Health Care System - Research Paper Example

Health Care System Paper (U.S.' and Singapore's health care in comparison, What system can be adopted from Singapore) For many years, U.S. has been asserting its supremacy over other countries in terms of health care delivery system. But recent major shortcomings raised doubts to that assertion (University of Maine, 2001)1. The frustration level of both patients and clinicians are high. The frequency of health causing harm is on the rise and the potential benefits that it should give often fail (Executive Summary, Crossing the quality chasm: a new health system for the 21st century)2. On the other hand, the National Center for Policy Analysis (NCPA)3, in their August 14, 2001 issue of Daily Policy Digest concerning health issues, claimed that Singapore's health care ranked first in an international comparison. The NCPA paper stated that "Canadian health economist Cynthia Ramsay ranked the health-care systems of Singapore, Canada, the United States, the United Kingdom, Switzerland, Germany, Australia and South Africa". The Daily Policy Digest further said that "An index similar to the United Nations Human Development Index and the Fraser Institute Index of Human Progress were used. The score, ranging from zero to 100, compares performance of one health care system to the other. The NCPA paper said that according to Ramsay, overall rankings are as follows: Singapore has the "best" health-care system with a score of 62.1. Second-place United Kingdom (60.5), followed by Canada (56.7) and United States (53.6). Perhaps, being the best in the world is not a major issue. The question that the government of each country must answer is, are their constituents receiving the health care system that they truly deserve As Martin Luther points out, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane". In the study conducted by the University of Maine using data from the Organization for Economic Cooperation and Development (OECD), the US Census Bureau and other organizations, it said that "Among the developed or industrialized country, U.S health care system is the most expensive health care system in the world". The International comparison on health care system conducted by Ramsay (Canadian Health Economist), which appeared in the paper of National Center for Policy Analysis, placed Singapore in rank number one. The comparison also put so much weight on each country's level of expenditure. As the Canadian Health Economist stated, "more spending on health is worse than less" (National Center for Policy Analysis 2001)4. The same study reveals that among the developed countries, excluding South Africa, U.S. is the only country which denies many of its people the benefit of a valuable health care. Some people have to be contented with the health care that goes with their employment. But when insurance rates go up, employer either raise deductions on insurance premium or remove health care insurance in their list of benefits. Medicard and Medicaid are limited to the elderly, veterans, military, the poor and the disabled. Counterpart of U.S. Medicard and Medicaid is Singapore's '3M' framework of Medisave, Medishield and Medifund. These schemes combine the individual responsibility and government subsidy (through taxation) (Tucci 2004)5. In the "healthcare market review" which appeared in the October 2004 issue of the paper Watson Wyatt Worldwide, John Tucci explores Singapore's '3M' framework as: "Medifund is an endowment fund set aside up by the government to assist the needy in meeting their medical expenses. Medisave is a forced medical savings scheme to be used in future personal or hospitalization of immediate members of the family, surgical operations and other expenses outside the hospital. Medisave is provided in the Central Provident Fund where there is a total of 33 percent employee-employer contribution (13% employer and 20% employee). Part of this is intended to employees' retirement fund. Almost 85 percent of Singapore's population is covered by Medisave. Where Medisave ends, Medishield begins. It is intended for catastrophic or prolonged illness. The people of Singapore can choose between Medishield or a private alternative which the government allows to operate. Extension to the '3M' system has recently been introduced. Eldershield, as the name suggests, is intended to pay for medical expenses of the elderly. In addition, private health insurance covers a big chunk of workers (including their dependents). More often, this is funded by employers given to employees as benefits". The Singapore government has instilled in the minds of its people the importance of investing for their own health care. This has been the key to the efficient health care delivery system in the country for many years. It also reduces the government's expenditure on health with a huge contribution of individuals and/or their employers. Medisave account which is compulsory savings has been the major source of private funding for hospital expenses (Tucci 2004)6. Tucci stated that, "Singapore also strictly regulates the prices of medical supplies and health care services. This is geared towards preventing inflation, which the world experience from time to time, to affect their overall health expenditure". While some U.S. organizations push for the expansion of the existing and highly successful Medicard to extend to the entire population (The University of Maine 2001)7, they should also adopt the system of focusing some of their energies putting price control to medicines, medical supplies and health care services. This will significantly reduce their health care budget. Fairness in financing can be measured in terms of how contributions to health care are distributed across the whole population. Data gathered by the University of Maine shows the U.S.' and Italy's unfairness in financing health care (The University of Maine 2001)8. Singapore addresses the 'fairness in financing' issue through the '3M' frameworks. As its citizens are disciplined to invest in their health care, when need arises, they find no difficulties in paying for their medical services. On the satisfaction rate category, 40 percent of the American people said that they are either very satisfied or fairly satisfied with their health care system. This is a dismal performance because Denmark got 91 percent and Finland 81 percent. U.S. U.K. has 60 percent satisfaction rate despite the consistent health care problems (The University of Maine)9. American health department should consider a closer look at Singapore '3M' system. Apparently, it solves several aspects of the health care system. It did not only address the issue on fairness in financing but also maintain a high satisfaction rate among Singaporeans. If they do not encounter any problem in meeting their medical requirements on time, they surely will do thumbs up sign in the government's health care program. Tucci again stressed that, "Singapore put heavy emphasis on the citizens to be very responsible in their own health and ensure a budget for the health expenditures. This results into a system that is privately funded subsidized only by the government". This is a system that U.S. policymakers and organizations should carefully study. If considered, this will result into lower taxes because smaller budget will be allocated to health care services. Private organizations like the University of Maine and Physicians for a National Health Program (PNHP) as well as U.S. government agencies like the General Accounting Office and the Congressional Budgeting Office, are pushing for the single payer system (The University of Maine 2001/PNHP 2003)10. PNHP defines Single-payer system as "a system where the government finances the health care, but keeps the delivery of health care to mostly private control." PNHP believes that it will solve U.S. many health care problems like the 43 million citizens with no health insurance, other with very limited coverage, increasing premiums on health insurance, medical malpractice and relatively poor health indicators (Physicians for a National Health Program 2003)11. A Single payer system may either contradict or, at a closer look, may compliment Singapore's health care system which is predominantly private funded. Although, it may be true that the Singapore health system ranks number one in Ramsay survey, one reason why replicating it is a difficult task is that it is a small country with only a total land mass of 660 square kilometers with four million people. The mapping of health care structure is easier than bigger countries. Nonetheless, a careful look at its system is worth the time of each country's leaders specially those with health care delivery problems (Tucci 2004)12. Reference: 1 Bureau of Labor Education, University of Maine, http://dll.umaine.edu/ble/US%20HCweb.pdf 2 The National Academies Press; Executive Summary, Crossing the quality chasm: a new health system for the 21stcentury; Institute of Medicine; http://www.nap.edu/books/0309072808/html 3 National Center for Policy Analysis, Daily Policy Digest; http://ncpa.org/pi/health/pd081401c 4 National Center for Policy Analysis, Daily Policy Digest; http://ncpa.org/pi/health/pd081401c 5 John Tucci, healthcare market review, October 2004, Watson Wyatt Worldwide; http://watsonwyatt.com/ 6 John Tucci, healthcare market review, October 2004, Watson Wyatt Worldwide; http://watsonwyatt.com/ 7, 8, 9 Bureau of Labor Education, University of Maine, http://dll.umaine.edu/ble/US%20HCweb.pdf 10 Bureau of Labor Education, University of Maine, http://dll.umaine.edu/ble/US%20HCweb.pdf, and Physicians for National Health Program; http://www.pnhp.org/ 11 Physicians for National Health Program; http://www.pnhp.org/ 12 John Tucci, healthcare market review, October 2004, Watson Wyatt Worldwide; http://watsonwyatt.com/ Read More