Please analyze the health care system for each country and tell if the US should implement or not implement from them. 1. France- 2. Germany- 3. Japan- 4. UK- 5. Canada-

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Ashley Kannan | Middle School Teacher | (Level 3) Distinguished Educator

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The notion of "should the US implement" health care models simply cannot be answered because the standards that people use to address such an issue vary. The criterion that individuals recognize within the issue of health care are varied.  We can put a qualifier on it which might help.  For example, from a social worker's stand point, should the US adopt and implement an expanded notion of health care model based on a particular nation.  Yet, this makes the presumption that social workers would be in favor of health care, which can be argued, but it is far from absolute fact. While analyzing health care systems in other parts of the world can be undertaken, determining how they should be implemented and if they should be embraced by the United States is going to be very difficult.

In different parts of the work, there are some distinct differences in the health care paradigm than in the United States.  Canada's health care system is largely a public element.  The role of the private sector is a very limited one. Canadian health care is largely delivered by the government.  The single payer system is evident in how doctor's rates are predetermined and cannot be negotiated unless the province and/ or the doctor themselves have opted out of the system.  The wide level of government involvement in Canadian health care is one distinct difference from what is present in the United States.  It can be argued that service professions like social workers would benefit from such a system because clients would not have endure the added burden that come with being deprived of health care services.  As the Canadian government covers roughly 70% of all individual health care costs, individuals do not have to necessarily worry about health care.  However, it is interesting to note that health care is only about 10% of the entire GDP in Canada, while in the United States, it amounts to over 16% of the total nation's GDP.  While the United States health care system features fierce division amongst the body politic, Canadian public opinion regarding their health care is much more consensus based:  "82% of Canadians preferred their healthcare system to the one in the United States, more than ten times as many as the 8% stating a preference for a US-style health care system for Canada."

The same public focus is evident in the British health care system.  There is a general tax that all citizens pay which goes to health care that is provided to all UK citizens.  There is a free access to medical services on demand, such as emergency room visits or ambulance services.  The public aspect of health care is one that mirrors what is in Canada and differentiates it from the United States.  The NHS provides health care in a wide manner, to all British citizens, and does so without rising costs being an impact on both the consumer and the nation.  Health care in England amounts to under eight percent of the nation's GDP, reflecting a significantly reduction from the United States.  This reflects an efficiency in health care services that is absent in the United States' vision of health care.  Social workers could easily embrace the specialized nature of services that UK hospitals offer that result from a general practitioner's recommendation.  In both visions, the public sector delivers most of the health care services to the individual.  While there are private sectors, neither nation features a significant privatized element within their construction of health care.

As with Canada and England, Germany does feature a public health care option.  However, it also demonstrates a private health care sector which is equally significant, making Germany different than what is offered in Canada and England. For those under a specific economic level, a public option for health care is enacted and for others, a more private notion of health care is evident.  Health care is thus preserved on both levels.  There is a privatized vision for those who can afford it, whereby individuals can use financial means to craft out a health care construction of their own desire and a public option for those who need health care and lack the means to obtain it.  The dual construction of the German health care system is one that allows it to retain the best aspects of both realities.  This is in large part why patients in Germany have "quick access to specialty services and face little out-of-pocket costs."  The dual system also speaks to cost efficiency, as health care amounts to just over 11% of Germany's total GDP.  The model offered in Germany demonstrates how publicly funded health care can coexist with private options and the free marketplace.  For client advocates like social workers, the need to be able to provide services on both levels is extremely persuasive and reflective of meeting individual needs on multiple levels.

The World Health Organization made the claim that France's health care provides "the best overall health care in the world."  The French system of health care is rooted in the public sector in the form of reimbursements to patient cost.  Nearly 70% of the patient expenditure is reimbursed by the government.  This allows to retain the freedom of choice in health care design, but also provides the public option to ensure that all citizens receive health care. While there is a private design within the French health care system, it is not as autonomous as in the German construction.  The public reality is always there to ensure that the marketplace does not play a role in determining quality and access of health care.  Contributions to the public sector are made on a scale based on income, reflective in the 11% that health care costs occupy in French GDP.  An interesting aspect of the French medical system is how the public option vests based on individual illness.  The more sick someone is, the more the government pays for their health coverage.  This helps to preclude catastrophic health care costs upon the individual and helps to minimize insurers removing coverage at critical moments of need.  It is significant to see that the French government recognizes public solidarity with the needs of the individual.  Social workers might find that the commitment of the government in the needs of individuals who are significantly ill can help ease the burden of family members who are already undergoing a very difficult moment.

I think that Japan features similar elements of what has been already outlined. There is the existence of a dual natured system.  Private offerings are available, as well as a public option.  The government covers about 70% of patient costs. Similar to the French and German systems, the Japanese health care system enables the individual to choose privatized options as well as offering a coverage for citizens if the private options prove too costly.  One of the most significant aspects of the Japanese health system is the expectation that hospitals are not run as "for- profit" institutions.  They are to be run by physicians and corporations are not allowed to own hospitals.  This single fact is critical.  The health care debate in America rages on, but the reality is that the "corporatization" of medicine lies at the inequalities within health care.  The Japanese system of providing health care to its citizens seems to have preempted this with a demand that physicians control hospitals, as opposed to business organizations.  Contrary to conventional wisdom, such an edict has helped to keep health costs down in Japan, amounting to about 8% of the nation's GDP.  The wide access and philosophical approach that doctors remain in control has helped to establish Japanese citizens as possessing the longest life span in the world.  Social workers would advocate the idea that trained professionals are in charge of decisions relating to health care and not corporations.

What individuals believe would be desirable from these nations, if anything, and implemented in the United States cannot be addressed here.  The only reality one is left with, something that all people can find common ground, is that the system of health care in America does need to be fixed:  "The U.S. ranks last of seven nations overall. Findings in this report confirm many of those in the earlier three editions of Mirror, Mirror. As in the earlier editions, the U.S. ranks last on indicators of patient safety, efficiency, and equity."  What this looks like is going to vary.  However, it is evident that other nations in the world have developed different means of addressing health care concerns and have established these paths with significant results.

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