Health care abroad
Contrasting insight into the medical systems of the United States, United Kingdom and Canada
By Staci Reafsnyder | Entertainment Editor
The United States’ economic system is based on capitalism, with many social programs administered by private companies. Currently, this also includes health care.
Where does the money come from to support the health care system? How does the United States’ health care system compare to other health care systems around the globe?
By juxtaposing three vastly different health care systems in the United States, United Kingdom and Canada, making sense of the current issues, concerns and hopes surrounding the current health care debate in Congress may become a bit easier.
The United States
What kind of Health Care system does the country have?
The United States has a private health care system through privately owned insurance companies. The majority of individuals in the US either pay for his or her own insurance or receive benefits from an employer.
According to Susan Goodman, former head of billing and data management at Methodist Occupational Health Inc., if a person decides to pay for his or her own insurance, any pre-existing condition will probably not be covered for up to a year. This occurs when there is a lapse in coverage or there was no coverage prior to paying for health insurance. The only time that a preexisting condition would be covered is when a person is transitioning from one health insurance company to another, and they need to temporarily pay for health insurance during that time. Also, insurance can cover all aspects of health – doctor and dentist visits, eye exams and so forth, depending on the individuals plan. Usually, an individual must pay a co-pay set by the insurance company upon each visit to the doctor.
Where does the money come from?
Insurance companies take the money collected from employers and pay-out to the health care system. Other corporations use insurance companies that also negotiate for lower costs. Health care benefits vary. Usually, payment for insurance comes out of an employee’s paycheck. Some companies contribute to the costs, and others do not.
If a person is applying for state health care, he or she must meet certain criteria. Usually, they must be at poverty level income, or if they are just above poverty-level income and supporting a larger family.
According to Assistant Professor of History Chad Martin, 2002 figures show that the United States spent approximately $4,271 per person. He also said that the United States paid more per person in 2002 than any other country in the world.
The United Kingdom
(Britain, Scotland, Wales and Northern Ireland)
What kind of Health Care system does the country have?
The U.K. health care system is the National Health System, or NHS, which was founded in 1948 to accommodate the post-WWII-struck countries, when socialized medicine was put into place. According to Martin, the system has been tweaked and improved over the years.
“What it has covered over the years has changed,” Martin said. “[But] it always covered your basic health care.”
This basic health care includes check-ups, prenatal care and hospitalization for disease or trauma.
The program has been modified over the years, though. Under the NHS, a person is expected to pay for certain dental and optical services, as well as pharmaceuticals. If an individual does not require a necessary surgery, he or she must also pay for it. Plastic surgery, for example, is an elective surgery.
“All the essentials are taken care of, but non-essentials are not,” Martin said.
People of the U.K. also have the option of purchasing private health care. Because there is national health care, however, people usually do not purchase it.
Where does the money come from?
The funding comes from the general taxes that people pay. These taxes come out of each person’s salary. If a person is not employed, he or she is asked to donate money for the years he or she did not work. According to “Health Care Systems in Transition: United Kingdom 1999,” the Department of Health designates the Secretary of State and five ministerial colleagues responsible for health and personal social services in England. These six people decide where the funds are allocated within in the health care system.
According to Martin, the United Kingdom spent approximately $1,675 per person in 2002.
Canada
What kind of health care system does the country have?
Under the Canada Health Act of 1984, the country adopted public health care insurance, referred to as Medicare, under provincial jurisdiction. Private health care can be sought to cover health services outside the realm of public health care insurance.
Each provincial government must meet several criteria to receive the federal government’s cash and tax point transfers, including comprehensiveness, universality, portability and accessibility. All provincial governments also are required to annually disclose information regarding extra billing and user charges, practices strongly discouraged by the act.
Health services fully insured by provincial governments include hospital services necessary for maintenance of health, preventing disease or diagnosing or treating an injury; any services required by a medical practitioner; and any surgical or dental procedures that require the attention of a hospital.
Extended health care services include nursing home care, adult residential care, home care and ambulatory services and are susceptible to partial or full private rates.
Where does the money come from?
Canada’s public health care insurance program is primarily based on income tax. All citizens pay a specific amount based on income, rather than on the benefits they expect to receive.
When provinces adhere to the specific requirement outlined in the Canada Health Act, the federal Canada Health Transfer provides cash and tax point transfers on an equal per capita basis.
According to the non-profit Web site economicexpert.com, health care comprised 16.2 percent of government spending in 2001, equating to $1,533 per person.
