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:
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More recent source:
The Kaiser Family Foundation Survey:
http://www.kff.org/uninsured/7403.cfm.
====================================
Orland Hooge, BC, Canada
omjhooge@shaw.ca
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