In their move from a completely government-paid and -- operated healthcare system to a fees-based approach, the Chinese have greatly improved the efficiency, availability, and efficacy of their healthcare system (Wan & Wan 2010). This suggests that a combination of perspectives, rather than the market or single-payer perspectives that form so many healthcare systems, is most effective.
There are also, of course, healthcare systems that have developed in the same period as those mentioned above, but with far more negative results. The South African healthcare system, though effective in combating certain specific conditions, has many of the same failings as the United States' system, only on to a far more apparent degree. A lack of organization and responsiveness, exacerbated by an attempt to exert highly politicized and highly centralized control over healthcare provision, has plagued South African efforts to combat AIDS and many other problems the country -- and the continent -- is facing (Sewankambo & Katamba 2009). Lack of provider and patient input on the system, and of the responsiveness of the system to changes in medical needs, are largely reflective of problems the United States healthcare system is facing, according to some (Squires 2009).
The countries and healthcare systems that are arguably the most analogous to the United States' system -- and to what the United States' system perhaps ought to be reformed into -- are several of those located in Europe. An overall analysis of Western European healthcare systems yielded three basic types: health service provision oriented, typified by free access to a preponderance of providers; universal controlled access, where equal access supplants freedom of choice in primacy; and restricted access, where high fees become the major factor in determining who receives what level of care (Wendt 2009). None of these systems is perfect, of course, but all...
A move towards increasingly limited access is not what is needed in this country, so rather the policy makers in the United States ought to look at ways to provide greater access and control to physicians and patients on a low fees-based system, providing a universal/provision oriented system of healthcare for its citizens.
Conclusion
Fixing the United States' healthcare system will not be easy. It is a complex problem with many complex solutions available. An understanding of the way these solutions have played out in various international situations, however, should provide an understanding of the best methods for healthcare reform in this country. There is no need to reinvent the wheel, or to embark on an entirely new experiment in such an important area of public policy. Instead, lessons should be taken from countries that have recently adapted and adjusted their own healthcare systems, to continue the trajectory of improved care that the twentieth century has seen.
References
Offredy, M. (2008). "The health of a nation: perspectives from Cuba's national health system." Quality in primary care 16(4), pp. 269-77
Sewankambo, N. & Katamba, A. (2009). "Health systems in Africa: learning from South Africa." The lancet 374(9694), pp. 957-9.
Squires, A. (2009). "U.S. Healthcare reform: A comparative book review." Nursing ethics 16(5), pp. 673-5.
Wan, Y. & Wan, Y. (2010). "Achievement of equity and universal access in China's health service: A commentary on the historical reform perspective from the UK National Health Service." Global public health 5(1), pp. 15-27.
Wendt, C. (2009). "Mapping European healthcare systems: a comparative analysis of financing, service provision and access to healthcare." Journal of European social policy 19(5), pp. 432-45.
