Canada & Britain: Universal Health Care Systems for All - Paper Example

Introduction

Canada has a National Health Insurance system that provides universal health coverage for all its citizens. The government covers about 70% of all healthcare spending, and the private sector delivers most of the care (Martin et al., 2018). Britain has a national health system, where the government provides care and finances it. As a result, citizens access a broad range of services free; it contributes to 80% of all healthcare spending. Britain and Canada's health system achieve more and better quality care for less, with only a little over 10% of the Gross Domestic Product going to health care.

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In the US, health is an individual responsibility. It spends 17.6% of its GDP on health care, which is the highest in the world (Davis, Stremikis, Squires & Schoen, 2014). However, about 45 million of its population is still uninsured, with many only having limited coverage. In Canada, only 12% of the GDP goes to healthcare, producing better health outcomes than in the States (Martin et al., 2018).

The National Health Insurance covers primary care for every citizen. With this kind of success, it is prudent for the United States to adopt or learn from the Canadian single-payer system. Treating health as a public service and not a business will ensure quality primary and preventive care at affordable costs.

Compared to other international healthcare systems, the United States spends most of its national income on healthcare. The amount spent on healthcare varies from one country to another due to the diverse social, economic, and political attributes, which greatly determine the amount it would spend. For instance, the US spent over $10600 per individual in healthcare- which is the highest per capita healthcare cost, according to the Organization for Economic Corporation and Development (OECD) 2019 Statistics on Health.

Stakeholder Forum

In the United States, the cost of healthcare significantly influences the industry. For instance, among the industrialized nations, the US leads in expenditure on healthcare. However, despite the high spending on healthcare within the United States, life expectancy is still lower than in other industrialized countries. For example, according to a study conducted by the Journal of the American Medical Association (JAMA), life expectancy in the United States is 78.8 years. In comparison, the average life expectancy in other high-income nations ranges from 80.7 to about 83.9 years. Due to the high cost of healthcare in the US, only 90% of the entire population has medical insurance compared to 99% to 100% in the other industrialized countries.

It is essential to note that an average American pays about four times as much for pharmaceutical drugs as the various citizens of the other countries. Unlike in other industrialized nations where the government controls the prices of medicines and other healthcare services, the prices in the United States are controlled by the market forces since the private sectors form the significant stakeholders within the healthcare sector. In the United States, the high cost of healthcare affects all the stakeholders- both sick and well.

Multiple healthcare systems create waste within the industry. For instance, excess medical spending has often been incurred in the administration of healthcare facilities and programs. About 8% of the healthcare spending within the United States goes on administrative costs. Hospitals and other healthcare facilities have become profit centers for various stakeholders within the healthcare sector (Taft & Nanna, 2008). For example, it is indicated that hospital care accounts for about 33% of the nation's total healthcare costs. It is essential to note that between 2007 and 2014, outpatient and inpatient care cost rose faster than the physicians.

Structure Class Forum

2. Gatekeepers relate to the policies and people that act as a go-between by controlling the access from one particular point to another. In the context of health care insurance, gatekeepers are often in-charge of the treatments of the patients. As such, gatekeeping plays a central role in providing health care services to patients (Taft & Nanna, 2008). It is an effective and efficient way to cut costs by reducing unnecessary interventions in medical care. Since the primary care physicians are considered to be more informed than their patients, they could benefit from such information by ensuring that they make a more efficient search for adequate secondary care providers.

In my opinion, I believe that gatekeeping plays a significant role in ensuring that patients seek help from relevant healthcare specialists (Collyer, Willis & Lewis, 2017). It is essential to note that when it comes to long-term care, gatekeepers are not people but rather the various care policies that must be met before individuals receive payouts from the insurance plan (i.e., long-term insurance plan) (Collyer, Willis & Lewis, 2017). Therefore, more insurance carriers ought to make gatekeeping a requirement so that it is not solely a part of the managed care plans.

The gatekeepers play a central role in deciding on the appropriate use of services, thus contributing to the cost of containment while at the same time enhancing the quality of health care. It is essential to note that the patients always value the first contact as well as the coordinating role of the primary care physicians (Taft & Nanna, 2008). As such, the managed care plans that focus on offering primary care physicians as gatekeepers hinders access to health care specialists, thus undermining the confidence and the trust of the various primary care physicians. Therefore, gatekeepers should be made a fundamental requirement for the insurance carriers rather than the managed care plans.

Financing of Health Care Services

The Affordable Care Act (ACA) expanded the insurance coverage for the Americans, thereby increasing access to healthcare services. For instance, since the introduction of the ACA in 2013, there has been a significant reduction in the number of uninsured citizens from 41 million to 27 million (Taft & Nanna, 2008). The study indicates that by 2015 the overall proportion of the Americans lacking personal doctors had decreased by 3.5% while the number of Americans that reported inability to afford healthcare reduced by 5.5% (Collyer, Willis & Lewis, 2017).

Before the implementation of the Affordable Care Act, most Americans experienced inadequate access to health care. The ACA had three fundamental goals; reduction in healthcare costs, increasing the number of insured, and improving healthcare quality. The ACA significantly widened the gap between providing the patients with mechanisms for making healthcare payments and receiving the services (Uberoi, Finegold & Gee, 2016). It has since been applauded by various healthcare specialists and other stakeholders for increasing the number of insured, including the 6million Americans who had lost their health insurance.

However, although the ACA came along with several benefits in the healthcare sector, the legislation came along with several drawbacks. For instance, most Americans faced the challenge of uneven access to health care since those on Medicaid were affected by narrow networks. The people on exchanges and those were obtaining benefits from the employers facing high out of pocket costs (Uberoi, Finegold & Gee, 2016). Again, ACA did not take into account factors such as recession, increasing prices of drugs, reducing the coverage of the insurers, and increased out-of-pocket costs. As such, I believe that due to the enormous positive impacts of ACA, it could simply be improved or modified to take into cognizant essential elements that could have been left out, as stated above, such as recession, increased drug costs, etc.

References

Collyer, F. M., Willis, K. F., & Lewis, S. (2017). Gatekeepers in the healthcare sector: Knowledge and Bourdieu's concept of field. Social Science & Medicine, 186, 96-103. Retrieved from https://doi.org/10.1016/j.socscimed.2017.06.004

Davis, K., Stremikis, K., Squires, D., & Schoen, C. (2014). Mirror, mirror on the wall. How the performance of the US Health care system compares internationally. New York: Commonwealth Fund. Retrieved from http://www.resbr.net.br/wp-content/uploads/historico/Espelhoespelhomeu.pdf

Martin, D., Miller, A. P., Quesnel-Vallée, A., Caron, N. R., Vissandjée, B., & Marchildon, G. P. (2018). Canada's universal healthcare system: achieving its potential. The Lancet, 391(10131), 1718-1735. Retrieved from https://www.sciencedirect.com/science/article/pii/S0140673618301818

Taft, S. H., & Nanna, K. M. (2008). What are the sources of health policy that influence nursing practice?. Policy, Politics, & Nursing Practice, 9(4), 274-287. Retrieved from https://doi.org/10.1177%2F1527154408319287

Uberoi, N., Finegold, K., & Gee, E. (2016). Health insurance coverage and the Affordable Care Act, 2010-2016. Washington (DC): Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Retrieved from http://garnerhealth.com/wp-content/uploads/2014/02/ACA2010-2016.pdf