Friday, 18 September 2009
Healthcare around the world
I visited good old Wikipedia and found out a few things about healthcare around the world. It's an easy format to follow and as the subject involves mainly facts and figures, it's a fairly reliable source in this case. I picked some countries to illustrate my point about the contrast between the US and an assortment of other countries regarding healthcare.
Health care systems vary according to the extent of government involvement in providing care, ranging from nationalized health care systems (such as the U.K. and Sweden) to decentralized private or non-profit institutions (as in Germany and France). Universal health care is implemented in all industrialized countries, with the exception of the United States. It is also provided in many developing countries.
Germany has Europe's oldest universal health care system, with origins dating back to Otto von Bismarck's Social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889. As mandatory health insurance, these bills originally applied only to low-income workers and certain government employees; their coverage, and that of subsequent legislation gradually expanded to cover virtually the entire population.
Currently 85% of the population is covered by a basic health insurance plan provided by statute, which provides a standard level of coverage. The remainder opt for private health insurance, which frequently offers additional benefits. According to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004.
The government partially reimburses the costs for low-wage workers, whose premiums are capped at a predetermined value. Higher wage workers pay a premium based on their salary. They may also opt for private insurance, which is generally more expensive, but whose price may vary based on the individual's health status.
France, like other countries in Europe, has a system of universal health care largely financed by government through a system of national health insurance. In its 2000 assessment of world health care systems, the World Health Organization found that France provided the "best overall health care" in the world. In 2005, France spent 11.2% of GDP on health care, or US$3,926 per capita, a figure much higher than the average spent by countries in Europe and less than in the US. Approximately 77% of health expenditures are covered by government.
Most general physicians are in private practice but draw their income from the publicly funded insurance funds. These funds, unlike their German counterparts, have never really gained much management responsibility. Instead the government has taken responsibility for the financial and operational management of health insurance (by setting premium levels related to income and determining the prices of goods and services refunded). It generally refunds patients 70% of most health care costs, and 100% in case of costly or long-term ailments. Supplemental coverage may be bought from private insurers, most of them nonprofit, mutual insurers.
Until recently, social security coverage was restricted to those who contributed to social security (generally, workers or retirees), excluding some poor segments of the population; the government of Lionel Jospin put into place "universal health coverage" and extended the coverage to all those legally resident in France.
Health Services in Australia are universal. The Federal Government pays a large percentage of the cost of services in public hospitals. The public health system is called Medicare. It ensures free universal access to hospital treatment and subsidised out-of-hospital medical treatment. It is funded by a 1.5% tax levy on all taxpayers, an extra 1% levy on high income earners, as well as general revenue.
In the Japanese health care system, healthcare services, including screening examinations for particular diseases at no direct cost to the patient, prenatal care, and infectious disease control, are provided by national and local governments. Payment for personal medical services is offered through a universal health care insurance system that provides relative equality of access, with fees set by a government committee. People without insurance through employers can participate in a national health insurance program administered by local governments. Since 1983, all elderly persons have been covered by government-sponsored insurance. Patients are free to select physicians or facilities of their choice.
The Brazilian health system is composed of a large public, government managed system, the SUS (Sistema Único de Saúde), which serves the majority of the population, and a private sector, managed by health insurance funds and private entrepreneurs.
The public health system, SUS, was established in 1988 by the Brazilian Constitution, and sits on 3 basic principles of universality, comprehensiveness and equity. Universality states that all citizens must have access to health care services, without any form of discrimination, regarding skin color, income, social status, gender or any other variable.
On April 9, 2009 the Government of Peru published the Law on Health Insurance to enable all Peruvians to access quality health services, and contribute to regulate the financing and supervision of these services. The law enables all population to access diverse health services to prevent illnesses, and promote and rehabilitate people, under a Health Basic Plan.
The universal health care system is used in Trinidad and Tobago and is the primary form of health-care available in the country. It is used by the majority of the population seeking medical assistance, as it is free for all citizens.
Canada, Argentina, Canada, Chile, Costa Rica, Cuba, Mexico, Panama, Uruguay and Venezuela all have public universal health care provided.
In Europe, the following countries have with universal health care: Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, the Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Russia, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Ukraine and the United Kingdom.
Bhutan, Brunei, China, Hong Kong SAR, India, Kuwait, Qatar, UAE, Saudi Arabia, Israel, Malaysia, South Korea, Seychelles, Sri Lanka, Taiwan, Pakistan and Thailand also have universal health care.
Surprisingly, one major country doesn't have universal healthcare provided or managed by the government:
Health care in the United States is provided by many separate legal entities. More is spent on health care in the United States on a per capita basis than in any other nation in the world. Medical debt is the principal cause of personal bankruptcy in the United States, weakening the whole economy. Some have argued that the system does not deliver value for the money spent.
Around 84.7% of citizens have some form of health insurance; either through their employer or the employer of their spouse or parent (59.3%), purchased individually (8.9%), or provided by government programs (27.8%; there is some overlap in these figures). All government health care programs have restricted eligibility, and there is no government health insurance company which covers all citizens. Americans without health insurance coverage at some time during 2007 totaled about 15.3% of the population, or 45.7 million people.
Some Americans do not qualify for government-provided health insurance, are not provided health insurance by an employer, and are unable to afford, cannot qualify for, or choose not to purchase, private health insurance. When charity or "uncompensated" care is not available, they sometimes simply go without needed medical treatment. This problem has become a source of considerable political controversy on a national level.
I find it absolutely unbelievable that the most powerful country in the world, with just about the largest economy, the country that for a long time sought to set the parameters for everything around the world is still centuries behind many minor nations when it comes to healthcare.
The vast majority of the countries I mentioned above are not socialist dictatorships. Some government run health services are more comprehensive than others, there are complex relationships between the government and insurers in some of the countries, but they all regard healthcare as a basic right and strive to provide cover for all their citizens.
What is seen as a human right in so many countries is regarded as a privilege in the US. The per capita expenditure on healthcare in the US is higher than anywhere else in the world, but it's not the government footing the bill. Those who can afford it inflate these figures and swell the coffers of the insurance companies, leaving 48 million Americans without cover. That's more people than the population of some countries.
The same people who are protesting in the US, the people who are buying the dishonest lies propagated by Fox News, by politicians like Sarah Palin and the health insurance companies, could have the tables turned on them and they could find themselves bankrupt in order to preserve their health and that of their loved ones. Instead of accepting a government trying to serve one of their most basic needs, they prefer to part with sizeable amounts of money each month for the benefit of very big corporations that ration the services so they can make more profit.
Added link: healthcare premiums in Alaska