How would one briefly compare the health status of two European Union (EU) countries with that of the U.S., describe two efforts in those EU countries to reduce health inequities, and explain what lessons can be learned from the EU's efforts that can be implemented in the U.S. nationally or by individual states? How might the community one lives in adapt these interventions?
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To complete your assignment, you'll first want to do some research on health inequities in countries belonging to the European Union (EU), and a great deal of research has already been conducted on the issue. You will probably be able to find more contemporary articles in your school library's databases, but one such article concerning health inequities in the EU was published in 2009 and discusses inequities in life expectancy after birth and infant mortality rates. Poorer countries among the EU will see greater discrepancies in inequities but so will lower economic groups in all countries. The article reports the study found that people who migrate, people of ethnic minorities, people who live in impoverished urban and rural areas, and people who live as subsistence farmers, as well as many others have much lower life expectancy rates than others. For example, "the Roma can expect to live 10 years less than the majority population in some countries"; the Roma refers to an Indian ethnic group, often called Gypsies, who live in many locations of the EU, including Bulgaria, Hungary, Romania, and Slovakia ("Reducing Health Inequalities in the EU--Briefing"; "Romani People"). To further narrow your study of health inequities, you can choose to focus on low life expectancy rates in one specific country; for example, both Bulgaria and Romania are reported as having some of the lower life expectancy rates at ages 70 to 75 ("Map of Life Expectancy at Birth in European Countries").
Another major health inequity you may choose to research further is infant mortality rates. Currently, Romania is reported as having the highest infant mortality rate of the EU, with 9.4% of infants dying per 1,000 live births ("Romania, Highest Infant Mortality Rate in the EU"). Doctors argue that most deaths are caused by pre-term births and poor equipment in hospitals. The Romanian Save the Children Organization has joined with Save the Children International to initiate several programs aimed at lowering infant mortality rates. They initiated a program called Every Child Matters as well as a fund-raising program called Welcome to the World. Together, the programs have "helped 15 maternity hospitals in Romania buy new equipment to save the children who were born prematurely" ("Romania, Highest Infant Mortality Rates"). One particularly serious problem is the devastating underfunding of the Romanian healthcare system. However, the Health Ministry is working on a financial rehabilitation program to be funded through the World Bank, which they anticipate will be able to buy new equipment for 20 more maternity hospitals. So, you could focus on further researching and exploring the initiatives of the Romanian Health Ministry and Save the Children Romania to lower infant mortality rates.
Other health inequity initiatives are listed in the European Portal for Action on Health Inequalities website, reported under the article titled "Health Inequalities in the EU." The newest includes Europe 2020, a means of "economic, social and environmental development for the EU over the next 10 years," which will reduce inequities since most inequities connect to social and economic oppression. Other strategies listed include the EU Health Strategy, the EU Health Programme, and the Expert Working Group on Social Determinants and Health Inequalities.
Greece Health Care Overview - EU Nation
- Free or low cost health care to those who pay into the Greek social security system.
- Free for all in major center public hospitals.
- Hospitals are centered in major areas.
- Hospitals are excellent.
- Accident and emergency care is generally limited to major areas and the subject of cries for reform.
- EU funds are to be directed at mobile medical units and building new facilities.
- Non-essential medication and health accessories (dentures, eye glasses, etc) are charged at high rates.
Spain Health Care Overview - EU Nation
- Free health care, even for most expatriates of other EU nations.
- Wide network of hospitals and health care centers.
- Facilities are 15 minutes from any residence.
- Doctors make housecalls.
- Hospitals are excellent.
- Accident and emergency care provided at most hospitals in the large national network of hospitals.
- Dental needs not covered except for emergencies.
United States Health Care Overview - Non-EU Nation
- During Obama's administration, public medical insurance became mandatory, though choice of which, and at what cost, insurance is left to the consumer.
- Health care administration is divided between the federal and state levels, so there are differences in health care quality and delivery that vary by state and by states in regions (e.g., northern states versus southern states).
- For the poorest, medical services still need to be paid for out-of-pocket because they can afford only insurance that covers high expense items and that has a deductible of $500 or more.
- Hospitals are abundant, even in rural areas.
- Hospital excellence varies depending upon wealth of the community.
- Doctor excellence varies upon wealth of the community.
- People in rural areas who can afford it opt to have major procedures performed at urban hospitals instead of at their rural area hospitals.
- Accident and emergency care are available at almost all public hospitals; individuals who can't pay are directed from private hospitals to the nearest public hospital.
- Dental and eye care may be covered in a given state or may not be depending upon the wealth of the state, for example in California dental and eye are covered while in Maine and Massachusetts they are not except in emergencies.
- Health care is an extension of the free market capitalism prevalent in all American enterprises.
- Poor people are still left out of the health care system except in the most serious situations.
Sweden - EU Nation - Addressing Inequities
Sweden, an EU nation, is endeavoring to address the inequities in their health care system by encouraging regions to adopt individualized region-specific changes or modifications that will provide universally uniform health care. Since regions are so diverse in population and need, Sweden opted for regional action instead of national action.
United States, Addressing Inequities
Since health care in the United States is the one system that is most driven by economic profit dependence, attempts to address inequities are "grass roots" and come from the populace, this despite the efforts of the Obama administration to correct inequities. One of the grass-roots populace efforts to address inequities is the movement out of the mainstream capitalist medical system into alternative health care with homeopathic doctors, acupuncturists, herbalists, naturopathic doctors, shamanic medicine and Chinese medicine. Another grass-roots populace movement is the spread of free or low cost clinics funded and operated by charitable foundations.
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