What is an optimal model for health care? This is a highly debated issue internationally. Much of the debate centers around whether health care should be treated as a type of public—good supplied by the government and funded by taxpayers. Others believe that a better system is delivered by the private sector. Another model advocates a public/private mix. This analysis will consider several important factors such as; public access, health outcomes/results, economic sustainability, as well as if it provides room for research and development, in order to recommend which health care system is optimal.
Countries health care system including Canada, U. S, and Cuba will provide an insight on the final decision. “A public health care system is a financial system designed to meet the costs of all or most health care necessities of a country from a publicly managed fund, which is usually under some form of “democratic accountability. ” Cuba has a great example of a public health care system, in fact, in 2000, Secretary General of the United Nations Kofi Annan stated that “Cuba should be the envy of many other nations” adding that achievements in social development are impressive given the size of its gross domestic product per capita. Cuba guarantees “free medical and hospital care by means of the installations of the rural medical service network, polyclinics, hospitals, preventative and specialized treatment centers; by providing free dental care; by promoting the health publicity campaigns, health education, regular medical examinations, general vaccinations and other measures to prevent the outbreak of disease. ” This funding model has allowed Cuba’s “life expectancy and infant mortality rates to be nearly the same as the USA’s.
Its doctor-to-patient ratios stand comparison to any country in Western Europe. Its annual total health spend per head comes in at $251: just over a tenth of the UK’s. ”This may seem like a conquest but many Cuban’s “complain about politics in medical treatment and health care decision-making. There is no right to privacy, patient’s informed consent, or right to protest for malpractice. The patient has no right to refuse the treatment, including for religious or ethical reasons. ”This leaves us to wonder the government has the public’s interest in mind.
One would argue that since they are producing positive results of high standards on par with the U. S. A and Western Europe, the government is acting in the Public’s Interest. Others could agree with that statement but wonder if it is at all true since the communist government can manipulate results it releases, but if true, were there any unethical/immoral actions done to attain the results at hand? A private health care system requires patients to pay a monthly or annual premium, which usually “requires them to pay a deductible or co-insurance when using the insurance.
The insurer covers the remaining costs. Participation in a private insurance scheme is voluntary and premiums are typically based on the insured’s level of risk. ” The U. S. A relies heavily on private insurance health care. The only “direct government funding of health care is limited to Medicare, Medicaid, and the State Children’s Health Insurance Program. ” For everyone else in the U. S who is not covered, health insurance must be paid for privately. Some 59 per cent of U. S residents have access to health care insurance through employer. These employees may face what is called “job lock,” meaning “people become tied to their jobs for fear of losing their health insurance. This reduces the flexibility of the labor market. ” The other 41 per cent of uninsured Americans are “less likely to have regular health care and use preventive services. They are more likely to delay seeking care, resulting in more medical crisis, which can be more expensive treatment in the long run…they were also twice as likely to visit hospital emergency rooms as those with insurance; burdening a system meant for true emergencies with less-urgent care needs.
The government has not guaranteed everyone in the nation or at least 41 per cent, rights to health care even though it is embedded in their Constitution. This leads me to believe that the government isn’t concerned with the Public interest but rather with profits it is making off the private health care sector. Proof of this can be found in a “study from Johns Hopkins University where roughly one in four patients believe their doctors have exposed them to unnecessary risks. ”Unnecessary risks may include pointless risky tests, risky surgeries, igh-risk treatments along with unnecessary medical expenditures that are due to vicious marketing and compensation systems between practitioners and pharmaceutical firms. Although the patients may be aware of the risks, doctors tend to turn into a “salesman” if you will and sell patients “life” in exchange for their “soul” so to speak, or more accurately excessive debt. Private health care also incurs a cost that is found in public health care systems but smaller in scale, an administrative overhead. “Information determined that some 31 per cent of U. S. ealth care dollars, or more than $1,000 per person per year, went to health care administrative costs, nearly double the administrative overhead in Canada, on a percentage basis. ”
This extra cost makes general insurance more expensive for American Citizens, which makes it more inaccessible. Americans who are in favor of universal health care “argue that the large number of currently uninsured Americans creates a hidden cost that is shared by all, and by extending coverage to all would lower overall costs and possibly improve quality. ” The American people are considered to be the most diseased people in the world among the advanced nations.
They spend more on health care than anyone, paying the highest prices for medication and have the best medical technology in the world. If that is true, why is it that 50 million Americans have no health insurance? “Hospitals literally dump uninsured patients on the street, abandoning the sick to protect profits while politicians negotiate on behalf of the Big Pharmaceutical companies to make sure Americans keep paying the highest prices in the world for medications (500 per cent mark up). ” Clearly there is something wrong with the private system; it only works for the rich, elite and employed.
The U. S needs to re-evaluate their ethical practices because this is not what the founding fathers signed for when they signed the American Constitution. We have analyzed both public and private health care systems so far and now we move onto a mix of them both. Canada’s health care system is a perfect example to measure the effectiveness of a mixed health care system. “Generally speaking, Canada has a mixed public-private system — a system where the private sector delivers health care services and the public sector is responsible for financing those services.
The Canadian system, however, is not completely consistent with this model. Canadian governments exercise considerable authority over the delivery of services by the private sector. Moreover, while governments fund the large majority of services, the private sector does play an important, albeit secondary, role in health care financing. ” Public health is governed by the Canada Health Act, which has four conditions attached to the cash it transfers to the provinces to cover health care costs. It must be portable, meaning that if you choose to move from province to province, you are still covered.
It must also be universal, applying to all residents of provinces and territories. The third condition is that it must be accessible meaning that citizens must have reasonable access to insured hospital, medical and surgical-dental services on uniform terms and conditions. The final condition is that it must be free from extra charges that are covered (doctors cannot charge citizens extra for the insured medical treatments, tests, medications, etc). These conditions allow for Canadians from all provinces to enjoy universal health care.
Many clinics in Canada are privately run with the consent of the government but are subjected to limitations. For example, they have limitations on the use of MRI machines, allowing them 40 hours of testing per machine per week. This can create longer wait times to be tested and can heavily impact future spending since it may take longer to diagnose patients, causing them to worsen and need more medical attention. Physicians in the clinics are paid on a fee-for-service basis by the Canadian Insurance Plan to read the test results for covered patients. The clinics however operate on a profit-basis.
This can reduce the quality of doctor patient care seeing as how doctors will most likely spend less time with each patient in order to see more people and make more money. With most private clinics in the U. S. you can pay to be seen first, however in Canada, there is no such thing. Although the private clinics exist, they are still under government “watch” and do not permit them to act on behalf of their wants/needs in order to promote a fair system. Canada is seen as an exemplar country when it comes to their health care system seeing as how it is universal, but there are certain factors that can possibly burden the system.
A major problem that Canada will face in the near future will be influenced by the baby boomers. “Increasing demand for health care, due to aging population, must be met by either increasing taxes or cutting government spending” causing a huge strain on the Canadian economy seeing as how the younger population is not large enough to cover costs. “Canadians are, overall, statistically healthier than Americans and show lower rates of many diseases such as various forms of cancer. On the other hand, evidence suggests that with respect to some illnesses (such as breast cancer), those who do get sick have a higher rate of cure in the U.
S. than in Canada. ” This can be explained by the fact that all Canadians do receive health care on an equal basis but the Americans can pay for better treatments as well as select which works best for them and can therefore have a high “curing” rate in comparison to Canada. Canadians also have a longer life expectancy; “in 2006 it was about two and a half years longer in Canada, with Canadians living an average of 79. 9 years and Americans 77. 5. Infant and child mortality rates are also higher in the U. S. These outcomes can also be attributed to lifestyle choices. The OECD (Organization for Economic Co-operation and Development) “found that Americans have slightly higher rates of smoking and alcohol consumption that do Canadians as well as significantly higher rates of obesity. ” Overall the public/private mix health care system seems to work for Canada (considering the small population). The government has always injected funds into the system in order to advance research and development in trying to achieve new efficient and effective means of treating Canadians.
With both private and public health care, it allows Canada to be more flexible in providing health care to all families across the country. This analysis has allowed me to have an in-depth look into some of the health care systems in the world today. Each of them has pros and cons. Public health care in Cuba ensures that all citizens are covered but the government decides how things are done including treatments, but sometimes they cross the line and go against personal beliefs or religion.
Private Health care has allowed the U. S to advance in medical technology and has become the leading nation in medical discoveries. However, their population is the most diseased among the advanced nations. The mix of public/private health care has created more flexibility in the Canadian health care system and enables private companies to take some of the burden off the government when it comes to publically delivering medical services. But on the other hand, everyone is treated as an equal.
No one is entitled to special treatment, not even if you can pay for it, which might seem unfair to people who work hard and earn high amounts of money and should be entitled to pay for the treatment that they wish for. No health care system is perfect but I believe that a mix of the two is the most effective and most optimal in terms of outcomes, quality, fairness, and public access. Having a balance of the two has allowed Canada to become a model for other developing countries. I wouldn’t want to live anywhere else!
