Health Care Systems in the United States, Australia, and Japan - Assignment Example

Analysis of Three Different Health Systems Analysis of Three Different Health Systems Table of Contents Table of Contents 2 0 Introduction 3 2.0 Design and Functioning of Two Different Health Care Systems 3 2.0.1 The American Health Care System 3 2.0.2 The Australian HealthCare System 5 2.0.1 The Japanese Health Care System 6 3.0 Explain why they are Different 8 4.0 Evaluation based on the Equity, Efficiency, and Effectiveness Framework 11 4.0.1 Equity 11 4.0.2 Efficiency 12 4.0.3 Effectiveness 12 5.0 Evaluation Proposals for Reform in Each System 13 6.0 Conclusion 14 7.0 References 15 1.0 Introduction A healthcare system is the way a given society organizes its institutions, resources, and people for the efficient provision of health care services to that population. The health care systems differ between countries based on the defining factors of that country such as the country’s economy. In many countries, the health care system comprises of both the public and the private health providers. The United States has a comprehensive health care system that encompasses a high-level use of technology. The system has many similarities and differences from that of Japan and Australia. The similarities and differences are based on the different economic capabilities of the two countries and the population size. This paper is based on a comparative overview of the American health care system, the Japanese health care system, and the Australian health care system. The differences between the three health care systems are analyzed as well as the evaluation of the systems in terms of equity, efficiency, and effectiveness. The necessary reforms to the health care systems are also discussed in the paper. 2.0 Design and Functioning of Two Different Health Care Systems 2.0.1 The American Health Care System The healthcare system in the United States comprises of both the private insurers and the public health system that covers the low-income families and the elderly (Emanuel, 2014). Many Americans receive insurance coverage via the employer-sponsored private insurance with most of the services being provided by private insurers. The Medicaid program serves the disabled and poor families. Different states in the country are also required to cover the medical expenses of low-income pregnant women, the elderly, children, and the disabled (Gillies, 2003). States can also expand their eligibility, but the Medicare program is a universal healthcare program that covers people aged over 65 years. The children whose families do not qualify for the Medicare program and do not make enough to buy the private health insurance are covered in the State Children Health Insurance Program (Levine, 2009). A separate health program is also available for the veterans in the United States. The health benefits in the US vary based on the insurance type. The program comprises of both the inpatient and outpatient hospital care and a home visit by the physicians. Other services also include dental care, preventive care, and the use of prescription drugs. The employer-sponsored plans accept patients at the same cost and are underwritten based on the weight, age, smoking status, and health history of the patient. The Medicaid program covers many services including physicians and medication, inpatient and outpatient services. The basic Medicare covers the hospital services, but beneficiaries can also pay premiums and access prescription drugs. The Medicare program is financed by the government money collected from taxes. The program also collects funds from the tax subsidy for employers (Saigusa, 2006). The government revenue accounts for more than 46 percent of the total spending on health care in the country. (Shi, L., & Singh, D. A. (2010) The American healthcare system is as summarized in the figure below. Figure 1: The American Health Care System 2.0.2 The Australian HealthCare System Similar to the American health care system, the Australian system comprises of both the private and the public health programs. The health care in Australian is managed by the Federal Ministry of Health (Willis, Reynolds, & Keleher, 2012). Different states in the country follow the health care directives and programs that are directed by the national government. The public health program is managed by the state governments. However, the state governors are free to redesign their health programs based on the different health care factors impacting on the state. The Australian healthcare system is a universal program that is funded by the state. The national government sponsors the health programs with money collected from taxation as well as a Medicare levy of 1.5 percent that is collected from the middle and high-income earners (Russell & Dawda, 2014). The rich are held accountable for their health care where they are required to have a private medical cover. An additional medical levy is charged on the people in the high-income class who do not have a medical cover. The private insurance covers are important to cover the private medical programs. Considering the small proportion of the funds levied from the rich people in the society, it appears that the Australian government almost sponsors the health care system entirely. In most cases, the government covers 100 percent of the medical expenses of the patient (Palmer & Short, 2000). Otherwise, the patient may be required to cater for the remaining amount, which is even affordable to the low-income earners. Specific health services are also provided by distinguished nongovernmental organizations in the country, such as the Red Cross. 2.0.1 The Japanese Health Care System Having a medical insurance is mandatory in Japan. The system is based on a universal program that guarantees quality health services to all the citizens. It is compulsory for the insurance of employees in the country (Doctors oppose healthcare system reforms in Japan, 2013). The insurance must be adequate to cover all the medical needs of the employees. The healthcare insurance cover in Japan is classified as employees’ health insurance and the national health insurance. Different levels of work and different organizations offer different healthcare insurance packages under the employee health insurance. The unemployed people in Japan benefit from the national health insurance cover. Both the self-employed and students are covered in the program. The cover is divided in such a way that every town, village, or locality in Japan has a specific health system to cater for the health needs of the people (CIA: The World Factbook: Japan, 2011). Insurance coverage on health matters is a highly emphasized aspect in Japan. More than 90 percent of the Japanese citizens have an insurance cover, both the employed and the unemployed (CIA: The World Factbook: Japan, 2011). The beneficiaries only pay for about 30 percent of the medical cost while the insurance cover pays for the rest. The national health insurance cover may be supplemented with the private insurance to give patients 100 percent coverage (CIA: The World Factbook: Japan, 2011). The economic level of individuals determines the insurance premium paid and the type of insurance cover they can take. With most of the people in Japan being covered by the medical insurance, citizens are free to attend any hospital of their choice without being compelled. The health program is managed by both the national government and the state authorities. The hospital administration is also expected to manage the healthcare program at a profit. For-profit organizations are prohibited by the government to own hospitals to ensure that citizens are not overcharged. For that reason, all the private hospitals and clinics in the country are fully owned and operated by medical practitioners and physicians. The Japanese healthcare system is as summarized in figure 2 below. Figure 2: The Japanese Healthcare System 3.0 Explain why they are Different The United States, Japan and Australia are all developed countries with a history of historical economic interactions. However, the healthcare systems in the three countries have many significant differences. The differences are contributed by the economic differences and the national policies related to health care that have been successfully passed by each of the countries. The American health care system is not as comprehensive and straightforward as the Australian healthcare system. The American healthcare facilities emanate from the jurisdiction of different legal entities. These comprise of different state programs such as the Medicaid and the Medicare. The programs are designed to ensure that health benefits are accessed by all the people in the society, but the program is far from universal. The major difference between the American and the Australian healthcare systems is that in Australia, the Medicare program covers a larger percentage of the population since everyone living in the country is eligible in the program. The program entitles all members to be treated in all public hospitals at no charge. This is unlike in the United States where most of the healthcare facilities are privately owned and charge differently for different services to the patients (Baghbanian, Hughes, & Khavarpour, 2011). In the United States, almost everyone, including the illegal immigrants, are entitled to the hospital emergency care. This does not depend on whether the individuals can pay for the services. However, this is the point where the public system is less convoluted. Since there is no further public coverage, the United States is said to be the only develop nation that fails to ensure that all the citizens have a universal healthcare coverage. According to an estimation done in 2009, more than 50.7 million American residents did not have a health insurance cover (Berman & Bitran, 2011). Similarly, it was reported that more than 5,000 Americans die annually due to the lack of health insurance annually. The healthcare costs in the United States have grown superficially, even more than the inflation rate (Budrys, 2012). Likewise, medical debts have contributed to more than all the personal bankruptcies in the country. Private health insurance is available in the United States, but it is much more costly as compared to Australia. Moving to Japan from the US can be a really astounding experience as far as the healthcare experience is concerned. The Japanese healthcare program is more comprehensive for its citizens. The Japanese government provides universal care for all its citizens, unlike the United States that only partially sponsors healthcare. Even without the insurance cover, basic medical appointments in Japan cost an average on $20, which is almost the same cost among the insured beneficiaries in the US. Another significant difference between Japan, the US, and Australia is the visitor qualifications in Japan. Non-citizens who have stayed in the country for more than a year are qualified for alien registration. One of the reasons for a different healthcare program in Japan is the country’s economy. Japan’s economy depends on its well-established manufacturing industry. The country leads in innovation in various sectors. Likewise, foreign investments are a significant booster for the economy, especially based on the fact that Japan is among the largest creditor nations. This implies that the Japanese government generates adequate revenues to cater for the social and health needs of its population. The Japanese population also has a high buying power parity, which implies that they can afford to meet their medical needs. Paying 30 percent of their medical expense is not a burden to the Japanese population. The Australian economy is among the largest in the world. The country also ranks high in various economic sectors such as the quality of life, healthcare, and education. The country exports both the agricultural and the mineral resources (CIA: The World Factbook: Australia, 2010). Australians are rated among the most affluent people in the world. For that reason, the provision of a medical cover by majority citizens is not a problem. The analysis of the three countries in terms of religion and geography also depicts significant differences. Japan is predominantly Buddhist while Australia is predominantly Christian, and the US comprises of both the Islamic and Islam population. However, the three countries are similar in terms of revenue collection. They all predominantly depend on exports to fund their medical programs. In Australia, for instance, the program puts a demand on the public to provide for the policy. The wealthy class is required to pay for their health services without relying on the government. The wealthy class has no difficulties with this program, especially given that Australia is among the wealthiest nations in the world. 4.0 Evaluation based on the Equity, Efficiency, and Effectiveness Framework 4.0.1 Equity The three healthcare systems are evaluated on the basis of their effectiveness, efficiency, and equity. Health care systems are evaluated in terms of the quality and cost of care that the people obtain from them. Despite the ObamaCare program in the US, there have been reported cases of poor performance. There is no equal access to the healthcare professionals nationally, especially after the establishment of the private wings where physicians attend to patients at a profit. The system also seems to marginalize the low-income earners, the elderly and children. On the other hand, the Japanese healthcare system is one of the most equitable in the world. Patients are free to select the hospital and physicians to attend to them. They are also charged equally, a factor that gives them access to equitable services. The Japanese healthcare program is among the best and one of the cheapest. However, numerous quality cases have been reported since the physicians aim to treat a greater number of people to make profits. The fact that physicians are not required to charge an extra cost also leads to mismanagement of some services which may be operated below their normal budget. The same factor has led to numerous reported cases of neglect and discrimination of the patients. Physicians do not have the motivation to rush for emergency medical situations. In terms of equity, the Australian medical system is among the best in the world. Despite its huge economy, the education system in Australia is poor. This has led to a huge increase in the shortage of physicians. The country experiences an expertise shortage of more than 100,000 practitioners, a factor that compromises its provision of equitable medical care (CIA: The World Factbook: Australia, 2010). 4.0.2 Efficiency Efficiency is the achievement of the best medical outcomes using the available limited resources. The efficiency of healthcare is obtained by comparing healthcare expenditures with the country’s GDP. The US healthcare expenditure has increased with the government financing more than 70 percent of the expenditure. The healthcare expenditure as a percentage of GDP in the US stands at approximately 17.4 percent (Berman & Bitran, 2011). The percentage is at 10.1 in Japan and 9.1 in Australia (Berman & Bitran, 2011). 4.0.3 Effectiveness Although the US healthcare has been termed as fair, it is not up to the standards. In 2013, the US registered a total of 2,596,993 deaths. This was a death rate of 821.5 deaths per every 100,000 people (Budrys, 2012). Life expectancy was reported at 78.8 years, and the infant mortality was at 5.96 deaths per every 1,000 live births (Budrys, 2012). Medical data have reported an increased life expectancy in the US, an indication of increased effectiveness of the system. Changes in lifestyles, especially the increased consumption of fast foods, have led to an increase in the number of lifestyle diseases. Diabetes and cancer have been of major concern in the US healthcare system. Compared to the US healthcare system, the Japanese system is effective in many ways. For instance, compared to the life expectancy of 78 years in the US, the life expectancy in Japan is at 86.4 years in females and 79.6 in males (CIA: The World Factbook: Japan, 2011). The general life expectancy in Japan is 83 years. Likewise, the death rate is lower at 9.5 per every 1,000 people (CIA: The World Factbook: Japan, 2011). The infant mortality rate in Japan is at 7.5 per every 1,000 citizens (Gillies, 2003). On the other hand, the Australian system is moderately effective. Life expectancy in Australia is close to that of Japan; 86.3 years in females and 79.5 years in males and the infant death rate were registered at five deaths per every 1,000 live births (CIA: The World Factbook: Australia, 2010). The death rate in the same country was reported at 6.5 per every 1,000 people. Cigarette smoking has been reported as the major health risk in Australia and has been the major cause of preventable diseases in the country (CIA: The World Factbook: Australia, 2010). 5.0 Evaluation Proposals for Reform in Each System The health system reforms in the US focus on the delivery of affordable care to all the citizens irrespective of their economic status. This can be enhanced by ensuring accessibility of the healthcare program by all the people in the country. The small costs that individuals are supposed to cover may be a burden, especially for the low-income earners. For that reason, the government should take responsibility by sponsoring the health program completely. The improvement should also involve increasing the number of available nurses and physicians to cater for the increasing number of the ailing population. The US government should come up with an alternative strategy to fund medical care by ensuring that the care is absolutely free to all. This has been attempted through the ObamaCare but more needs to be done to make it easier for people of all economic classes to access healthcare. The major challenge in the Australian healthcare system is the shortage of experienced doctors and nurses (CIA: The World Factbook: Australia, 2010). The government has sought to develop the education system to offer a lasting solution to the problem. Medical training institutes have been set up to increase the number of enrollments in medical courses. The strategy has effectively increased the number of nurses. However, the government needs to do more by liaising with other countries such as India with high-tech medical services. The Australian government also does not offer good employment packages for nurses, a factor that leads to the shortage in the profession. Nurses should be compensated equally or more than the other public servants based on the level of risk in their jobs. The same will help to attract more students to study medical courses. Although the Japanese health care system is among the best in the world, the quality of service delivery has been an issue of concern (CIA: The World Factbook: Japan, 2011). The government has invested heavily on medicine and research to improve the quality of healthcare. However, the quality of the entire health system is flawed and needs to be addressed accordingly. This can be achieved by the establishment and improvement of the quality control programs that access the performance of nurses and doctors and the cost of care. 6.0 Conclusion The paper provided a comprehensive comparison of the health care systems in the United States, Australia, and Japan. As can be noted, despite being a world superpower, the United States is not the best provider of healthcare. The paper highlighted the healthcare flaws in each of the systems and suggested the ways in which such flaws can be improved. Overall, the improvement focuses on the cost and quality of healthcare. The governments should offer affordable health services to the people while ensuring that quality is not compromised. For instance, despite the high level of economic growth in Australia, there is a shortage of nurses and the quality of healthcare. This implies the need to focus on the education system in the improvement of the healthcare system. 7.0 References Baghbanian, A., Hughes, I., andKhavarpour, F. A. (2011). Resource Allocation and Economic Evaluation in Australias Healthcare System. Australian Health Review, 35(3), 278-283. doi:10.1071/AH10890. Berman, P., & Bitran, R. (2011). Health Systems Analysis for Better Health System Strengthening. Budrys, G. (2012). Our unsystematic health care system. Lanham: Rowman & Littlefield Publishers. CIA: The World Factbook: Australia. (2010). CIA World Fact Book, 42-45. CIA: The World Factbook: Japan. (2011). CIA World Fact Book, 339-342. Doctors oppose healthcare system reforms in Japan. (2013). PharmacoEconomicsand Outcomes News, (687), 2. doi:10.1007/s40274-013-0703-0. Emanuel, E. J. (2014). Reinventing American health care: How the Affordable Care Act will improve our terribly complex, blatantly unjust, outrageously expensive, grossly inefficient, error prone system. Gillies, A. (2003). What makes a good healthcare system ?: Comparisons, values, drivers. Abingdon: Radcliffe Medical Press. Levine, R. (2009). Shock therapy for the American health care system: Why comprehensive reform is needed. Santa Barbara, Calif: Praeger. Palmer, G. R., & Short, S. D. (2000). Health care & public policy: An Australian analysis. South Melbourne: Macmillan Education Australia. Russell, L., andDawda, P. (2014). Lessons for the Australian Healthcare System from the Berwick Report. Australian Health Review, 38(1), 106-108. doi:10.1071/AH13185. Saigusa, O. (2006). Japans Healthcare System and Pharmaceutical Industry. Journal of Generic Medicines, 4(1), 23-29. doi:10.1057/palgrave.jgm.4950039. Shi, L., & Singh, D. A. (2010). Essentials of the U.S. health care system. Willis, E., Reynolds, L. E., & Keleher, H. (2012). Understanding the Australian health care system. Chatswood, N.S.W: Churchill Livingstone. Read More