How does the US Stack Up Against Other Countries Health Care

Discussion 7:healthcare economics class book- Henderson, James W. 2015. Health Economics and Policy, 6th edition. Southwestern Cengage
chap 13 and 14/View the video on youtube entitled, “How does the US Stack Up Against Other Countries Health Care.”
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healthcare economics class
chap 13 and 14
Scroll Down for Full Transcript

SP 1: In the largest survey of healthcare ever 92% of Canadians say they like their doctors so much they would recommend them to family or friends. In Canada primary healthcare physicians are basically family doctors and handle everything through a private practice, physical, mental health, maternity, pediatrics, geriatrics, says an author of eighteen books on Canadian Health law.

SP 2: This is not socialized medicine. The government does not provide doctors, does not provide hospitals, you go to whatever doctor you want just as you do here. And doctors can either take more patients or not take patients it is up to them. And the same is true with hospitals.

SP 1: All Canadians have healthcare coverage through the government. 70 percent of healthcare is publically funded and 30 percent is privately funded. Each province runs its own healthcare budget although the federal government supplements some provinces that are not as prosperous as others. It is a very cost effective system. Only 10 percent of GDP, compared to nearly 16 percent of the US economy. And Canada only spends some 3,895 dollars per person a year. That is about half of the expenditure for the average person in the United States.

SP 3: Germany has two strands of health insurance, public and private. Under any plan visits like my routine physical with Doctor Shivara are covered.

SP 4: There are treated it doesn’t matter if they are private or normal patients.

SP 3: Universal healthcare. Germany has one of the oldest systems in the world. Founded in 1883 by the first German Chancellor Otto Von Bismarck, with a principal that remains unchanged still today. Everyone must be covered and ideally everyone should get equal treatment. Most German’s are insured under the public plan which is not funded by taxes and employees pay half the premium while employers pay the other half to insurance companies that are heavily regulated by the government. Here at Berlin’s Charite hospital the director says that means world class healthcare for everyone.

SP 5: If you go to the emergency room or if you go to an out-patient doctor you can get a vaccination and a liver transplant without difference between people.

SP 3: And doctor Frie says even with universal healthcare the cost per patient is lower in Germany than in the US.

SP 6: How does healthcare work in Cuba? It is not an easy question to answer but there are some impressive statistics. According to the World Health Organization, Cuba’s life expectancy is 78 years the same as Chile in Costa Rica and the highest in Latin America. And it’s infant mortality rates are the lowest in the hemisphere, in line with those of Canada. This clinic in Managua, a community outside Havana, is one of the Cuba’s newest and best equipped. It serves a population of some 15,000 people. The director tells us under one roof she has dentists, general practioners, physical therapy, homeopathic medicine, and a laboratory that makes vaccines.

SP 7: Built just five years ago this clinic is really a symbol of what Cuba wants to do with healthcare all over the country. You can see the machinery is new, the walls freshly painted, it is an idea of where the country wants to go, the future of its healthcare.

SP 6: All of it free of charge. How does Cuba do it? First of all the government dictates salaries, doctors earn less than thirty dollars per month, very little compared to doctors elsewhere. Priority is given to avoiding expensive procedures, says Gail Reed, who has lived and worked in Cuba for decades. They concentrate on prevention.

SP 8: They queue long before dawn to get healthcare at a free healthcare clinic in Virginia ran by volunteers. Just a few of the 46 million people in America without health insurance. It blows my mind how many people are here who really do not have medical care. United States spends far more than any other country on healthcare. In real numbers, 7,062 dollars per person in 2006, about double the European average; but just five percent of Americans are responsible for nearly half the money spent on healthcare. While half the population spend between them just three percent. The United States faces the same problems as other developed countries, an aging population and the exploding cost of medical technology; but has no tradition of publicly provided universal healthcare. Most Americans pay insurance premiums often through their employer, to commercial healthcare providers, who then negotiate with doctors and hospitals. And those premiums have risen much faster than inflation or wages in the last decade.

SP 9: So insurance agents for thirty five years, I loved the business because it rewarded you for the effort over the years. Like I saw the coverage get more expensive but you got less; but here is my tax return from 2002, our medical expenses that year a month was 960 dollars. Now we go to 2007 and the cost came out to 1990 dollars a month that is almost 24000 dollars that year because we could no longer afford that cost. We did the unthinkable and we dropped our insurance.

SP 10: It is really scary not to go to the doctor when you think maybe well I should have this checked.

SP 9: But we finally got her coverage. It was around 500 dollars a month, not a very good plan.

SP 10: And still today with changing in my deductibles, higher deductibles every year, still the cost keeps going up up up.

SP 11: Insurance I cannot even get prescriptions that I am supposed to take every single day. I have doctor’s orders right now for different tests that I can’t do because there is no way to cover it. You know we’re making ourselves here with the business, trying to just stay above, afloat and it is like the water is at the nose that is how close it is. So we don’t know where to turn we don’t know what to do. These are the asacols 400mg each. These are 450-500 dollars a month depending on where you go, none less than 450 dollars anywhere, except for Canada. I am supposed to take 12 a day and this keeps my Crohn’s under control.

SP 9: With her having Crohn’s disease it does make it impossible for us to buy insurance that covers anything.

SP 11: It’s voodoo. It is like Crohn’s is voodoo they do not want to touch it. It is pre-existing.

Select ONE of the following critical analysis and discussion questions and post your answer. Please write out the question at the top of your answer.
a. Advocates of a market orientation system argue that exclusive reliance on the visible hands of government will never bring spending under control. The missing component has been the invisible hand of the market pricing mechanism. Patients spending their own money have an incentive to control spending. Do you agree or disagree? Please support your argument.
b. Ronald Coase received the Nobel Prize in economics for his contribution in the theory of externality and common property resources. Common property often means that no one takes care of resources, or at minimum that resources are not cared for as well as if they were privately owned. What are some of the problems with collective ownership in the health care industry? Can you think of some examples in which collective ownership works? In what situation does it not work?
c. View the video entitled, “How does the US Stack Up Against Other Countries Health Care.” (The link may be found in the Content.) This video contains clips of different countries and their healthcare systems and compares them with our US health care. What can we learn from the healthcare systems in other countries? Do you think it is possible to institute similar systems in the U.S.? Why, or why not? Please support your argument.


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