The U.S. Health Care System is in great need of reform. When you compare the U.S. with other countries, it has the highest health care costs with 15.2% of GDP, highest percentage of government revenue spent on health at 18.5 %, and it has the lowest percentage of health costs paid by government at 44.6%. The U.S. has 2.56 doctors per 1000 people, 9.37 nurses per 1000 people, and life expectancy is 77.5 years,  5 years less than Japan. The World Health Organization rated the U.S. health care system performance in 2000 at 37th, and overall health of americans at 72nd place. Also, the U.S. spends more per capita then any other nation in the world, but is the only wealthy industrialized country in the world that lacks some form of universal health care. These are just some statistics to give you more of a background of how the U.S. Health Care System is failing. I will now compare the U.S. Health Care System with that of other countries such as France, Canada, and England.

I will give you the statistics of our first country France, and then give you information about it's health care system. The health care costs in France are 10.1% of GDP, 14.2% of government revenue spent on health, 76.3% of health costs are paid by the government,  france has the most doctors per 1000 people than any other country with 3.37 doctors per 1000 people, and 7.24 nurses per 1000 people. In a recent World Health Organization health care ranking, France came in first, while the U. S. scored 37th, France did slightly better than cuba and is one notch above slovenia. France's infant death rate is 3.9 per 1000 live births, compared with 7 in the U.S. France average life expectancy is 79.4 years, 2 years more than the U.S. The difference in deaths from respiratory disease, an often preventable form of mortality, is striking: 31.2 per 100,000 people in France, vs. 61.5 per 100,000 in the U.S. French medicine is based on a widely held value that the healthy should pay for the sick. The sicker you get the less you pay. All French citizens are given universal health coverage which is similar to Englands' health care coverage. Chronic diseases, such as diabetes and critical surgeries, such as coronary bypass, are reimbursed 100%. Cancer patients are treated free of charge. Patients suffering from colon cancer, for instance, can receive Genentech Inc.'s Avastin without charge. In the U.S. a patient may pay $48,000 a year. The French can choose their doctors and see any specialist they want. Doctors in France, many of whom are self-employed, are free to prescribe any care they deem medically necessary. To make all this affordable, France reimburses its doctors at a far lower rate than U.S. physicians would accept. However, French doctors don't have to pay back their crushing student loans because medical school is paid for by the state, and malpractice insurance premiums are a tiny fraction of the $55,000 a year and up that many U.S. doctors pay. That $55,000 equals the average yearly net income for French doctors, a third of what their american counterparts earn. Then again, the French government pays two-thirds of the social security tax for most French physicians, a tax that's typically 40% of income.

In the year 2000 Canada was ranked 30th in health care system performance among 191 member nations and 35th on overall health by the World Health Organization. Canada's health care costs are 9.9% of GDP, 16.7 % of government revenue is spent on health, and 69.9% of health costs are paid by the government. All canada's citizens have coverage, but access can be a problem. The various levels of government pays for about 70% of Canadians' health care costs. Under the terms of the Canada Health Act, the publicly-funded insurance plans are required to pay for medically necessary care, but only if it is delivered in hospitals or by physicians. There is considerable variation across the provinces/territories as to the extent at which such costs as outpatient prescription drugs, physical therapy, long-term care, home care, dental care and even ambulance services are covered. About 30% is paid for through the private sector. This mostly goes toward services not covered or only partially covered by Medicare such as prescription drugs,dentistry, and optometry. Some 65% of Canadians have some form of supplementary private health insurance; many receive it through their employers. An estimated 75% of Canadian health care srevices are delivered privately, but funded publicly. One of the major complaints about the Canadian's health care system is waiting times, whether for specialist, major elective surgery, such as hip replacement,, or specialized treatments, such as radiation for breast cancer. Studies by the Commonwealth Fund found that 57% of Canadians reported waiting 4 weeks or more for a specialist; and 24% of Canadians waited 4 hours or more in the emergency room. Although Canada's health care system is criticized for having long wait times, based on 2003 data from the Canadian Community Health Survey, an estimated 1.2 million Canadians don't have a regular doctor because they can't find one, and just over twice that number because they haven't looked for one. These people are 3.5 times more likely to visit an emergency room for treatment. Canada remains the only Industrialized country that outlaws privately financed purchases of core medical services. 

Thirdly, the country of England has health care costs that are 8.0% of GDP, 15.8% of Englands revenue is spent on health, while the percentage of health costs paid by the government are 85.7%.The life expectancy in England is 79.5 years, along with France which are both 2 years higher than the U.S. England also has 2.30 doctors per 1000 people, and has the most nurses per 1000 people at 12.12 nurses per 1000. Two types of health services are provided to a common citizen in England. Primary and secondary health services are provided by NHS units also known as "trusts." Primary Health Care includes health services such as GP's surgeries, dental and optician services. Secondary Health Services is consisted of specialized health services like, hospitals, ambulences and psychiatric health services. The other method of arranging health care in England is outsourcing of treatment to private companies. The Foundations trusts which are formed to work independently converted from NHS units with good performances. In comparison to NHS, private health care has limited infrastructure and in most cases cater to the primary health services.

While researching information for this article I came across two other countries which I thought were important enough not to leave out. These countries are Sweden and Japan. I will start with Sweden. Sweden has health care costs which are 9.4% of GDP, 5.8% below the U.S.. It has the lowest percentage of government revenue that is spent on health which is 13.6%, that is 4.9% below the U.S. The highest percentage of health costs that are paid by the government at 85.2%, and 40.6% above the U.S. The life expectancy in Sweden is 80.5 years, the same as Canada and 3 more years than the U.S. Sweden has 3.28 doctors per 1000 people, which is .46 more than in the U.S. Also, Sweden has 10.24 nurses per 1000 people, slightly above Canada's figure. Japan has the highest life expectancy averaged at 82.5 years. It has 1.98 doctors per 1000 people, and 7.79 nurses per 1000 people both these amounts are the lowest among all these countries. Japan also has the lowest percentage of health care costs at 7.9% of GDP, that is 7% less than the U.S. The government revenue spent on health is 16.8%,just above Canada and 1% higher than the U.S. The government also pays for 81% of health costs, 36.4% more than the U.S. All citizens of Japan have coverage, free choice of health care providers by patients, a multi-payer, employment-based system of financing. Virtually all are covered without regard to any medical problems they may all ready have or to their actuarial risk of succumbing to illness. Premiums are based on income and ability to pay. Although there is strong government regulation of health care financing and the operation of health insurance, control of the delivery of care is left largely to medical professionals. In only 20 years Japan has achieved the lowest infant mortality rate in the world. The U.S. remains 19th among developed nations.

 



Comments

  • BDevil38 said May 4, 2008...
    Your article gives statistics for how much governments spend on health care, but you do not mention how much the citizens pay in taxes. All of the countries, except Canada, have higher taxes than the U.S. What governments pay for health care comes from the people through taxes.
  • HeatherSherer said May 17, 2008...
    Tax Burdens   Country       single,married       Married 2 kids U.S                29.1%                     11.9% UK                 33.5%                      27.1% Canada         31.6%                     21.5% France           50.1%                     41.7% Japan            27.7%                     24.9%   The U.S pays less taxes than most of the countries but does not provide as much social services as the countries that pay more in taxes.  The top 1% of income earners in the U.S. pay 30.5% in taxes while the lowest 10% of income earners pay 30.7%
  • TeigerEiger said Feb 13, 2009...
    Interested in clarification of the preceding. Is the comparison of the top 1% of income earners to bottom 10% by average or median individual, or by total contribution as a group? A source would let someone else go look at the context of this statement. But more importantly, the article discusses proportions of GDP etc. in relation to health expenditures, and it is not at all clear about how individual and family tax levels relate, say, to GDP. One could look at government income versus outgo, the relative proportions of national budgets devoted to the military.... And, how effectively the health money is spent, and HOW, is pretty important--Heather has given us some really nice details here about how French doctors operate, for instance. I think that once one asks these additional questions, and looks at the other differences between systems, plus the clear waste in the U. S. system, bringing in taxation levels as such doesn't have a convincing relevance. Surely there is some, but it's far from the first thing I would consider. If tax levels had any close relevance, one could say "let's raise taxes a little, put that money into the health system, and we'd be better off." But would you readily accept that claim?
  • mkovavch1 said May 19, 2009...
    Your Data is wrong... Top 1% 39.89% of the Federal Income Tax Bottom 50% pays 2.99% of the Federal Income Tax http://www.ntu.org/main/page.php?PageID=6
  • notso said Aug 2, 2009...
    Why does the percentage of GDP as it relates to health care define the need for reform? US health care can not be acquired for free or at historic prices. If we want 2009 quality we need to pay for it. Yes drugs are expensive but their results are superior to what one could expect 30 years ago. One cannot complain about health care costs without acknowledging the fine quality achieved for that cost. This statement is made by the author: 'When you compare the U.S. with other countries, it has the highest health care costs with 15.2% of GDP, highest percentage of government revenue spent on health at 18.5 %, and it has the lowest percentage of health costs paid by government at 44.6%'. This statement is made as if this point is agreed on in the first place and it is certainly not. Some would challenge whether the government should cover everyone for everything in the first place. I am one of them. I agree with TeigerEiger and mkovavch1. Clarification is important because just throwing out GDP does not tell me much without medians and averages. The data that is given about income earners and taxes paid is wrong. Interpretation of data is as important as throwing all the data on the table. Thanks to mkovavchi for correction. Read this article which is my favorite: www.stumblingontruth.com.
  • Erniemiles said Aug 3, 2009...
    I had to look hard top find any information on the comparison between countries health plans. It seems such information is being denied to the public and congress in their efforts. The cost of prescriptions is much higher in this country due to a contrived means of supporting the pharmaceutical companies without regard to controlling their obscene profits. This artificial tax is a serious part of patients going bankrupt. Other countires do not have this tax burden and that was not mentioned if my quick read is accurate.

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