Discussion 7.1: Health Care Around the World

While watching Sick Around the World opened my eyes to the U.S. health care system compared to other countries. The U.S healthcare system is 37th in the world, and other countries are spending way less than the U.S (Palfreman, 2008). Palfreman explains how Britain National Health Service is dedicated to where you shouldn’t have to pay a medical bill, not even pay a copay, just needing to wait for a doctor (2008). But, in Britain, they are still complaining about their healthcare; the government owns the hospitals (Palfreman, 2008). Patients can choose what hospital they want to go to, but all the hospitals compete even if they can’t make more money, but more to survive and keep having patients (Palfreman, 2008). In Britain, they pay a higher tax than the U.S., so they don’t have to pay for healthcare (Palfreman, 2008). Japan has the longest healthy life expectancy globally; they get covered healthcare but don’t pay more taxes (Palfreman, 2008). They sign up for health insurance policies. The government picks up the bill for poor people; it’s more for wealthier countries (Palfreman, 2008). It’s fascinating learning about different countries’ health care systems and how the United States is so different.

I recently went to Costa Rica and wanted to compare and contrast their health care system to the United States. Costa Rica is ranked as of the top 20 public systems globally and the best in Latin America (Rudasill, 2015). On The Commonwealth Fund, the United States is ranked number 11 in health care systems among the top 11 high-income countries (Rudasill, 2015). Costa Ricans citizens who are most financially in need have free public healthcare (site). Residents with a job will have to pay for the public health care system (Rudasill, 2015). The healthcare in Costa Rica is called Caja Costarricense de Seguro Social, commonly referred to as the “Caja.” Costa Rica has a universal health care system, while the United States health care system is privatized, with some public health insurance options provided by the government (Rudasill, 2015). Costa Rica health care is structured as a three-tiered system that increases specialization with subsequent levels.

In contrast, U.S. health insurance is vital to health care, with most people obtaining it through their employer (Courier, 2021). The United States has no single nationwide system of health insurance. Health insurance is purchased in the private marketplace or provided by the government to specific groups.

Researching both Costa Rica health care systems compared to the U.S., they do not share much in common at first glance. The U.S. has more people and capital resources than Costa Rica (Rudasill, 2015). Costa Rica is decentralizing its health care system after more than three decades of government control by relying upon private clinics and physicians to provide care (Rudasill, 2015). In contrast, the United States adopts a more centralized system with greater government responsibility for universal coverage (Rudasill, 2015). In similarity, the present success of each country’s health care system is nearly identical in World Health Organization (WHO) ratings.

In Costa Rica, people and patients are happy with the health care system. The country continually upgrades its private and public health care system without adding extra costs (Harrah, 2014). This allows locals and foreigners to experience optimal healthcare services at a meager price (Harrah, 2014). This country is known for medical tourism, especially from places with more expensive health procedures, like the United States. In the United States, we do not have universal healthcare coverage; we tend to see many health disparities in health services. The United States has higher rates of amenable mortality than peer countries. Costa Rica’s life expectant is high, nearly 80 years old (Rudasill, 2015). Compared to peer nations, the U.S. has the highest number of hospitalizations from preventable causes and the highest rate of avoidable deaths (Rudasill, 2015).

With Costa Ricans also having a public and private health system, the cons to their public health are that it’s flooded with patients, there are long wait times for people to be seen at hospitals and clinics (Rudasill, 2015). They also have understaffed clinics and hospitals, which can lead to even longer wait times; you also do not choose which practitioner you see. Private health insurance in Costa Rica includes shorter wait times and is still affordable. Around 30% of Costa Rica’s population has private insurance (Harrah, 2014). If you have Caja, they can’t turn anyone down. If you are a legal resident, you are eligible for Caja insurance (Harrah, 2014). Pre-existing conditions will not be excluded, and once your Caja dues have been paid, there is no other charge or cost, deductible, or copay (Harrah, 2014). There is no age limit for enrollment, and there’s no limit to the cost of the care Caja provides (Rudasill, 2015). In the United States positives of healthcare is that you most likely can get health insurance from your employer, and if you have the money for premium health insurance, you will receive outstanding care (Rudasill, 2015). Physicians and surgeons go through rigorous training for specialties to effectively treat the rarest conditions (Courier, 2021). Americans also have different Medicare options available based on their preferences. The U.S. health care services are expensive; if you are underinsured or don’t have insurance, you pay out of pocket. Americans must pay out of pocket for any medical costs that their insurance doesn’t cover (Courier, 2021). If you don’t have a job or lose your job, you can lose your health coverage, and this is why most Americans want a medical system reform.

The United States health care system is more expensive than Costa Rica’s. The price of medical care is the single most significant factor behind U.S. healthcare costs, accounting for 90% of spending (Courier, 2021). Health care in Costa Rica costs “about a third to a fifth” of what Americans pay for specific treatments. Doctors usually charge no more than $60 U.S. per visit, including house calls (Courier, 2021). Private health care, although more expensive, is still low cost and of good quality. Hospitals, doctors, and nurses all charge more in the U.S. than in other countries, increasing hospital costs faster than professional salaries (Courier, 2021).

Overall, it’s very informative learning about different countries’ health care systems and how big of a difference the United States system is. I see how Americans struggle to afford health insurance and how it’s affecting people’s lives.

References

Courier, C. (2021, November 16). The Pros and cons of the US health-care model (the direct-fee system). The Clinton Courier. Retrieved February 22, 2022, from https://www.theclintoncourier.net/2020/09/14/the-pros-and-cons-of-the-us-health-care-model-the-direct-fee-system/

Harrah, S. (2014). Health care around the world: Costa Rica. UMHS. Retrieved February 22, 2022, from https://www.umhs-sk.org/blog/health-care-around-world-costa-rica#:~:text=Health%20care%20in%20Costa%20Rica,low%20cost%20and%20good%20quality.

Palfreman, J. (Producer). (2008, April 15). Sick around the world (Season 2008, Episode 11) (TV series episode). Frontline. Sick Around The World (56:19 minutes) [Video]. YouTube.

Rudasill, S. E. (2015). “Comparing Health Systems and Challenges in Costa Rica and the United States.” Inquiries Journal/Student Pulse, 7(02). Retrieved from http://www.inquiriesjournal.com/a?id=979