Health Care Systems and Institutions Term Paper

Excerpt from Term Paper :

Health Care Systems

In today's advanced and modern society, which is dependent upon new and emerging technologies in almost all fields of life, the importance of health care systems cannot be denied in any case. Health care is being associated with the technological advancement as because of several new medical techniques, it has become possible to devise the treatments of many such diseases which were considered deadly in older times. On the whole, from diagnosis to treatment and to make preventions from the disease, health care systems have now become an essential part of today's civilized nations, particularly those having an economic boom and strong financial sector. It is a common observation that stronger the economy of the country, greater would be the number of facilities provided to the citizens. Good health care systems are too, associated with strong and developed nations like U.S., UK, Canada and Germany etc. These countries spend a heavy amount and expenditures for the welfare of its citizens as far as the health care is concerned. Different policies are implemented according to the entire system and particular demography.

While describing the health care systems, the structure is the important thing. Some countries have a centralized structure in which the choices of production, consumption, and distribution of health care services are done by a centralized authority, which could be the government itself who makes a committee or an individual as the authority. Some have a decentralized structure in which the choices are made by the individual consumers and health care providers by their mutual interaction in the marketplace. There are also some third-party payers which are actually private/public health insurance companies that act as a middle-man between the consumer and the health care producer. They are responsible for financial issues and risks involved in health care products and to keep the costs under control. The public health insurance companies make finances of medical insurance through taxes, while private health insurance companies do it by the methods of premiums, deductions, co-payments or co-insurance plans (Santerre and Stephen 3, 6, 7). All or some of these methods of the health care system are practiced in countries like U.S., UK, Canada and Germany. Let's have a brief glance over it.

Canada's health care system is based upon several national health insurance plans that work all over the country and provides coverage to all citizens. The system runs upon the funds taken from the public in the form of taxes and in return the citizens are provided health care services from primary up to secondary and tertiary levels. There are no concepts of deductibles or co-payments. Taxes are collected at provincial and territorial levels which are then transferred to federal government for the appropriate utilization. There are also some private insurance providers and the citizens can take services of such companies too. Primary care takes the lead as there are about 30000 primary care doctors in Canada, followed by specialists who are currently about 28000 in number (Santerre and Stephen 4). A successful story of this system is indicated by one of the highest life expectancies and lowest infant mortality rates of industrialized countries. Approximately 10.4% of Canada's GDP is spent on health care (Canadian Health Care 2012). The Canadians are quite contended with their health care system as according to a survey conducted in 2009, 82% of the population strongly supported this system (Laidlaw 2009). Also, there are large impacts of Canada's health care system upon the economy. The funding and the spending are increasing every year and in 2009, the per capita spending reached around $183.1 billion which is approximately $5,452 per person (CBC News Health 2009). On the whole, Canada has a single-payer, publicly funded health care system.

In a great contrast to Canada in both size and practice, U.S. has a multiple-payer, private health care system in which there is a variety of third-party payers that include Federal government and other commercial health insurance companies, but the main difference from Canadian system is that not everyone is insured automatically and offered health care services. Canada provides universal access to health care for its citizens while around 84% of the U.S. citizens get health insurance. The private sector takes a huge place in the market, i.e., around 68% while the publically funded insurance is around 27% which include medi-care for aged and disabled people and medic-aid for financially lower class of citizens. The remaining 16% of the un-insured population of U.S. has access to health care services that include public hospitals and clinics and also to health programs run by the state. In overall U.S. health care system, there are more than 800,000 physicians and dentists, about 2 million nurses, nearly 7,000 hospitals and more than 80,000 nursing homes and mental retardation facilities (Santerre and Stephen 24,25,27,28). Approximately 16% of U.S. GDP is spent on health care which is far more than Canada, hence U.S. spends much more money on health care both on GDP basis and per-capita basis, but still has a long way to achieve Canada's successful health care system's figures (NBER 2012).

The public health care system of UK is very much similar to that of Canada, i.e., there is single payer system which is funded from general taxes upon the public. The regulatory authority is National Health Service NHS, which provides funds to district and community-based health authorities and there are community-based family practitioners and general physicians GP, that make contracts with NHS on uniformly weighted capitation basis. The only difference is that the government makes contracts with private health care service providers and thus there is an environment of competition in various service providers to take contracts. For those who can afford more, there are also private health care services other than public health care system (Santerre and Stephen 10, 11, 21, 23). NHS is bearing 86% of total health care expenditures and the rest accounts for national insurance contributions (19%) and user charges (5%). The services provided by NHS, which includes GP, hospitals and treatment facilities, drugs etc. are free of cost to most of the citizens. These services cost a total of several billion pounds/year, but on the whole, UK lacks behind both U.S. And Canada with an expense of 9.4% of GDP in 2008. Although it is a general perception that NHS is a good service provider and there is a high-level satisfaction amongst the public, some surveys also indicate that only 51% are satisfied with the services and due to this NHS has been the subject of criticism for many years. But since NHS is world's fourth largest employer (over 1.3 million people), it is encountering several organization related issues which must be resolved in order to provide good service to the public (Sean 2008).

As far as Germany is concerned, the co-payment system dominates there. It has a universal multi-payer system that consists of two main types of health insurance, which are Law-enforced health insurance that includes sickness funds and the Private not-for-profit insurance companies. The organization is Socialized health insurance SI that takes care of all the matters. The main benefits include health insurance, accident insurance, and long-term care insurance. The funds are collected from both the employers and employees to reimburse physicians and hospitals (Santerre and Stephen 9, 20, 23). Germany spent 10.7% of its GDP on Health care in 2005 and according to the World Health Organization (WHO) statistics, Germany has an average of 358.40 physicians per 100-000 inhabitants and it is ranked 25th out of 191 countries based on a cost/effectiveness ratio (MedKolleg 2012). Due to many insurance plans, on the whole Germany's health care system is confusing and is not as efficient and effective as it should be, although the life expectancy and mortality rates are still considerable as compare to other…

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