HCA 302. Health Care Organization
Introduction
Health care systems are essential in providing security to nation-states world-over, which goes beyond health issues; entire economies depend on such vital system for security. One only has to imagine the devastation of a population by an infectious disease such as HIV/AIDS. Despite having some similarities, health systems vary from one country to the other. Notably, nations design as well as develop their health systems in line with their needs as well as the available resources. The United States and Canada share a border, and thus there is a natural inclination to compare the two health care regimes. And as such, the health systems of these two countries offer interesting comparisons to each other. Interestingly enough, although these two nations approach health care differently, there are some observable resemblances in their health care systems. The present paper delves into these resemblances and differences. Specifically, the paper focuses on the population and health status, availability of health services, expenditures, and macro environmental influences of the health care system of each country.
Population and Health Status
A country’s population size undoubtedly influences the cost of care offered, as well as the health care resources required. The population size of the United States differs a great deal with that of Canada. According to the World Health Organization (2016), the total population of the United States as of 2015 was 321,774,000, while that of Canada was 35,940,000 for that same year. Both the United States and Canada can be described as multiethnic and multicultural countries thanks to immigration. In essence, immigration has been playing a significant part in demographic growth in both countries. The United States is among the most populous countries in the world as a direct result of a rise in net immigration, reduced deaths, and increased births. The United States continues getting more populous, more diverse, and older compared to Canada.
It is important to mention that compared to the United States population health status indices, the Canadian population health status indices are superior. According to the World Health Organization (2016), the life expectancy at birth in the United States for males as recent as 2015 was 77 years, while it was 82 years for females. The life expectancy at birth for both males and females in Canada is higher than that of the United States. In other words, the Canadians have longer life expectancies than their United States counterparts. As reported by World Health Organization (2016), the life expectancy at birth in Canada for males was 80 years, while it was reported at 84 years for females in 2015. It is worth mentioning that the life expectancy at birth in both countries is higher than in most of the other industrialized countries. Ideally, this is attributable to enhanced lifestyle and advancement in health care in the two countries. The life expectancy at birth in both countries is essentially driven by factors such as nutrition habits, smoking, access to high-quality primary care, and physical activity.
Infant mortality indicates the health of children as well as the society well-being over time. OECD (2015a) describes it as the rate upon which children and babies less than one year die. Infant mortality is an essential indicator of the health of a country as it is related to factors such as public health practices, socioeconomic situations, and quality of medical care. Canada has lower infant mortality than the United States. For instance, in 2013, the infant mortality in Canada was 4.8 while it was 5.0 in the United States in the same year (OECD, 2015a). The higher infant mortality rate in the United States compared to Canada is not due to a shortage of neonatal birth facilities or professionals; quite the opposite, the number of neonatologists in the United States is higher compared to the same in Canada. The infant mortality in both countries is higher than infant mortality in most of the OECD countries. The common causes of infant mortality in both the Unites States and Canada include the disorders linked to short gestation and low birth weight as well as congenital malformations. Canada performs better in terms of low birth weight. The number of newborns weighing below 2500 grams in Canada is lower than the same in the United States. In 2013, the percentages of low birth weight infants in Canada and the United States were 6.1 and 8.0, respectively (OECD, 2015a). The United States has higher death rate than Canada. Among the chief causes of death in both countries include the coronary heart disease, kidney disease, diabetes mellitus, dementia, stroke, and hypertension.
Canada performs better compared to other OECD nations in Better Life Index. In essence, the quality of life in Canada exceeds the same in the United States. According to OECD (2015b), 88.7 percent of the adults in Canada perceive their health as good. As reported by OECD (2015c), 87.5 percent of the adults in the United States perceive their health as good. Canada ranks high in health status, work-life balance, wealth and income, subjective well-being, and environmental quality. In fact, Canada boasts of lower death rate and infant mortality rate in addition to higher life expectancy than United States thanks to its enhanced quality of life.
Availability of Health Services
The United States and Canada differ a great deal when it comes to access to healthcare services. The health care services in Canada are available to all its citizens. As a matter of fact, the Canadian health care system is characterized by universal access. The Canadian government guarantees universal healthcare to all the residents. In other words, Canada offers universal access to health care for its legal residents. It is imperative to mention that there is a public health insurance plan that is based on uniform terms and conditions in Canada. Ideally, this plan provides health services to all the citizens devoid of discrimination. Hence, no citizen in Canada is denied healthcare services on the basis of his/her health status, age, standard of living, or income. In contrast, the federal government in the United States does not guarantee universal health care to all the country’s legal residents. Health care access in the United States relies on a set of criteria that establishes the extent and type of coverage eligible residents receive. The United States citizens have varying degrees of coverage. It is disheartening to note that a significant percentage of these citizens do not have health insurance coverage. Although the Affordable Care Act have broadened health insurance coverage, the individual obligation hinges on a central insurance principle, one that puts profit-making above actual health care needs.
The administration of the health care system in Canada and United States also differ, as aforementioned. Bernard (1993) noted that the duty for administrating the health care system in Canada is left to a single public agency. It is vital to note that this agency is answerable to the provincial legislature and functions on a non-profit basis. According to Bernard (1993), the access to pricey, high technology medical equipment in Canada is limited as the provincial governments strive to control the increasing health expenditures by distributing the use of technology to the hospitals in any particular area. Consequently, the procurement of the medical facilities and equipment, as well as the rise in the doctor's fees and hospital funds, are determined by the provincial governments. The Canadian government pays for all the insured health care services. In contrast, the administration of the health care system in the United States involves all the levels of the government, that is, the local, state, and federal governments, the employers, and the private insurers. The U.S. federal government is greatly involved in the administration of the country’s health care system through legislation and regulation. The essential regulation by the federal government entails the testing and authorization of the medical devices and medicines, as well as the licensing of the health care providers.
Regarding the benefits/health services offered, the provincial health insurance plans in Canada cover all the basic physician and hospital services, as well as specific surgical, dental procedures. In fact, there is no need for a range of health insurance plans in Canada, since almost all fundamental care is covered. The provincial governments in this country may include additional benefits; for example, drugs for aging citizens. The private health insurance covers the uninsured services in Canada. The citizens purchase private insurance for the services that their provincial plans do not cover. The examples of these services include cosmetic surgery, extra amenities in the hospital rooms, and dental care. In contrast, the coverage benefits differ broadly among the insurers in the United States. The United States health system is characterized by both the private health coverage and government health programs. These programs provide a range of benefits to only the citizens who can afford them. It is the responsibility of every state to regulate the private insurers. Ideally, this ensures that these insurers offer minimum benefits. The benefits provided by the United States health system are not the same for all the citizens. In fact, the ability of a resident to enjoy these benefits depends on whether he/she has enough money to purchase a specific insurance cover. In other words, the high-quality health care services in the United States are only available to those citizens who can afford good insurance covers or plans.
There are no financial barriers to health care in Canada. Every Canadian is entitled to access the country’s health care system. The provinces are not allowed to charge fees to the citizens accessing the publicly insured services, with the exception of the patients suffering from chronic diseases and living in institutions such as nursing homes and hospitals. The citizens in Canada only spend their money for the health care services that their provincial plans do not cover. Notably, no legal resident in Canada is deprived of the access to the health care on the basis of whether or not he/she have enough money to pay. The Canadian health care system efficiently distributes funds between health care administration and health care providers to ensure that no legal resident is excluded from accessing the health services. Unlike in Canada, there are financial barriers to health care in the United States. In essence, the high user charges, overpriced private insurance, and health program insufficiencies in the United States health system prohibit a substantial percentage of the citizens from accessing the health care. Only the citizens who are well-off can afford the state-of-the-art care. There is a significant number of the citizens of the United States who have been excluded from the Medicaid, Obamacare, and Medicare programs. The access of the citizens to health care in the United States hinges on how much care they can afford, but not how much they need.
Expenditures
The health care expenditure is essentially a fundamental component of the economy of any country (Squires, 2012). The health care spending in Canada differs greatly with the United States health care expenditure. The big difference in health care spending between the two countries is brought about by the difference in the populations as well as health care needs. Compared to the United States, Canada spends a lesser proportion of its total economic output on health care. According to the World Health Organization (2016), the total spending on health per capita in Canada during the year 2013 was $4,750, while it was $9,146 in the United States for the same period. The World Health Organization further reports that Canada’s total spending on health as a percentage of GDP in 2013 was 10.9% while the same for the United States was 17.1 percentage during the same year. Based on these statistics, it is clear that the health care costs in Canada are lower than the health care costs in the United States. As it stands, the United States health care expenditure dwarfs Canada’s health care expenditure, though the Canadian system arguably delivers more bang for each dollar.
As far as their funding apparatuses, the provincial governments in Canada provide the financing for the medically necessary health care through taxes. The federal government in Canada both guides these provincial governments and provides some funds. In essence, this government is devoted to providing the provincial governments with the funding for health care spending, provided that these governments adhere to the accessibility guarantees. The Canadian health system is publicly-funded as noted earlier. The United States federal government spends a significant percentage of tax dollars on the health care of its population through third party providers and insurance companies. According to Squires (2012), the expenditure on the physician services by the United States federal government is an even greater component of the overall health expenditure than pharmaceuticals. Nonetheless, the direct federal government financing of the health care in the United States is essentially limited to the State Children’s Health Insurance Program, Medicaid, and Medicare. It is imperative to note that the public funds in the United States facilitate health care through the programs as mentioned above.
It is important to mention that the Canadians share the health care expenditure burden collectively, unlike the United States citizens. The cost of health care in the United States has continued to rise more than that of Canada over the years. The high health care expenditure in the United States is attributed to the country’s use of more costly medical technology than the other nations (Squires, 2012). Compared to Canada, the United States utilizes more expensive medical technology. In spite of spending more on healthcare, the United States quality of care is less than Canada’s quality of care. Also, a deal of the high prices for services is as a result of high pharmaceuticals costs based on stringent patent laws and flat out price-hiking by some of these companies, in an area that is screaming for greater regulation as it concerns prices.
Macro Environmental Influences on the Health Care System
Different macro environmental factors influence the United States and Canadian health care systems. These external factors include political, socioeconomic, cultural, and technological factors. Politics affect healthcare decision-making in both Canada and the United States. In Canada, the health care decision-making is essentially political. The healthcare decisions in this country are usually made on the basis of what is okay with the polling public as opposed to what makes what seems sensible from a monetary sustainability outlook. Politics make the health care decision-making in Canada slow and complex, thus, leading to inconsequential incremental change. In the United States, the reorganization of the health care has failed on some occasions thanks to political pressure that can be described as conservatism. For instance, health care restructuring failed during President Clinton’s tenure in spite of it having great public support. The political factors in both countries, thus, have a negative impact on the availability, cost, and use of the health care services. However, pluralism plays a greater and more potent role in the shaping of the Canadian health care system.
Moreover, there are some socioeconomic factors that influence the health of the citizens in both Canada and the United States, and in one way or another contribute to health inequalities. In particular, the economic and social drivers such as social connectedness, education, and income have a direct bearing on health care system in both Canada and the United States. In essence, these factors influence the need for and use of the health care services. The cultural factors also have a significant influence on health care. Inevitably, culture affects the health or disposition diseases and eventually health perceptions and social prescriptions as far as methodologies in both Canada and United States. The traditionally dominant cultures of both countries have shaped their health system. Canada has a more social and inclusionary disposition versus the United States more market-based culture, though they are both Western democracies. Technology has also played an imperative role in facilitating the quality of health care in both the United States and Canada, with the US having a slight lead in innovation due to the greater incentive of competition for profit-oriented firms. In essence, the health care provided by the health systems of the two countries has improved a great deal thanks to technological advancements.
Conclusion
The health care systems in both the United States and Canada have their challenges, obviously. For instance, the health care decision-making in both countries is a great political struggle. Consequently, the impact of such cannot go unrecognized, for it makes both systems more cumbersome and inflexible to even more responsive measures with the changing environments and needs. This can have an adverse impact on the availability, cost, and use of the health care services in both countries, as well as prevent hijacking by sectarian political interest. Though in the United States, the moneyed interests have long co-opted the system to their sole advantage. The access to health care in the United States is essentially a significant problem since its health system does not guarantee universal health care. Besides, the United States health care system is costly and does not treat all the citizens the same, to say the least. But that reality had to have been as a result of power brokering that left much of the population deprived. The benefits offered by the Canadian health care system are only basic. Nonetheless, it proves to be more effective and efficient as a social delivery service, which is what health care systems essentially represent as a national security mechanism, in the protection of the viability of the national economy and cultural sustainability. There is no doubt that both the United States health care system and Canadian health care system will benefit from the advancement in the clinical research as well as technological breakthroughs. All in all, the United States can essentially use the Canadian health care model to learn the concept of universality as well as how to provide excellent health care.
References
Bernard, E. (1993). The Politics of Canada's Health Care System: Lessons for the US. Radical America, 24(3).
OECD (2015a). Health at a Glance 2015 OECD Indicators. Retrieved from: http://www.patients-rights.org/uploadimages/FULL_REPORT.pdf
OECD. (2015b). How’s Life in Canada? OECD Better Life Initiative. Retrieved from: https://www.oecd.org/statistics/Better%20Life%20Initiative%20country%20note%20Canada.pdf
OECD. (2015c). How’s Life in the United States? OECD Better Life Initiative. Retrieved from: https://www.oecd.org/statistics/Better%20Life%20Initiative%20country%20note%20United%20States.pdf
Squires, D. A. (2012). Explaining High Health Care Spending in the United States: An international comparison of supply, utilization, prices, and quality. Issue brief (Commonwealth Fund), 10, 1-14.
World Health Organization. (2016). WHO | Canada. Retrieved July 13, 2016, from: http://www.who.int/countries/can/en/
World Health Organization. (2016). WHO | United States of America. Retrieved July 13, 2016, from: http://www.who.int/countries/usa/en/
