Comparative Health Care Systems
“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” MTK, Jr.
It is on this note that the Framework of Major Influences on Health Care Systems based on the work of Alford (1969), Leichter (1979), and Lassey, Lassey, and Jinks (1997) was developed to clarify these indefinite and infinite forces (Weiss and Lonnquist, 2009:373). The framework addressed issues related to the physical environment such as the presence of environmental pollutants, historical and situational events that influence health care such as (recessions, wars, depression), cultural norms and values (such as high increase in surgery, drugs, diagnostic procedures) and the societal structures (such as the extent of centralized government), economic factors such as the (level of national wealth), demographic characteristics such as age structure and social factors such as (social support versus reliance on family).
Globally, a number of recent studies have shown comparison in the health systems of various countries developed and developing alike. “Using information and concepts from these studies, it is possible to evaluate the health care system of the U.S. and other countries, with respect to such fundamental issues as cost of medical coverage, access to health care, and how well the health system succeeds in producing good health outcomes in a population” (Bureau of Labor Education, 2000; Weis and Lonnquist, 2009:374). The World Health Organization (2000) evaluated the health care system of 191 nations on health care delivery specifically taking into accounts those fundamental issues such as the cost of health care services, access to health care, and the successes associated with these health care systems in producing good and health outcomes in the population. According to WHO (2000) assessment, France ranked number 1 followed by Italy, San Marino, Andorra, Malta, Singapore, Spain, Oman, Austria, and Japan, while the United States ranked in the 37th place in its overall health performance.
Health care is a fundamental issue to almost all developing countries and this problem is intensified by the lack of appropriate technologies, more health problems that develop as a result of risky behaviors and fewer resources to invest in medical research both in the public and private health care sectors. Today, “most developing countries spend only about 4 percent of their income on health care, which constitute about one-half of what most developed countries spend” (Weiss and Lonnquist, 2009: 375). The issues of access to care, quality of care, and system efficiency are some of the challenges that most developing countries are presently experiencing and this is even worse in rural areas where transportation is a major challenge follow by high illiteracy rate. In the process of addressing some of these issues in developing countries, the United Nations through the offices of the United Nations Development Programme (UNDP) and other International Non-Governmental Organizations and governments of developing countries are working closely together in developing poverty reduction strategies frameworks to combat against most of the social, economic and environmental challenges, which include providing access to and funding for programs to address some of the global health issues such as eradicating HIV/AIDS, Malaria, Cholera, Tuberculosis and other diseases, reduce child mortality and improve maternal health. In order to assist developing countries and their governments to have access to resources to combat the various forms of health related issues that they encountered that the United Nations Millennium Development Goals (UN MDGs) were established in 2000 to be achieved by 2015.
Roger suggested that in order to evaluate the distinctions in health care systems throughout the world, the level of affluence a country possess and its government’s degree of control will subsequently lead to four types of health care system and he termed these as: private insurance with private services, national insurance with private, regulated services, national insurance with public, regulated services and lastly, national insurance state-run system. It is in this background that countries such as China, Russia, Canada and Great Britain have been selected to discuss their health care systems with emphasis as to how they relates with the US Health care system.
China is one of the most populous nations on Earth with about 1.3 billion people. With most of the country’s population migrating to urban communities, China remains predominantly an agrarian society in which agricultural productivity is the hallmark of economic development. Mao Zedong presented four precepts as the ideological foundation for the health care system in China during his period and these include the following; that the availability of health care must be directed to the working people, the prioritization of preventive medicine over its curative counterpart, the addition of modernized health care to traditional Chinese approaches and lastly, the obligation of health workers to be actively involved in mass movements of health related policies. Notwithstanding, the introduction of the “Cultural Revolution” by Mao Zedong shaped China’s health care system. Access to health care was considered a right that everyone must enjoy and this had tremendous moral commitment. Health policies are formulated by the Ministry of Health followed by the establishment prices and also supervise medical research projects. With cuts in local subsidies or government’s fundings, the accessibility of health care in rural areas becomes largely depended on their ability to pay. The occurrence of health related illnesses differ between urban and rural settings. With the dominance of China’s private market economic system created several malfunction in the system.
Russia has a socialized health care system. Their system is based on these foundations that the state has the responsibility and provision of the health care system, the centralization and bureaucratization of the health care system, it is considered as a right of all citizens, the provision of preventive medicine at no cost, and orientation of medical research should be to addressed practical problem solving perspectives” (Weiss & Lonnquist, 2009: 381). It is stated in their constitution that health care must be free and as such it is guaranteed that all Russian citizens receive such services; notwithstanding, it is understood that only some part of the services are actually free. Currently, Russia’s health care system is at experiencing significant amount of challenges and these are indicated by specific markers as the increased in mortality rate, significant decrease in life expectancy and the high increases in infant mortality rate.
Canada, a neighbor to the United States has a current population of about 33 million people. The creation of Canada’s universal health care system was fundamentally influenced by three extreme determinants namely: the extreme prevalence of indigency created as a result of the depression, local governments inability to deliver assistance, and the issues of physicians not be paid for their professional services. In 1968, the Medical Care Act was passed in Canada, which unified all geographical provinces unto a universal health insurance program. This system “covers basic hospital and physician services and services as deemed to be necessary are covered” (Weiss & Lonnquist, 2009: 385). With this kind of system, Canada has one of the best health care systems in the world.
Great Britain has a current population of about 60 million people, which also include Scotland, Wales, and Northern Ireland. It health care system is owned and operated by the government and this include the establishment of health care policies, generating fundings as well as planning budgets for the entire system. With government’s funding, British citizens receive comprehensive health coverage.
1. Weiss, Gregory L. and Lonnquist, Lynne E. (2009). “The Sociology of Health, Healing, and Illness.” Pearson Education, Inc., Upper Saddle River: NJ. U.S.A.
2. Bureau of Labor Education (BOE). “The U.S. Health Care System: Best in the World, or Just the Most Expensive?” University of Maine, Orono: Maine. U.S.A