Introduction
An important indicator of the level of development of nations around the world is that of the existing policies towards healthcare, health promotion, wellness and prevention of outbreak of diseases . The preparedness of the government as well as historical records of success or failure to contain diseases and healthcare conditions help in providing an outlook on the overall healthcare condition in a nation . Sometimes it does happen that a major disease outbreak transforms into a national emergency which seeks to test present the true picture, especially when the healthcare policies and strategies are analyzed against that of a developed nation like the USA for example, or the recommendations of the World Health Organization. In this presentation, this aspect will be focused upon and parallel will be drawn to the mitigation of global health risk of recent times – the Zika virus outbreak in USA and Brazil respectively.
The importance of Healthcare promotion in nations
The term healthcare promotion refers to the collective processes involved in provision of a framework whereby the people of the nation are able to bring about an improvement in their health by gaining control over the different important factors associated with well being and prevention of healthcare conditions . Therefore, it becomes important to mention that healthcare promotion is not only a requirement for the masses, but a duty and responsibility of the government as well. Sadly however, many a times the true nature and effectiveness of healthcare promotion and policies are evaluated through the outbreak of diseases, just like in the case of the Zika virus outbreak in Latin American countries in recent times. Among the countries affected, Brazil was hit the hardest where more than 1,000,000 cases were recorded.
Zika Virus, Global Impacts and Healthcare
Zika virus outbreak had earlier been recorded in Africa 2007 and in 2013 in French Polynesia . The virus is spread through populations by mosquito bites (vector borne) and even though mortality is said to be much lower than other diseases such as Ebola, it is particularly contagious in cases of pregnant mothers and newborn children. It needs to be mentioned here that till date no antidote has been discovered for the diseases and that symptoms make take as many as 3-12 days to surface in the affected .
Taking the socio-economic scenario of Brazil, few factors have been identified which need to be highlighted. In the first place, there was an absence of a concrete public health policy in case of an epidemic outbreak like that of the Zika virus in 2015. Much of the response to the outbreak is believed to have been provided by the AMRO (WHO’s Regional Office for the Americas) and PAHO (Pan American Health Organization) . Towards ensuring proper public healthcare services in the nation, the AMRO and PAHO took the lead from the government of Brazil and 28 other such Latin American countries. The immediate measure to have been developed for addressing the same was the implementation of Strategic Response Framework and Joint Operations Plan.
The fact that even by February 2016 the Strategic Response Framework and Joint Operation Plan in Brazil was partnered by 23 independent entities highlights lack of a public healthcare policy in the country. Moreover, the Strategic Response Framework and Joint Operation Plan were not provided timely funding by the Brazilian Government to fight their own healthcare threat – that too of such a grave nature. It also needs to be highlighted that as much as 85% of the nation’s population resided in urban areas. The relevance of this fact is that infrastructural framework, which often limits efficiency in calamities was very much present as a support. Even then, to arrest the spread of the disease and bring the situation under control, it took the AMRO and PAHO and 23 independent partners – which were only possible by February 2016, since the outbreak was detected almost a year ago in May 2015 . Identification of these factors necessitates the requirement to compare public health policies of Brazil and USA
Comparison between public health systems in Brazil and United States
There are many similarities as well as dissimilarities between the public health systems in existence in both Brazil and United States. The first and foremost similarity is that both countries state that in them exists a system of public healthcare which is both public and private in nature . However, the key difference which can be observed in case of the two different forms of public healthcare is that while USA brings the healthcare services under the purview of insurance, in Brazil the system has the provisions for accommodating both insurance and ‘pay-out-of-pocket’ healthcare service facilities.
The first to take into consideration is the public healthcare system in existence in the USA. There exists both public and private healthcare systems in USA – the public healthcare system consists of the government programs Medicare and Medicaid. The private healthcare system is constituted by Employer Sponsored Insurance, Individual Market Insurance and American Health Reform. Medicare is a government program that covers healthcare of the particularly elderly (65 and over). Individuals under 65 years of age can be secured just in the event that they are rendered physically handicapped due to a medical condition or situation; or that they suffer a potentially threatening internal injury which limits free movement and routine activities. This project is managed by the government and the financing depends on government statutory income taxes, a finance charge shared by bosses and employees of organizations equally. Medicaid is another US program intended for individuals and families with low salary and assets. Unique in relation to Medicare, Medicaid is financed by the government level as well as by the states through duties, so the states can extend qualification, for instance expanding salary qualification levels . There are other qualification classes and inside every classification there are necessities other than wage that must be met.
The three private public healthcare systems – employer sponsored insurance, individual market or the bindings of the American Health Reform act as supplemental healthcare systems. In other words, the public healthcare system is organized in such a manner that one way or the other the country will be able to provide cover during times of crises. On the other hand, the healthcare system in Brazil and many other Latin American countries is largely unorganized. Even though SUS plays a significant role in the country, the existence of public, private and pay-out-of your pocket frameworks highlight the fact that there are still major requirements towards improving the framework and health policy existent in the country – one which clearly has been unsuccessful in establishing accountability in times of national crises. As a result public funding, which is a major requirement in emergencies is often unorganized leading to poor responsiveness of the overall healthcare system altogether.
Conclusion
It needs to be highlighted that this presentation does not seek to undermine the public health care system prevalent in Brazil. It is only that from the recent Zika Virus outbreak has it emerged that the overall public healthcare system of the nation is required to reshuffle the existent frameworks to prevent repetition of drawbacks in the 2015 public health emergency. It also needs to be highlighted that in instances of massive spread of conditions such as Zika virus infections, the speed of response plays a vital role which is expected to be improved upon by Brazil in coming years.
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