds private spending in each nation to the data, the United States spends a great deal more on healthcare than its European counterparts. Indeed, according to Businessweek, the United States spends twice as much per-capita as most European nations. (Capell, 2007) Yet Americans might be considered lucky to have that option. In some nations, private insurance is virtually non-existent. Those on waiting lists for public care must simply wait and those who must rely on rationed care are often out of luck if they need more care than the government is willing to give them.

In any discussion of healthcare, knowing who is covered is every bit as important as knowing how much money is spent on care. Many European nations boast of universal coverage. When one of these countries spends $2,000 per capita on healthcare, they may really be spending that much money per person. The US system works differently. Not every American is eligible for public funding. The United States, instead, provides care for select groups with programs like Medicare and Medicaid.  Medicare covers some of the medical costs of people who are over 65 years of age and others with certain disabilities. (Centers for Medicare and Medicaid Services, 2008) Medicaid, meanwhile, is intended to help those who cannot afford health insurance. Those who enroll must fit inside certain income brackets. Certain conditions may also make Americans eligible for Medicaid, including pregnancy and disabilities. Legal immigrants may qualify for care, even if they are not US citizens (Department of Health and Human Services, 2010).

What this means is that more money is spent on fewer people in the United States, but whereas, in countries such as the UK, everyone is taxed, including those who are poor and everyone receives care, including those who are rich, the United States does not tax the poor to provide healthcare to the wealthy. The European systems, then, are, perhaps, more egalitarian, but the American system could be seen as more efficient.

Yet, perhaps the most important question of the healthcare debate is neither “who?” nor “how much?” but instead, “What is the quality of care?” According to Businessweek’s Kerry Capell, The United States, in spite of its massive spending, “ranks last or near last on basic performance measures of quality, access, efficiency, equity, and healthy lives.” (Capell, 2007) Although Capell admits that some European systems, such as the UK’s NHS, have problems of their own. However, says Capell, France may be the model the United States should look toward. Its citizens are healthier than US citizens and it spends, she says, “half as much.” Capell’s last statement is not accurate if one figures in the cost of taxation, but France’s health might indeed be a factor to consider.

The quality of care in the UK is also worth considering. France combines universal coverage with price controls and private insurance options. The UK’s system is mainly government run.  The government run system has made the quality of care in the UK very bad. According to Capell, 41% of British patients had to wait at least four months before undergoing elective surgery. Only 10%of Americans had to wait so long.

British citizens have very limited access to life-extending cancer drugs, which, says Capell, have given its people one of the lowest rates of cancer survival. Indeed, less than half of British men diagnosed with cancer survive, and only 53% of women do. In France, 53% of men diagnosed with cancer live and 71% of women do. Capell does not mention the survival rates of Americans, perhaps because it does not support the idea of France as a perfect model. According to CDC data, the survival rate of white males in the United States is 69.1% while the survival of white females is 68.9% white men, then, have a significantly higher chance of surviving cancer in the United States. Black men also have a significantly higher rate of cancer survival in the United States than they do in the UK. 62.2% survive. Meanwhile, 56.2 percent of black women survive. Women, then, have a higher rate of cancer survival in France; men have a better chance in the United States. No one seems to have a better chance of survival in the UK (Centers for Disease Control, 2009).

The disparity between survival rates for men and women and between blacks and whites is an issue that may also deserve attention. It is notable that in France, women tend to survive a great deal more than men do, while the reverse is true in the United States. It is also notable that white Americans have a higher rate of survival than blacks. Perhaps some of the disparity is due to genetics, but part of the problem may lie in socioeconomic factors. Better screening methods for diseases affecting women might need to be adopted in the United States, while methods concerning the screening of male diseases might need more attention in France. The UK’s doctors are comparatively bad at preventative care, says Capell, not spending as much time as they should with screenings. These are things that the United States is much better at (Capell, 2007).

When comparing the quality and cost of care in America to that of UK, The Economist says the following:

Both health systems have their virtues and their faults. At its best, America offers extraordinarily good clinical care, but too many people lack insurance cover or fret about losing it. The NHS provides health care to all at a much lower total cost, but patients have less clout. Both countries are crying out for reforms to bring about better and cheaper care.

Access to care is also important. In the American system, almost anyone can obtain care if he is able to pay for it. In some states, like California, illegal immigrants are eligible to receive medical care at no cost. In Europe, the story is different. Marie Norredam, Anna Mygind and Allan Krasnik of Denmark’s Department of Health Services Research found that of the 25 European nations they surveyed, ten countries placed prohibitive legal restrictions on healthcare for asylum seekers (Norredam, Mygind, & Krasnik, 2006). Indeed, according to their survey, the only medical services the ten EU nations provided to Asylum seekers were emergency services and medical screenings. Greece did not even provide asylum seekers with medical screenings (Norredam, Mygind, & Krasnik, 2006).

Meanwhile, Nayanah Siva reports that the UK recently passed legislation to limit the number of asylum seekers who could receive secondary care for free. This, says Siva, has “caused concern among campaigners and clinicians.” (Siva, 2009) The EU has tried to gain support for viewing healthcare as a human right, rather than a benefit, but many of its member nations disagree. In the UK, for instance, the Lord Justice Ward says the following:

The purpose of the National Health Service Act is to provide a service for the people of England and that does not include those who ought not to be here. Failed asylum seekers ought not to be here.

So far then, healthcare is no more a human right in European nations than it is in the United States. The systems of both countries have benefits and flaws. Because of the diversity of these, none can claim any real superiority over the other.

Works Cited

Adair, G. (2005, October 10). European vs American Healthcare Spending. Retrieved March 23, 2010, from The Brussels Journal: http://www.brusselsjournal.com/node/326

Capell, K. (2007, June 13). Is Europe’s Health Care Better? Retrieved March 23, 2010, from Businessweek Online: http://www.businessweek.com/globalbiz/content/jun2007/gb20070613_921562.htm

Centers for Disease Control. (2009). Health, United States, 2009: with Special Feature on Medical Technology. Retrieved March 23, 2010, from Centers for Disease Control Web Site: http://www.cdc.gov/nchs/data/hus/hus09.pdf#050

Centers for Medicare and Medicaid Services. (2008, September 17). General Enrollment and Eligibiliy. Retrieved March 23, 2010, from Medicare.gov: http://www.medicare.gov/MedicareEligibility/Home.asp?dest=NAV|Home|GeneralEnrollment#TabTop

Department of Health and Human Services. (2010, January 5). Medicaid Eligibility. Retrieved March 23, 2010, from Centers for Medicare and Medicaid Services: http://www.cms.hhs.gov/MedicaidEligibility/

Leonhardt, D. (2006, October 18). A Lesson From Europe on Health Care. Retrieved March 23, 2010, from The New York Times Online: http://www.nytimes.com/2006/10/18/business/18leonhardt.html

Norredam, M., Mygind, A., & Krasnik, A. (2006). Access to health care for asylum seekers in the European Union–A Comparitive Study of Country Policies. European Journal of Public Health , 16 (3), 285-289.

Siva, N. (2009). Raw deal for refused asylum seekers in the UK . The Lancert , 2099-100.

Walt, V. (2010, March 23). E.U. Gloats Over Belated U.S. Health Care Reform. Retrieved March 23, 2010, from Time Magazine (Online): http://www.time.com/time/world/article/0,8599,1974424,00.html