What Healthcare Looks Like Around the Globe
The debate about health care in the United States has been raging for years and will probably continue to rage for years to come. People across the country, from the girl next door to a politician of the highest office all have differing opinions on what would be best for our country. No matter what you think of the current system and its pros and cons, it is important examine the way things are done elsewhere in the world. The United States may be one of the world’s biggest superpowers, but is our health care system the best way to do things? Let’s look at other capitalism economies around the world and how their health care systems function.
Health Care in the United Kingdom
photo credit: Sar-ah Bear-ahThe UK spends about 8.3% of its Gross Domestic Product (GDP) on health care for its citizens. Families there do not pay any kind of premium for health insurance; it is all funded by taxation. Most of the time there is no-copay for patients, but occasionally one will pop up for dental care, eyeglasses and 5% of prescriptions. The young and elderly are exempt from co-pays of any kind.
The system in the UK can be deemed socialized medicine, meaning that the government both provides and pays for health care. Citizens living in the UK pay taxes in order to make this happen, and the HNS (National Health Service) distributes those funds to health care providers. General practitioners who run their own private practices are paid based on how many patients they see, while hospital doctors are paid salaries. There are a small number of specialists who operate outside the NHS and they see privately paying patients.
The system functions and functions well due to the fact that having all costs covered means that there are no bills to collect or claims to pay. Patients see their general practitioner as their “home” in the medical world, and their GP acts as a gate keeper to ensure that their patients are never taken advantage of. Britain is a leader in preventative care, and this is due to the dilligence of general practitioners. Some complaints about the UK’s socialized medicine are that you have limited choices and long waits. It seems that if these are your only complaints (speaking as someone who regularly spend 30-45 minutes in a doctor’s waiting room despite arriving at the appointment time) then the system is working remarkably well.
That being said, Britain has begun to create reforms designed to make the care system more competitive and to give patients more options. In April 2008, patients began to be able to choose where they wanted to be treated for medical procedures, and hospitals have to compete for NHS distributed funds.
Health Care in Japan
photo credit: Satoru KikuchiJapan spends about 8% of its GDP on health care, with families paying about $280 a month in premiums and their employers paying for half of that. Copayments in Japan are about 30% of the cost of a procedure, but the total amount that has to be paid in a month is capped by one’s income. All citizens in Japan are required to have health insurance under the “social insurance” system. They can purchase this insurance either through their employer or through a health care non-profit community based plan.
Patients who cannot afford to pay their premiums are able to receive public assistance, though most health insurance is private along with all hospitals being in the private sector. Some concerns of the way Japan handles its health care is that they are spending too little on care for its citizens. Half of the hospitals in the country are thought to be operating in the red, and there’s no way to monitor how the Japanese are using their health care.
Health Care in Germany
photo credit: MarxchivistGermany spends about 10.7% of its GDP on health care. The average family premium is $750 per month, and premiums are attached to a person’s income. Co payments are small; only about $15 every 3 months. Some patients, like pregnant women, are exempt from paying a copay. Just like Japan covered above, Germany operates under a social insurance model. Germany is actually the birthplace of social insurance, stemming way back to Chancellor Otto von Bismarck.
Germans have more of a freedom of choice when it comes to buying their insurance, being able to choose from over 200 private, non-profit “sickness funds.” As in Japan, the poor receive assistance to pay for their health care. Unlike health care in the United States, these non-profits cannot turn people away for preexisting medical conditions, and the non-profits compete with one another for members. Fund managers are paid based on the size of patient enrollment, and the sickness funds barter with doctors are a group to negotiate pricing.
Unlike in Britain, Germans are able to hop straight to a specialist’s office if they want to, but will likely end up paying a higher copay. Unfortunately, the system in Germany is leaving some of its doctors feeling underpaid and under appreciated. For comparison, a family practice doctor in Germany makes about 2/3 of what they would in America. That said, German doctors deal with a whole let less malpractice and they are able to attend medical school for free. A lower salary – yes – but free of those cumbersome and massive medical school debts! It doesn’t sound like a bad trade-off. The German elite (i.e. the richest 10% of the population) can buy for-profit insurance, thus insuring they get seen faster.
Health Care in Taiwan
photo credit: David RentonTaiwan spends about 6.3% of its GDP annually on health care, with about $650/year premiums for a family of four. Citizens in Taiwan spend about 20% of the cost of their prescription drugs $6.50; up to $7 for outpatient care; $1.80 for dental and traditional Chinese medicine. These costs have exemptions in the form of childbirth, preventative services, major diseases and for the poor, for veterans and for children.
Back in 1995, Taiwan created a National Health Insurance model after looking into how other countries were doing things. All citizens have to have insurance, but it is through a government-run insurer. People who are employed get to split their premiums with employers, the poor are fully subsidized and the end results is similar to The United States and Canada’s Medicare programs. The amazing thing about Taiwan’s set up is not only that it was able to increase the the extension of coverage to 40% more of the population, but the amount spent on health care per year actually decreased. Patients in Taiwan can see any doctor they would like without a referral, and each person carries a smart card containing their medical history and how to bill the national insurer. The integrated technology between the health care providers and the government run insurer has helped make Taiwan’s system one with the lowest administrative costs in the world. However, the health care system in Taiwan isn’t making enough money to cover its costs, and the situation is compounded by the thick political tangle in the country.
In looking at these other capitalist economies, it seems that the United States stands alone in its system. You have to wonder if making a chance in our current system wouldn’t help save money and provide health care to more of our citizens.
Tags: germany health care, japan health care, u.k. health care, united states health insurance
