Health Care Problems Across the Globe: The Whole World Is Sick
In the United States, there can be no question as to whether or not Obamacare is controversial. It’s been the subject of so much gridlock and partisanship at this point that no matter how it’s reformed or changed or improved, there will likely be some that hate it. The push back against Obama’s Affordable Care Act has, predictably, garnered some attention from other countries, and there’s been a great deal of talk about how other nations feel about Obamacare and their impressions of how Americans have reacted to it.
In particular, criticism from our closest neighbor, Canada, has been interesting to watch. Salon offers just one sample of Canadian health care discourse when pitted against a member of the GOP, quoting Dr. Danielle Martin from Women’s College Hospital in Toronto and her opponent, Sen. Richard Burr (R-N.C.). Martin also admits downfalls of Canadian public health and where the solution may lie. “The solution to the wait-time challenge that we have in Canada … does not lie in moving away from our single-payer system to a multi-payer system,” she said, pointing to Australia as an example.
I point this out, not in support or opposition of either system, but rather because this admission of problems alongside praising the aspects that work is what I’d like to focus on. Because indeed, every health care system around the world has its pros and cons; even ones with clear advantages over America’s past and present system have faults, and it’s useful to consider what they are. So rather than rehash what is at this point a very tired argument over health care reform and the Affordable Care Act, I’d like to look internationally.
First, let’s start with Canada; it seems an appropriate first stop on our list given the above context. Canada has universal health care and has government sponsored health care for all citizens. Each of the 13 provinces has some degree of power, but must meet national standards in order to be eligible for funding. Perhaps the most notable and obvious advantage to Canada’s health care is that it is so universally available and affordable. And the most obvious disadvantage, at least based on the majority of rhetoric discussing Canadian health care, has to do with extreme wait times — consider our VA scandal earlier this year and what wait times can mean for patients.
Going back to Martin and Burr’s discussion, Martin basically pitted these two items against each other, when asked how many patients die while waiting to be treated. “I don’t [know], sir, but I know that there are 45,000 in America who die waiting because they don’t have insurance at all,” she said, “we believe that when you try to address wait times, you should do it in a way that benefits everyone, not just people who can afford to pay.”
The United Kingdom
According to a health care ranking report from the Commonwealth Fund, the United Kingdom has itself a place on the top of the list for having the best health care out of 11 studied and ranked — with the U.S. falling last on the list. The U.K., on the other hand, ranked very well on a number of criteria. In particular, it did well in terms of the quality of its care and the access people had to the care based on cost. Like Canada, timeliness of care was listed as a bit of a problem, but nothing compared to our neighbor to the north, which was ranked last for timeliness, while the U.K. managed a third place ranking. However, the absolute worst score it received was actually near dead last, in terms of how healthy civilians lives were. Indicators for this were “mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60.” Another critique offered has been that the National Health Service caters to immigrants and visitors in the country as well as citizens, and that this complicates costs and wait times.
The World Health Organization places France at the top of a list of the World Health Systems — and notes that neither Canada or the U.S. even makes the top 25. France, like Canada, has universal health coverage. It has both private (mutuelle) and public aspects to its system, with a great deal of the cost covered by the government, making medical care much more available and much more affordable in France than in the U.S. Costs are also much more predictable in France than in the U.S.
According to Slate, 53% of France’s Gross Domestic Product is funneled to public spending. The wait times in France are considerable, as with Canada, and constitute a serious problem. Cost coverage in France has its advantages and its disadvantages. Some things are very well covered, but certain aspects of treatment and coverage can get pricey depending on your needs. Pharmaceutical expenditure per capita, for example, is much higher in the U.S. — $983 per capita in 2010, according to the Huffington Post — but it’s still comparably quite high in France as well, at $634 per capita.
Follow Anthea Mitchell on Twitter @AntheaWSCS
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