Healthcare Delivery in Australia Switzerland and Saudi Arabia

Comparative Analysis of Global Healthcare
Various governments across the globe are tasked with the responsibility of providing healthcare to the citizens. Their economic status and models influence the quality of care provided. This has resulted in the disparities in quality from country to another with some countries acting as case studies to be emulated. The following study is a comparative analysis of three healthcare systems around the world with a focus on Australia, Saudi Arabia, and Switzerland. The study compares the residents’ overall level of access to preventive and tertiary care. This is followed by the comparison of the health expenditures and healthcare funding mechanisms in the three countries. The discussion will then delve on the life expectancy for each gender, overall leading cause of death, and infant mortality rates in each selected country. The final section provides an overview of deaths caused by diabetes, obesity, cardiovascular diseases and oncological conditions in these countries.
The General Level of Access to Preventive and Tertiary Care
Australia’s healthcare system is regarded as one of the best in the world. However, it is not easy for the residents to get the care and information they need. It is difficult for many people to access healthcare services because of two major reasons. This has affected populations with special needs such as people with chronic and complex health conditions who are in dire need of health services. The first barrier relates to the availability of health professionals and health services (OECD Publishing. 2010). Therefore, there is a sharp difference in accessing healthcare services based on where one resides. The Australian Institute of Health and Welfare (AIHW) reports that remote and regional areas have higher rates of hospital admission and lower rates of doctor consultation as compared to the major cities. Most of the people lack access to a doctor in the weekends, evenings and public holidays. Language is also another factor contributing to the lack of access. For people to obtain the best healthcare, they must find a provider whom they can communicate well and is trustworthy. Sometimes, there is lack of information and services because the only language used is English.
The Saudi Arabian healthcare system comprises of the private sector, the semi-public sector, and public sector (OECD Publishing, 2010). The government is responsible for ensuring that all the citizens have access to proper preventive and tertiary care. For this reason, public hospitals are exclusively available and accessible to the Saudi nationals with some exceptions, which permit expatriates to access basic care hospitals or specialized services in areas such as the rural area where private facilities are unavailable. Therefore, the expat populace that is highly concentrated in Jeddah and Riyadh are increasingly using private healthcare facilities.
Switzerland provides its citizens with great access to government-sponsored medical and health care (OECD, 2003). The residents have access to these services using Health Insurance Cards (HICs). While seeking to enhance these services, the government has subsidized healthcare for them on a graduated basis. The subsidy prevents the residents from spending more of their income on insurance. However, people are free to choose between supplemental coverage and high-deductible plans (OECD Publishing. 2010).
Health Expenditures Regarding the GDP
From the comparison, Switzerland has the highest healthcare expenditure. In fact, the country has the second highest expenditure in the world, after the United States. Therefore, Switzerland provides its citizens with great access to government-sponsored medical and health care. The government of Saudi Arabia has allocated roughly 11% of the national budget towards healthcare and social services. It translates into a 50% increase over the previous year's allocation of 8% of the national budget. About 70% of the country’s healthcare expenditure is funded via public sources while the remaining 30% are funded by private sources (Jacobs et al. 2009). In Switzerland, health expenditure is quite high compared to Australia and Saudi Arabia. The healthcare expenditure in Australia is significantly lower than the per capita expenditure of advanced nations. This year, only 18% of the total budget has been allocated to healthcare.
The Common Mechanisms for Funding Health Care
In all the three countries, the government has set a statutory mechanism for funding health care, especially the universal coverage. In Australia, the provinces are required to fulfill specified conditions to participate in the provincial fund sharing programs. However, the mechanisms of raising funds vary. For instance, the National Health Service of Switzerland draws largely on the general revenues. Almost 70% of the country’s health bill derives from the provincial and national general revenues (Jacobs et al. 2009). Australia relies heavily on work-related social insurance contributions. Moreover, Australia and Switzerland have numerous types and degrees of cost-sharing by patients. Saudi Arabia’s public sector owns most of the healthcare facilities and offers the bulk of care services in the country. This sector is funded largely by oil revenues. Statistics from World Health Organization reveal that Saudi spent $620 per citizen on healthcare, of which the government paid 78% and 16% was an out-of-pocket expenditure.
The Making of Health Policy Decisions at the National Level
In the past few years, the three countries have been engaged in health system reforms, which have promoted competition underpinned by a dedication to patient choice. In Australia, choice of primary care provider, autonomy, and participation remain the central mechanism for empowering the patient (Jacobs et al. 2009). However, it is less apparent because attempts to regain public confidence in the services offered have sparked a consumerist approach that seeks to improve efficiency through democratic engagement. In fact, the 2012 Health and Social Care Act reversed the opportunities for engaging the public and patients in making health policy decisions both at the state and national levels (OECD, 2014). Currently, Australians participate in policy decisions through local Health Watch Organizations such as the NHS Citizen, a national program created to give the citizens a say on health policy matters. Citizens also give their contributions through local patient participation groups. Moreover, the government involves the public by developing joint approaches with local authorities, local health Watch, voluntary groups, health and wellbeing boards as well as other organizations, particularly those that have already established relationships with the local neighborhoods. Conversely, in Saudi Arabia, the government sets all the health policy decisions and directions for healthcare. The government has always undermined efforts to ensure the public, patients, and cares to participate in the decision-making process (Jacobs et al. 2009).
Unlike Australia and Saudi, public participation in health care policy decision in Switzerland is highly embedded in democratic organizations. Elected officials primarily represent the citizens in all the healthcare regions. This means that in Switzerland, healthcare policy decisions are made according to the public interest. Public participation is perceived as a way of influencing the political decisions and the political process within a region or a state. While seeking to revamp the chances of public involvement in regional health matters and practical terms of care, the country has developed more participatory versions of public participation under the umbrella phrase “citizen dialogue” such as mechanisms like public meetings, citizen panels or surveys. Both Switzerland and Australia have a long-standing history of engaging both the public and patients in making health policy decisions, unlike Saudi Arabia.
The Life Expectancy, Overall Leading Cause of Death and Infant Mortality Rates
Life Expectancy of Each Gender
Drawing from the most recent WHO statistics, there is a significant rise in the life expectancy for men and women in Saudi Arabia. The average life expectancy in Saudi has increased from 69 years (1990) to 75 years. The present statistics indicate that the life expectancy for Saudi men is approximately 74 while that of women is 77 years; three years higher than their male counterparts (Jacobs et al. 2009). The increase relates to the healthcare facilities made available to the population. The life expectancy for Australians has also been increasing steadily. The living conditions have been improving, and quality of life is equally on the rise courtesy of developments in key sectors such as healthcare. According to government data, the lifespan of both genders has increased. Previously, the life expectancy for men was 61, and that of women was 62 (OECD, 2014). Today, men are expected to live nearly 80 years and women born today are likely to live four years more than their male counterparts. Therefore, the life expectancy of women has increased by 22 years and that of men has increased by 19 years (Armstrong, 2011). In Swiss, the average life expectancy for any child is 80 years with at least 70 years being spent in good health condition. Over the years, the life expectancy for women has increased by two years to reach 85 years. Their male counterparts are expected to live for at least 81 years, signifying a two years increase (Olson, 2006).
Overall Leading Cause of Death
In Switzerland, the overall leading causes of death include stroke, heart diseases, Alzheimer’s and lung cancer. However, most people who live with disability attribute it to migraines, back and neck pains. Just as Switzerland, in Australia, heart disease, Alzheimer's disease, lung cancer, cancer of the trachea and chronic lower respiratory diseases complete the top causes of death. These leading causes of death have remained unchanged since 2015, and in total, they account for roughly 40% of the total deaths registered as of 2016 (OECD, 2014). In Saudi Arabia, heart disease is the overall cause of most deaths with cardiovascular diseases taking the second position. Specifically, cardiovascular diseases account for 40% of the deaths in Saudi Arabia. The third major cause of death in Saudi is coronary heart disease, followed by accident and senility.
Infant Mortality Rates
This is the number of infants who die before they reach one year in every 1000 live births in a year (In Holtz, 2017). Swiss has been ranked second in the developed world for the highest infant mortality rates. In Swiss, roughly 900 children out of 1000 die the very same day they are born (OECD, 2014). In contrast, only 1% of infant deaths occur in industrialized countries. Regardless where a baby is born, the newborn period is the riskiest time of a child’s life. The number of infants dying in developed economies, especially in Swiss is increasing just as in under-developed countries. Presently, stress, poverty, and racism are the major contributors to the high infant mortality in Swiss. As of 2015, Saudi was among the countries with the lowest infant mortality rates. This rate has been moderately declining from 23 deaths out of 1000 live births in 1995 to 12 as of 2016. The infant mortality rate of Australia has hit its record lows. As of 2015, Australia recorded 991 infant deaths (In Holtz, 2017). This represents a 2% decrease compared with the 1100 infant deaths registered in 2014. Over the years, the number of registered infant deaths has been declining with fluctuations from 1300 registered infant deaths as of 2006 to 991 infant deaths as of 2015 (OECD, 2014).
Statistics of Diabetes, Obesity, Cardiovascular Diseases and Oncological Conditions
Saudi Arabia has registered a significant percentage of deaths caused by diseases such as diabetes, obesity, cardiovascular diseases and oncological conditions. To be precise, heart disease is the overall cause of most deaths with cardiovascular diseases taking the second position (In Holtz, 2017). Apparently, these diseases are very costly to treat. Factors that drive the increase of these conditions in Saudi include sedentary lifestyles, urbanization, excess tobacco use and unhealthy eating habits such as fast foods (Keystone, 2013). In fact, cardiovascular diseases account for at least 45% of the deaths in Saudi. The risk factors include high blood sugar, high blood pressure and high rates of obesity (Olson, 2006). Among the three countries, Saudi Arabia ranks high in diabetes deaths relative to both the regional and global averages with over 20% of the populace suffering from Type 2 diabetes. Moreover, Type 2 diabetes accounts for roughly 5% of the deaths in Saudi. The prevalence is equally high in the general population (Zajac, 2014). Moreover, 18% of kids, 42% of women and 28% of men suffer from obesity. The prevalence of cancer and other oncological conditions is equally high, accounting for roughly 14% of the total registered deaths in Saudi Arabia.
In Swiss, oncological conditions are responsible for most deaths in the country. In fact, the prevalence of these diseases has been increasing steadily since 1995. In contrast, deaths associated with cancer and other oncological conditions have dropped significantly for both men and women. However, lung cancer has claimed over 5000 lives in 2015 alone. Out of the 8 million total populations, at least 500,000 have diabetes while over 1000 die annually from diabetes (OECD, 2014). Another 3000 deaths have been linked to high prevalence of cardiovascular diseases and high blood glucose. Swiss has low obesity prevalence relative to Australia and Saudi Arabia. I8n Swiss, only 9% of the adult population are obese while 36% of the total population is overweight (Zajac, 2014). Emerging health statistics indicate that the prevalence of overweight in Swiss, obesity included has risen by at least 4% from 2007.
The prevalence of diabetes is high in Australia accounting for 4000 registered deaths in the country in 2010 (Keystone, 2013). Diabetes contributes to 13,000 deaths as either an associated or an underlying cause of death. Obesity is the main factor behind the increase in other lethal and chronic diseases. As of 2010, Australia recorded at least 200 deaths where obesity was the underlying cause of death. At least 900 deaths were attributed to obesity as an associated cause or the underlying cause of death. As indicated, cardiovascular disease is one of the leading causes of death in Australia. The most common cardiovascular diseases include cardiomyopathy, heart failure, stroke and coronary heart disease. As of 2015, Australia recorded nearly 50,000 deaths attributable to cardiovascular (Zajac, 2014). Therefore, one Australian succumbs to cardiovascular every 12 minutes on average. In 2015, cardiovascular diseases were responsible for almost 30% of the total deaths in Australia. Out of these deaths, 30% were females while 28% were males.


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