Healthcare Around the World

I watched a rerun of an interesting Frontline report by T.R Reid entitled ‘Sick Around the World’ in which he compared the health care systems of five capitalist democracies, i.e United Kingdom (U.K), Japan, Germany, Taiwan, and Switzerland. According to an excerpt from his upcoming book on international health care ‘We’re Number 37!’, there are four basic health care systems: the Beveridge model, the Bismarck model, the National Health Insurance [NHI] model, and the Out-of-Pocket model. He chose the U.K as an example of the Beveridge model, Taiwan as an example of the Canadian-style NHI model, Germany, Japan and Switzerland as examples of the Bismarck model. He focused on three Bismarck countries on the theory that the U.S would learn more from these private-sector systems than the British-style National Health Service. Each example offered a system that delivered health care for everyone - but with remarkable differences and concerns.

Here is the full report:



The title of T.R Reid's newest book 'We're Number 37!', which is scheduled to be published by Penguin Press in May 2009, refers to the U.S's ranking in the World Health Organization 2000 World Health Report. Although some have criticized the WHO 2000 report, most agree with the 2007 report by the Organization for Economic Co-operation and Development (OECD) that the U.S spends more of its percentage of gross domestic production on health care than other nations including the U.K, Germany, Japan, and Switzerland. Defenders of America's health sector claim that it delivers superior health outcomes, such as longer cancer survival rates. Detractors claim that other nations' systems deliver equal or better health outcomes such as longer life expectancy and better infant mortality rates. The Frontline report shows that nearly every system faces problems of rising cost and lack of access to care. Still, as the U.S looks to reform its health care system, there are lessons that it can learn from these countries. I found the following excerpt particularly interesting:

“These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus.

When it comes to treating veterans, we're Britain or Cuba [the Beveridge model].

For Americans over the age of 65 on Medicare, we're Canada [the NHI model].

For working Americans who get insurance on the job, we're Germany [the Bismarck model].

For the 15 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India [the Out-of-Pocket model], with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you're sick enough to be admitted to the emergency ward at the public hospital.

The United States is unlike every other country because it maintains so many separate systems for separate classes of people...”