Which is the better Health Care System?

(1) Compare expenditures as a % of Gross Domestic Product in some Developed Industrial countries.
-- All of these countries have a National (Government run and funded) Health Care System, except the USA, which is 
mostly privately run.
-- The numbers are from the World Health Report 2000 and other sources listed at the end.
-- Total expenditure as % are for 1997.
-- Gross National Product numbers are for 2000, whereas, the population numbers are for 1999. So if you divide the 4th column by the 5th column to arrive at the Gross National Product per capita in the 6th column there will be a slight discrepancy. 
-- The population gives some idea of the size of the country being served by their Health Care System. 

Country

 Type of System  Total expenditure as % of Gross Domestic Product of the Country
[for year 1997]
Gross National Product of Country (in 1995US$)
[for year 2000]
Population of Country 
 [year 1999]
Gross National Product per Capita (in 1995US$)
[for year 2000]
Amount Spent on Health Care per Capita (in 1995US$)
[for year 2000]
 Canada  Public (through taxes)  8.6  693,149,000,000  30,857,000  22,537  1,938
 United States of America  Private Enterprise (some taxes)  13.7  9,008,507,000,000  276,218,000  31,806  4,357
 Australia  Public (through taxes)  7.8  457,255,000,000  18,705,000  23,893  1,864
 Austria  Public (through taxes)  9.0  265,716,000,000  8,177,000  32,886  2,960
 Belgium  Public (through taxes)  8.0  316,070,000,000  10,152,000  30,838  2,467
 Denmark  Public (through taxes)  8.0  205,551,000,000  5,282,000  38,637  3,091
  France  Public (through taxes)  9.8  1,755,614,000,000  58,886,000  29,637  2,904
 Germany  Public (through taxes)  10.5  2,680,002,000,000  82,178,000  32,676  3,431
 Iceland  Public (through taxes)  7.9  8,796,000,000  279,000  31,494  2,488
 Israel  Public (through taxes)  8.2  106,833,000,000  6,101,000  17,612  1,444
 Italy  Public (through taxes)  9.3  1,204,868,000,000  57,343,000  20,943  1,948
 Japan  Public (through taxes)  7.1  5,687,635,000,000  126,505,000  44,751  3,177
 Netherlands  Public (through taxes)  8.8  492,956,000,000  15,735,000  31,074  2,735
 Norway  Public (through taxes)  6.5  170,452,000,000  4,442,000  38,141  2,479
 Sweden  Public (through taxes)  9.2  276,768,000,000  8,892,000  31,301  2,880
 Switzerland  Public (through taxes)  10.1 335,570,000,000  7,344,000  46,799  4,727

(2) Compare the USA private health care system costs and coverage with the Canadian public health care system:

 Factor  USA  Canada
 Coverage  15.4% are not covered for the entire year (Census Bureau, 1995)
   [about 42,000,000 U.S. citizens]
 31% of the U.S. population were not covered or could
 not afford to pay
for care in 1995 (Harvard Study)
   [about 85,000,000 U.S. citizens]
 Every citizen is covered regardless of
 income.
 Cost  13.7% of Gross National Product
 [$4,357US per capita]
 Per Capita Cost of U.S. system is about 220% that
 of the Canadian System
 8.6% of Gross National Product
 [$1,938US per capita]
 Overhead Costs  13% of private insurance premiums.  less than 1%
 Hospital Billing
 and Administration
 25% of Hospital revenues (New England Journal of Medicine)  10% -- number of employees needed for
 administration is much less than in U.S.

(3) One Consequence for Business:

According to Competitive Alternatives, consulting firm KPMG's ranking of International business costs, total business costs in Canada are nearly 9% lower than in the United States, in part because of national health care.  Of 11 countries in the report Canada had the lowest total business cost ranking.  The rankings consider  a range of cost factors, including wages, taxes, benefits, land, buildings and utilities.

(4) A problems with the Canadian Health Care System and a possible solution:

Waiting lists for certain kinds of surgery have lengthened over the last few years.  This could be because funding has not kept up with inflation and with increase in population.
One suggested solution would be to increase national health care funding, not from $1,938US per person to $4,357US per person as in the U.S. [220% of what it is now, in raw money], but to the same % of Gross National Product as the US -- from 8.6% to 13.7% Gross National Product, that is from $1,938US per person to $3,087US per person.  A similar proportional amount of the Gross National Product.

This would result in essentially no waiting for any procedures, still cover everyone, and still be attractive to business.  The Canadian Health Care System would then be the best in the world!

Some Sources:
====================================
More recent source:
The Kaiser Family Foundation Survey:
http://www.kff.org/uninsured/7403.cfm.
====================================

ttp://www3.who.ch/whosis/menu.cfm
 
http://www.edscuola.com/archivio/handicap/whr_2000.htm
especially #3
 
Especially Annex Tables 2, 8,
http://www.edscuola.com/archivio/handicap/whr_03.pdf
 
http://earthtrends.wri.org/
especially http://earthtrends.wri.org/pdf_library/data_tables/ecn1_2003.pdf
for Gross National Product
 
http://www.competitivealternatives.com/
http://investincanada.ic.gc.ca/ipc/cms/browse?IPC_Lang=e&IPC_PageAction=viewWebPage&IPC_BranchID=2462

Orland Hooge, BC, Canada
omjhooge@shaw.ca
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