The U.S healthcare system can be seen as un

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Week One: Discussion

Tiffani Gottschalk (students name)

The U.S healthcare system can be seen as unique and complex compared to healthcare systems in other countries. The U.S healthcare system is comprised of many different components; education, research, suppliers, insurers, providers, payers and government (Shi & Singh, 2019). With almost all other developed countries having universal healthcare coverage for their citizens, the U.S healthcare system does not offer access to its citizens through a national health insurance program. The U.S healthcare system is financed through a mix of public and private healthcare insurances. According to the U.S Census Bureau, in 2020, American citizens were able to gain access to healthcare through employer-based healthcare insurance, private health insurance, direct purchase coverage, and government healthcare programs such as Medicaid, Medicare, Tricare, and Department of Veterans Affairs (Keisler-Starkey & Bunch, 2021). Since the U.S does not have a universal healthcare program that citizens can partake in, subsystems have developed within the U.S healthcare marketplace. These subsystems provide healthcare to certain populations based on qualifying criteria. The U.S healthcare system is considered to have “market justice,” rather than “social justice.”

In 1984, Canada passed the Canada Health Act to ensure universal healthcare coverage for all of its citizens. Canada has a publicly funded national healthcare system where funds are provided through individual and corporate income taxes. Canada’s government healthcare entity offers basic healthcare coverage to its citizens without any out-of-pocket fees. Canada’s national healthcare system is considered to have “social justice”. Comparing the U.S healthcare system and Canada’s healthcare system we can firmly state that:

•    The U.S views healthcare as an economic good, while Canada views healthcare as a social resource.

•    The U.S healthcare system is comprised of free market conditions, whereas Canada has full government involvement in health care delivery.

•    U.S citizens are unable to access healthcare if they are unable to pay, Canadians are able to access healthcare regardless of their ability to pay.

•    Healthcare coverage in the U.S is seen as a reward for ability to access, whereas Canada views healthcare as a basic right.

According to the "National Bureau of Economic Research", Canada spends far less of it's gross domestic product on healthcare spending than the U.S, has a lower infant-mortality rate, and higher life expectancy (Comparing the U.S, 2007). 

References

Keisler-Starkey, K., Bunch, L. (2020). Health Insurance Coverage in the United States: 2020. US Census Bureau. Retrieved from  https://www.census.gov/library/publications/2021/demo/p60-274.html

Shi, L. and Singh, D.A. (2019). Delivering Health Care in America: A Systems Approach. 7th Edition. Sudbury, MA: Jones and Bartlett Publishers.

Comparing the U.S. and Canadian Health Care Systems. (2007). National Bureau of Economic Research. Retrieved from  https://www.nber.org/bah/fall07/comparing-us-and-canadian-health-care-systems

Discussion week one

Rasita Lau (students name)

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The healthcare system in the U.S.  is very complex because the system still does not function entirely correctly. The healthcare system is mixed between government and private insurance companies responsible for paying expenses.  The U.S. has  medical insurance company and Medicaid (paid by the government) that will pay the difference if another coverage does not cover it. People working in a company will benefit from paying for medical insurance. But a person who is low income or elderly, over the age of 65 and up, will be covered by federal insurance.   The website ISPO (2022) states that:

The US healthcare system does not provide universal coverage. It can be defined as a hybrid system, where publicly financed government Medicare and Medicaid (discussed  here ) health coverage coexists with privately funded (private health insurance plans) market coverage. Out-of-pocket payments and market provision of range predominate as a means of financing and providing healthcare.2 As of 2019, around 50% of citizens received private insurance coverage through their employer (group insurance), 6% received private insurance through health insurance marketplaces (nongroup insurance) (discussed  here ), 20% of citizens relied on Medicaid, 14% on Medicare, and 1% on other public forms of insurance (e.g., Veterans Health Administration [VHA] and Military Health Service [MHS]), leaving 9% of Americans uninsured  (para. 2).

However, countries in Europe, such as the U.K., France, Italy, or other European countries, have a healthcare system works differently from the U.S.   The World Health Organization (WHO)  state that  healthcare  should be accessible for everyone at low cost  and individuals will not have to pay more  out of pocket “this means that everyone has equal access to quality healthcare that improves the health of patients and that seeking such care would not cause financial harm to those receiving it” (Rook, 2018, para.2).

Most people in Europe will get free healthcare at the first point of care. They may pay a little bit out of pocket when they get a prescription drug. Those benefits are from tax deductions from each paycheck.  Rook (2018) continues that,

One of the significant similarities across healthcare systems in Europe is that all citizens are included. Even in partially privatized systems, an individual mandate is in place (and strictly enforced) to ensure that healthy people are in the system to help offset the costs of sick people. Another commonality is that healthcare in Europe (regardless of method) is primarily funded by tax dollars collected from employers and the public (para.5).  

So, the U.K. or France people do not have to purchase health insurance, but they can see a doctor for free when they get sick.    This is similar to a benefit for low-income people in America.   The funds in the United States are from the government, and state capitals will cover medical expenses for that person. For people who have health insurance through a company, the organization has purchased a group health insurance that will pay for medical costs, employees responsible for co-pay, or some percentage of their treatments.

To compare between the U.S. and other countries in Europe, America has a higher number of maternal deaths: “Although most are preventable, maternal deaths have been increasing in the United States since 2000

That shows that pregnancy deaths in the U.S. are higher than in other countries in Europe such as France, Italy, the U.K., etc.  The Commonwealth Fund by Tiainen (2018) compares between developing countries;

Women in the U.S. are the most likely to die from complications related to pregnancy or childbirth.  In 2018, 17 maternal deaths for every 100,000 live births in the U.S. — a ratio more than doubled that of most other high-income countries (Exhibit 1). In contrast, the maternal mortality ratio was three per 100,000 or fewer in the Netherlands, Norway, and New Zealand (para.8-9).

The other high-income countries in Europe have fewer maternal deaths because they have more supplies, i.e., hospital physicians from different locations, higher quality care for normal pregnancies, child care for routine or sick babies after birth, and postpartum. The cause of maternal deaths in the U.S. is low supplies of hospitals and doctors. Patients have fewer options to select physicians and quality facilities services.

References

Rook. (2018). How does healthcare in Europe work? Blog. JP griffin group employee benefits broker. https://www.griffinbenefits.com/blog/how-does-healthcare-in-europe-work

SPOR. (2022). US healthcare system overview – background. SPOR. https://www.ispor.org/heor-resources/more-heor-resources/us-healthcare-system-overview/us-healthcare-system-overview-background-page-1#:~:text=Coverage%20Overview,health%20insurance%20plans)%20market%20coverage.

Tikkanen, R., Gunja, M. Z., FitzGerald, M., & Zephyrin, L. (2020). Maternal mortality and maternity care in the United States compared to 10 other developed countries. Issue briefs, Commonwealth Fund.

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