American Health Care and its Placement in the World

Introduction

 

Health care in the United States is a hotly debated issue in terms of quality and cost effectiveness. From challenges of cost-containment to providing insurance to the more than forty-nine million un-insured in America, which there are many variables that contribute, to the most expensive health care provided in the world, and then arguably the thirty-eighth efficient health care provided in the world, there is a lot of work to be done. This blog seek to answer basically two questions, what explains the paradoxical under achievement of the U.S. health care system in terms of money spent per capita, and the perceived failure of the U.S. to achieve the population outcomes of nations that spend much less per capita on health care?

 

            There will be three countries covered, France, the number one country in the world in terms of quality health care practices, Singapore the sixth country, and of course the United States the thirty-eighth country. A capricious number of factors determine America’s arrival at its placement in world health care. This blog covers a few areas that influence the governmental decisions of the various countries, cost and cost-containment procedures, types of insurance coverage and policies that dictate how their respective health care is implemented.

Comparison of Health Care Systems

French System of Health Care

 

Depending of the review a person read, the French health care system is one of the best systems in the world, some rate it the number one system. The French medical operation practices a 

universal health care system, with majority financial contributions from national health insurance(Keevil, Wicks, 2014). General practice physicians find themselves largely in the private sector for their individual practices, but are reliant on considerable subsidization from public insurance funds. Capital from these organizations are not heavily regulated, though similar practices by some of France’s European counter-parts are self-managed; the French government chooses to accept responsibility for fiscal and operational management of its national health care insurance.

This is accomplished by premium level set relative to income, and by the government being the primary determinant of product pricing and service refunds (Cowling, 2014).

 

            The French provide arguably the best health care in the world, with comparable health care systems France is still a respectable fourth per capita. France spends an estimated 11% of gross domestic product (GDP) on health care, approximately $4,000 US dollars per person. With financial packages such as refunding almost 70% of most health procedures and a whopping 100% of what is considered extreme or long-term care patients, makes for an extraordinary health care system (Moore, 2013). The generosity of the French government does not stop there, almost 80% of health care disbursements are covered by the government. Previous versions of the French health system only covered those citizenries that participated in the country’s social security program, excluding the indigent population, then in 2000 the ruling party of Lionel Jospin installed universal health and extended health coverage to all legal residents of France (Moore, 2013).

 

 

Singapore System of Health Care 6th

 

Singapore or officially the Republic of Singapore, is considered a sovereign city-state/island country in Southeast Asia. Though Singapore is small in stature it boast one of the world’s premier commercial hubs, with the fourth largest financial center and one of the five busiest ports in the world  (Keevil, et al., 2014).  This is not the end and certainly not the only goliath like achievement for this diminutive country; Singapore further avowal a sixth place quality rating for health care provided compared against all modern countries, in 2014 this country of nearly 5.4 million inhabitants was considered number one in health efficiency. The responsibility for the provision of health care is the charge of Singapore’s Ministry of Health. The country uses a non-modified version of universal health care; in this arrangement the government monitors reasonably priced health care be provided through the country’s public health system (Cowling, 2014)

 

 

In Singapore's non-modified health care organization, combinations of compulsory savings are used from payroll deductions that help to provide subsidies from a nationalized health insurance plan called Medisave (Stevens, 2014). This system amounts to a savings account where each citizen accumulate money that can be individually traced, and further, these funds can be shared with extended family members. Medisave have proven to be very successful, most Singaporeans have amassed a considerable financial reserves using this scheme. Central to the success of Singapore’s health care plan is that all medical services are charged services, no matter the level or origin of subsidization. Nearly 80% of medical care is obtained within the public health system, which amounts to government spending of only 1.6% of GDP, or basically $1,100 per person (Stevens, 2014).

The United States System of Health Care

With much disputation, the American health care system is perhaps the largest in the world and the most expensive, with a world-wide health care quality rating of thirty-eighth. The health systems of the United States are layered from many private sector medical and insurance organizations (Keevil, et al., 2014). The U.S. matrix of hospitals are shredded out this way, most are operated as a provision of privately owned businesses, with 58% being community or non-profit, 21% government owned, and 21% are for-profit. There is a large diversity in health care coverage with almost 60% of spending coming from Medicare, Medicaid, Children Health Insurance Program, and then Veterans Health. Conversely, Americans under the age of sixty-seven usually have insurance coverage through family member’s employer, while health insurance for public sector employees are government subsidized (Almgren, 2007).

 

The World Health Organization (WHO), reported that the United States spent $8,600 per capita on health care in 2013, more than any other country, and likewise a greater portion of its GDP at 17%. Though life expectancy in the U.S is up from 1990, it still ranks 50^th in the world and 27^th out of the 34 industrialized countries (Keevil, et al., 2014). Some huge drivers of boundless health care cost is the lack of an effective preventive health program, coupled with world-wide highs in areas such as obesity, infant mortality, heart and lung disease, sexually transmitted disease, adolescent pregnancies and homicides. Collectively these and other medical variables firmly place the U.S. health system near the bottom of most quality health systems of any significance. Ironically, the U.S. has singularly contributed to nine of the top ten most meaningful innovations in the last four decades (Almgren, 2007).

The U.S. has a census of over forty-nine million un-insured potential patients, with an incalculable number visiting the most expensive treatment facility there is, the emergency room. It is estimated that un-insured, under-insured or indigent care through the emergency room accounted for over 9% of all visits, which cost the health care system an estimated $15 billion dollars a years (Cowling, 2014) The unwillingness of the U.S. government to adopt and national health care coverage policy is believed to account for over fifty thousand, needless deaths a year. The U.S. insures approximately 78% of its citizens, while most industrialized countries insure around 90% of their citizens. Lastly, the aging baby boomers are retiring at a rate of almost one hundred thousand a month, taking with them highly skilled positions throughout the entire work-force, and leaving a depleted, under-skilled working force, that adopted dwindling wages and sky-rocketing health care cost (Almgren, 2007).

 

America’s Failure to Achieve Population Outcomes of Nations That Spend Less Per Capita on Health Care

America is a world leader in health care knowledge which is very interesting that it lags so far behind most industrialized countries and even some second-world countries in quality of health care provided (Keevil, et al., 2014). The extreme cost and most importantly the point that a significant number of Americans can enter the health care system create a tremendous barrier to effective, quality health care. The lack of an effective preventive health system and affordable health care is by far the largest contributor to the poor quality of health care in America. The social and political debate over health care is usually argued over socialized medicine; paradoxically most of the top performing health care systems in the world, use some form of socialized medicine. The limited access to health care has a medically rippling affect that not only place the health of the patient at jeopardy, but it places the financial health of the country at jeopardy as well (Almgren, 2007).

 

The U.S. leads the world in key medical demographics, such as heart failure, adolescent pregnancy, homicides, obesity, diabetes, and accidents, and often the patient of these medical emergencies have little to no insurance. Some of the disease states that face America’s patients could have been at least minimized if preventive health care was made available; teen pregnancy, infant mortality, heart and liver disease, could all be minimized to the point of not being significant. Health availability places the patient at risk certainly of health and even possibly death. Most countries above the U.S. on the chart of quality health, has significant government involvement and minimal private insurance control, allowing the government to provision quality health care, but the U.S. is almost the exact opposite, with private insurance and pharmaceutical companies playing vital roles in the health care cost and quality of Americans (Almgren, 2007).  

 

 

Conclusion

Health care in America for some is seen as an entitlement, to be earned and not a natural right of citizenry, while other see basic health care as a basic human right, that no one should have to choose between eating or being sick, and yet in a country that some believe to be the most prosperous country ever to exist, we have just that. The Health Care Affordability Act was an attempt to bridge the gap between the un-insured and even the under-insured and the insured, to be done in a way to make health care affordable for the masses. Instead it has created perhaps the largest political divide America has seen in decades (Moore, 2013). Thirty-seven countries with health systems on a per capita basis, enjoy a quality of life through health care that is substantially better than the average American’s. Life expectancies are longer, quality of life in terms of health are better; medical situations such as infant mortality, heart disease, and most notably homicides and far less likely in the other countries.

America produces some of the most brilliant minds in health care, receiving more Nobel Prize winners in medicine than all of the European nations combined, and yet when it comes to the implementation of an effective health system that avails America’s citizens to affordable, quality health care, there is no easy answer, or is it (Cowling, 2014). Pharmaceutical and insurance companies routinely make profits into the hundreds of billions of dollars, both often receiving governmental subsidies, when individual citizens requiring assistance with a variety of medical ailments are often refused by insurance companies, are politically legislated out of the system, and have been cancelled because of pre-existing conditions. Yes “Obama” care is supposed to eradicate such practices, but at demonstratively successful levels the rehearsal of medical/insurance denial continues. Until the moral conscious of America’s business and political leaders are awaken, America will continue to be thirty-eighth best or worst (Keevil, et al., 2014).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Almgren, G. (2007). The Contemporary Organization of Health Care: Health Care Finance,

            Health Care Politics, Policy and Services, pg. 89 – 137

Cowling, D. (July 2014). Inequalities in Health Care Provision, Teaching Geography, pg. 56-59

 

Keevil, A., Wicks, A. (October, 2014). When Worlds Collide: Medicine, Business, the

Affordable Care Act and the Future of Health Care in the U.S., Journal of Law, Medicine & Ethics, 42 (4), pg. 420-430

Moore, K. (April 1, 2013). Comparison of the Role of the Employer in the French and U.S.

            Health Care Systems, Hofstra Labor & Employment Law Journal, 30, pg. 459

Stevens, M. (June 1, 2014). Health Care Providers Industry Profile: Singapore, Health Care

            Providers Industry Profile: Singapore, pg. 1-31