Comparison of Healthcare Systems

Healthcare Delivery Systems are frameworks which enable the provision of adequate and efficient health services through different pooling resources such as institutions and organizations of people or professionals to meet the health needs of the population. Healthcare systems are unique due to the varying needs and resources that each nation has. However, common elements are usually present such as primary health care and public health measures. This paper seeks to look at the healthcare systems of four different countries, how they are similar, different, their advantages disadvantages and the different funding mechanisms.

Comparison of HealthCare Systems

India has fragmented healthcare providers ranging from public health sector including primary healthcare, Hospitals, health insurance schemes, as well as, other agencies. Apart from this, the country also has private sector health systems, indigenous ones, voluntary and national health programs. Vietnam also boasts the same kind of system with a mostly public and private mix of providers. The German system, on the other hand, is different from other universal healthcare systems. It has a dual system containing compulsory insurance and private insurance. The compulsory cover is obligatory to every living, working or studying person in Germany while the private one is voluntary and targets individuals who can earn a determined amount of money. Costa Rica has a universal healthcare plan covering both private and government systems.

Funding Mechanisms

The insurances in Germany especially the compulsory one is based on a concept of welfare state. All Germans pay money into the system which allows it to have a secure wealth resource pool since no one is exempted from paying for the insurance (Germany Health Insurance System, 2017). However, the downside of this concept is that not every person gets all the money back that they have paid over the entirety of the pay. Those eligible towards receiving the insurance are the sick or who have been involved in an accident. Therefore, if a person is not under any of these situations, they cannot receive any amount from the insurance. The framework is established in a way that everybody has to pay for those needing help. The amount of money one pays for the insurance is figured by the financial income of the person whereby those earning more pay more to the insurance and those earning less pay less. From this concept, the rich might feel too burdened by the system to pay for expensive medical procedures for people who cannot afford it.

Public health insurance in Costa Rica is through CAJA (Costarricense de Seguro Social) which is available to all citizens and legal residents. The cost of affiliation with the insurance is approximately 11.5% of a person’s income which is relatively small when compared to other covers. (Rudasill, 2015) The low cost and high quality of (CAJA) attract many individuals to its hospitals and clinics which increase wait times and long queues in almost all services thus burdening the efficacy of the system. The insurance covers a lot of the people’s needs ranging from pensions, disability, old age, and maternal health among much more. However, despite almost 90 % of the insurance funding being drawn from employer/employee tax the degree of cover is dependent on a person’s income. The government also covers for those who are not able to pay for the insurance which offers a compelling advantage towards improving the healthcare of the nation.

The fragmentation of the Indian healthcare systems means that financing is also done from many sources. The total expenditure on health in the country is only 4.1% of the GDP with 71.6% being financed by private funds and 26.7% through public funds including central, state and local government bodies (Commonwealth Fund, 2017). For the majority of the population in the country who are poor, tax-based financing is the primary source of pooling funds for 70% of the population. Access to government health care has however led to seek private care and high out-of-pocket payments. With regards to private health insurance, less than 5% are financed by voluntary health insurance with most of the funding coming through out of pocket payments.

In Vietnam, the social health insurance scheme covers about 70% of the population with funding coming mainly from employer-employee tax, the government, and the Vietnam social security. The amount collected is a fixed 4.5% of the salary/pension/protection allowance or unemployment benefit wherever possible (Hoang et al., 2015). For the poor, the government pays for their premium as well as children under six years and honorable people. The VSS, on the other hand, pays the premium for pensioners and unemployed who are eligible for 30% subsidy in the premium fully paid by the government. The benefits drawn from this system is that it offers inpatient cover for emergency services and birth delivery, together with outpatient covers such as primary care services, pharmaceuticals, and scans. However, despite the excellent financing system a lot of people are still outside the SHI coverage which requires a better funding and service delivery mechanism.

References

Commonwealth Fund. (2017). India : International Health Care System Profiles. International.commonwealthfund.org. Retrieved 24 April 2017, from http://international.commonwealthfund.org/countries/india/

Germany Health Insurance System. (2017). German Health Care System – an Overview - Germany Health Insurance System. Germanyhis.com. Retrieved 24 April 2017, from http://www.germanyhis.com/

Hoang, V., Oh, J., Tran, T., Tran, T., Ha, A., Luu, N., & Nguyen, T. (2015). Patterns of Health Expenditures and Financial Protections in Vietnam 1992-2012. Journal Of Korean Medical Science, 30(Suppl 2), S134. http://dx.doi.org/10.3346/jkms.2015.30.s2.s134

Rudasill, S. (2015). Comparing Health Systems and Challenges in Costa Rica and the United States. Inquiries Journal, 7(2). Retrieved from http://www.inquiriesjournal.com/articles/979/comparing-health-systems-and-challenges-in-costa-rica-and-the-united-states