Alyssa Duff ’19, Website Editor/Social Media Manager
Throughout the world there are many vastly different healthcare systems; however, most people only know the one system in which they live in. Particularly the United States, Canada, Sweden, and Mexico have very contrasting systems. It is important to explore the healthcare systems in different places in order to improve the healthcare system in the United States.
In the United States, healthcare is provided by many distinct organizations, which are mostly owned and operated by private sector businesses. Individuals under the age of 67 acquire health insurance by purchasing it on their own. In 2014, the United States spent more on health care per capita than any other nation. The United States has one of the highest prevalence of obesity, car accidents, infant mortality, heart and lung disease, sexually transmitted diseases, adolescent pregnancies, injuries, and homicides. Americans also undergo cancer screenings at a significantly higher rate than other developed countries, as well as access MRI and CT scans at the highest rate, compared to all other countries part of the Organization for Economic Co-operation and Development (OECD). According to the World Health Organization, 58 percent of community hospitals are non-profit, 21 percent are government owned, and 21 percent are for-profit. During a study by Agency for Healthcare Research and Quality, it was found that there were 38.6 million hospital stays in the U.S. in 2011, up from 11 percent in 1997. Since the population was also growing, the hospitalization rate remained stable at approximately 1,200 stays per 10,000 population during this period. Information from 2012 indicates that there was a slight decrease in hospital stays compared to 2011, 36.5 million. Hospital stays in 2011 averaged 4.5 days and cost an average of $10,400 per stay. The United States, Mexico, and Turkey are the only OECD countries that have not achieved universal or near-universal coverage for their populations.
Healthcare in Canada is delivered through 13 provincial and territorial systems of publicly funded healthcare. It is guided by the Canada Health Act of 1984. The government ensures quality of medical care, without participating in day-to-day medical issues or collecting any information about an individual’s health. However, the Canada Health Act does not cover prescription drugs, home care, long-term care, prescription glasses, or dental care. This means that most Canadians pay out-of-pocket for these services or rely on private insurance, which can get expensive. Hospital care is provided by publicly funded hospitals. Most of the public hospitals are required by law, under the Provincial Corporations Act, to stay within the government’s budget. Currently the healthcare spending is at about 5,988 US dollars per person. According to the Health Canada, a federal department that publishes surveys for patients, the median wait time for services such as MRI and CAT scans is around two weeks, with 86.4 percent waiting less than 90 days. The wait time for non-urgent surgery is around four weeks, with 82.2 percent waiting less than 90 days. According to Fraser Institute, the median wait time, in 2015, for a General Practitioner is around 19 weeks. Since 2012, the government has invested $5.5 billion to decrease the wait time. The Canadian healthcare system was ranked the 30th best worldwide. The border between Canada and the U.S. is considered a boundary line for medical tourism, in which residents can travel elsewhere to seek healthcare that is more available or affordable.
Sweden’s healthcare system is organized on three levels: national, regional, and local. At the national level, the Ministry of Health and Social Affairs creates guidelines for medical care and sets the political agenda for health and care. Along with other government bodies, the ministry supervises activities at the lower level, allocates grants, and periodically evaluates medical services. At the regional level, the executive board or hospital board of a county council has authority over hospital structure and management. Under Sweden’s health and care policy, every county council must provide residents with good-quality health services and medical care. County councils have leeway in how care should be delivered, which leads to a wide variation from place to place. At the local level, municipalities are responsible for maintaining the environment of citizens, such as water supply and social welfare services. Recently, post discharge care for the disabled and elderly, and long-term care for psychiatric patients has been decentralized to the local level. Private companies, in 2015, provided about 20 percent of public hospital care and about 30 percent of public primary care. Costs for medical care counts for around 11.9 percent of Sweden’s GDP. Prescription drugs are not free, but costs are capped at 2,200 kronas, about 240 U.S. dollars. Urgent cases are always prioritized and emergency cases are treated immediately. A seven day wait for a primary physician is standard. According to The Local SE, “Waiting times for pre-planned care, such as hip-replacement surgery or cataracts, cannot exceed 90 days.”
In Mexico, healthcare is guaranteed to all citizens, according to article four of the constitution. Based on the citizen’s employment status, healthcare is fully or partly provided by the federal government. However, all Mexican citizens are eligible for healthcare regardless of their work status through a system of healthcare facilities operating under the federal Secretariat of Health agency. Employed citizens instead, use a program administered and operated by the Instituto Mexicano del Seguro Social. While private hospitals account for two-thirds of all hospitals in Mexico, less than 10 percent of the Mexican population has private insurance coverage, meaning most of care is paid out of pocket. Aggregate health have greatly improved since the 1970s, but Mexico lags behind other OECD countries in health status and availability. The New York Times reported that residents of the United States living near the Mexican border, often would cross into Mexico for medical procedures such as dentistry and plastic surgery. The Washington Post reported that Mexican dentist charge only 20-25 percent the amount that is charged in the United States. In Mexico, health inequality is highly present; however, in more recent times, Mexico has witnessed improvement in its healthcare system that has allowed for an increase in access to healthcare and a decrease in mortality rate. According to World Bank, before the current healthcare system, only about 50 percent of Mexicans had health insurance.
In all healthcare systems it is inevitable that there will be positives and negatives, but there is always an advantage to be informed about the systems around the world.
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