Of the countries that were made available, the three countries health care policies I found most interesting were United Kingdom, Japan and Taiwan. These three countries all had a very different take on how to provide healthcare to the public but they also all managed to do so with a low government GDP.
The United Kingdom is a capitalist democracy with a health care system that tries to support it’s views of an economic, political and social economy. There system is referred to as the National Health Service (NHS), it is government funded and the main source of income is through taxation. The Brits call this process “socialized medicine,” where the government is in charge of providing and funding for their health care program. Once the high taxes are collected the government then goes and distributes them throughout the (NHS) to health care providers. Doctors have set salaries determined by the government, but before you can get to your doctor you have to see a General Practitioner (GP) or also known as the gatekeeper. These people run their own private practices and their pay is based upon how many patients they have and the health of their patients. This system may sound all tied together but some of the negatives that go along with the (NHS) are long waiting lists, and a limited choice on your health care provider. Some of the changes that the UK has managed to change over the years is how “Hospitals now compete for NHS funds distributed by local Primary Care Trusts, and starting in April 2008 patients are able to choose where they want to be treated for many procedures.” This has allowed for the market based economy to open up more, leaving patients with a wider choice for health services.Order now
Japan’s health care system differs from the UK in several ways, there GDP averages about 8% which is even less than the UK. Everyone in Japan has to sign up for Health Care Insurance or as they call it (Social Insurance). A families average premium totals out to be about $280 a month, and if you can’t pay a premium then you have a net to fall on, there is public assistance available. Japan pays all but about 30% of the cost, leaving co-payments minimal, but they base the total amount off of your income at the end of the month. Japan isn’t completely government based they found that having most health insurance agencies, doctors and nearly all hospitals in private sectors allowed competition leaving the GDP at a low 8%. The Japanese are known for being some of the longest lived humans due to their cultures diet and lifestyle, but many argue it has much to do with the stability of their health care plan. It was created with the intent to provide health care to all individuals in their society, singling no one out because of inability to pay for the system. The Japanese have also made it easier to get service to their citizens, they eliminated the idea of gate keepers, allowing the Japanese to go to any specialist as often as they wish. The Ministry of Health determines the price of every procedure every two years. This is the main factor in keeping costs low, but
keeping costs so low has been the soul cause of their hospital deficit. Their government is not spending enough on health care so hospitals are the ones suffering, not the citizens.
Taiwan’s system is merely a combination of all the systems. They analyzed other countries and looked at their flaws and then tried to build a health care system around them. They have what is called a “National Health Insurance.” All of their citizens are required to obtain health insurance, but the difference between Taiwan and many other capitalist democracies is their system has made it where they only have one government- run insurer, which cuts competition and gets strait to the point. Families on average pay a premium of $650 per fiscal year. “ Working people pay premiums split with their employers; others pay flat rates with government help; and some groups like the poor and veterans, are fully subsidized.” The Taiwanese system allows for citizens to see any doctor at anytime. Every citizen is allotted a card when receiving health insurance, it is called the ‘smart card.’ It contains medical history; how many visits the patient has had; and a bill history. It is a system that has much thought put into it, and a system that wouldn’t exist without the technological advancements we have today. Taiwan is currently leading in having the lowest health care plan, their GDP is only 6.3%, but from that statistic you can easily tell that the government spends very little on the up keep of their medical system. Taiwan is so concerned about providing health care to all of their citizens that that tend to forget about the hospitals that are actually providing this care and the money they need to stay active.
If the U.S adopted the health care system of the United Kingdom I believe that it would and could eventually work, but like anything else in the U.S it would take time. There system is not one that you can just convert to overnight because of some new reform, it has to gradually be built into our system. Doctors couldn’t turn around one day and suddenly be making a ⅓ of their current salary because the government became in charge of income distribution like in the U.K. The U.K also has gatekeepers or better known as General Practitioners that patients would have to see prior to their visit to the doctors, this would open a whole new private practice sector in the U.S creating more jobs thus being beneficial to our economy. The U.K also proves to have higher life expectancy at birth and lower death mortality, which is something I think the U.S should take into account when looking over the health care plan of The Brits. Everyone in their nation has access to some form of health care, where in the U.S only about 85% of our citizens have access to health care, leaving our life expectancy at birth at a low 77% and other poor statistics that coincide with our health care plan in the U.S
Some of the cons in converting our health care system to the UK’s would be some of the same problems they deal with over there. The waiting time to see a doctor or get appointed to surgery takes months at a time, and people in the US are currently used to a fairly speedy health care service. Citizens in the US who have insurance are also persistent about seeing a dentist about every six months, where in the UK the field of dentistry is not one of high desire due to the low government salary, finding a dentist can almost be impossible, you will sometimes hear horror stories of people trying to deal with their dental problems on their own which quickly leads to disaster. The UK has a plan that works for them, but overall I don’t think our government or society would be willing to lose the fast and efficient health care system we have today, even if it means not everyone is allotted health care in the US.
From a world wide comparison Japan has one of the worlds leading health care programs, it consists of a very low GDP; it’s life expectancy at birth scores the highest in the world (82.1%); it’s Infant mortality rate is the lowest in the world at a startling (2.8%) and they perform (40.1 million) MRI’s each year, the highest in the world, so now you ask, why don’t we just replicate their health care plan in the U.S because that sounds great! It would be beneficial in some ways, for people who don’t favor large government funded programs; it would seek more private sectors in hospitals, doctors and insurance agencies. Japan’s health care system in the U.S would allow patients the ability to see their physician as many times as they would like, without having to see a gate keeper and without any huge bill expectancies. When it comes to co-pay cost in Japan, their citizens only pay “ 30 percent of the cost of a procedure, but the total amount paid in a month is capped according to income.” Here in the U.S are co-pay system is also fairly low; if you have employer-sponsored health insurance or pay for it by other means, a typical checkup with your doctor would cost you about $20 and if your seeing a specialist about $40. But in comparison to Japan that is astronomically higher, so overall lowering the co-pay and the cost of insurance per fiscal year in the U.S would make many Americans happy.
Here is why we haven’t adopted their system yet, as it has many beneficial reasons but it also has some flaws that would be hard to untangle here in the U.S. In Japan today approximately 50% of their hospitals are in a financial deficit according to ‘Frontline News.’ They make the system work quite well for their citizens, but when it comes to funding and government spending on health care they lack, they actually spend ‘too little’ on health care, leaving their hospitals in a poor situation and unable to better their facilities. Having a $10 per night visit to the hospital would be a fraction of what U.S citizens pay to stay the night in a hospital but it also is not enough balance to keep their hospitals going. Which in the long run is a huge problem when deciding on a new health care reform.
Taiwan’s health care system is unique in the way they analyzed other countries from around the world pointed out their flaws and tried to create a new health care plan in 1995, that avoided all of those problems, and they did a very good job, increasing health care availability to the 40% who did not have access to it prior to their reform. Taiwan’s system is one that I believe the U.S could learn a thing or two from. Here in the U.S we have private sectors for our Insurance agencies, each in competition with one another for business, always fluctuating cost and stats about being the most reliable agency to choose. In Taiwan they eliminated that whole controversy, they only allowed one government insurer, and everyone has access to it, because if you can’t pay the insurance premium then there is accommodations to fully subsidize your cost.
In Taiwan they use a system called a ‘smart card,’ that has all the patients medical history, bill reports, visits to the doctor and so on. Every citizen is allotted a card and it is the only way they can receive service. In the U.S we don’t exactly have what they call a ‘smart card,’ but we do have our insurance cards, which play a similar role. Our Insurance cards contain our personal information that any health care provider can look up with the correct data base. I believe the Taiwanese saw our system of long paperwork a flaw in their new health care system and created what I would like to call the Ultimate insurance card, or what they call the Smart Card.
The Taiwanese do have a great system they created and one that is seeming to work quite well for them, but when adjusting their health care system they did not seek to increase government spending. They simply just don’t have enough money in their government to pay for all of their services. This flaw in health care is one that may not have a solution, in government systems across the world, these countries are either spending too little or too much on health care, leaving a string loose in the system. For years now, the world has been trying to come up with the most ideal health care system, one that works for EVERYONE. But in some countries, the single flaw of having too low of a GDP to support their hospitals is one they just look past because finding a health care cost that works for everyone including the government is merely unrealistic in their eyes. But it’s the struggle that the U.S has not given up on yet.
After analyzing these three health care systems in other capitalist democracies, it has helped broaden my views on the health care regime of the U.S. We currently have one of the most expensive health care plans in the world with Switzerland a far step behind us. But I believe the reason as to why we have not converted to plans similar to the U.K, Japan and Taiwan is because they all share one main flaw, each of their governments has a system that provides health care to all citizens at an extremely low cost leaving an extremely low GDP in comparison to the U.S, but each of these countries gives minimal support to their hospitals which when it comes down to it, they are our main resource in this whole process. Without Hospitals we have no services, I believe the U.S could learn a few things from each of these countries to help lower our cost to something more reasonable, but not completely convert our plan until we can tackle the flaw that no country has managed to do so yet.
* FRONTLINE. “Five Capitalist Democracies.” www.pbs.org. 15 April. 2008. http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/
* “Sick around the World.” Frontline News. PBS. 15 April. 2008. Televison
*Discussions from Class with Dr. Arwin