Comparing Health Care Systems: The United States and Cuba Essay

For many years, the health care in the United constituted the best that any country had to offer (University of Maine, 2001). But as the facts would tend to display, it is slowly becoming one of the most inefficient in the world (Maine, 2001). The United States health care system may tout itself of being in the category of being the most expensive in the world, meaning a dearth of resources for the care it delivers (Reed Abelson, 2008). But the disparity in the amount that the people spend and the quality of the service attached to that cost is seemingly not parallel to each other (Abelson, 2008). A report released on the United States health care system shows that the country is spending about twice the amount on the health care needs of its citizens is compared to that of the expenditures of other developed nations (Abelson, 2008). But if the prices of health care in the United States, the country is listed at the bottom of countries that in the mortality of people if treated with efficient medical care (Abelson, 2008). This is a growing concern across the social spectrum of the United States (Meena Seshamani, Jeanne Ambrew & Joseph Antos, 2008). The amount that the United States spends annually on health care is truly staggering. In 2006, the United States spent $2. 1 trillion on health care services alone, double what the country allotted a decade back and about half of that is targeted in nine years time (Seshamani, Ambrew & Antos, 2008). The United States currently ranks as the third largest nation in the world, with a population of around 294 million (Samuel Uretsky, 2008). Of this number, it is believed that approximately 75 million Americans have inadequate medical insurance or do not have insurance altogether (Abelson, 2008). It was also found that the quality and the attendants cost of health care greatly varies across the societal spectrum (Abelson, 2008). These costs drain the finances of American businesses, which in turn contribute a quarter of the capital for health care needs (Seshamani, Ambrew & Antos, 2008). The costs to employers in terms of contribution to the health care fund increased by a staggering 98 percent in the span of seven years- from 2000 to last year, which outstripped the increases in wages by four to one (Seshamani, Ambrew & Antos, 2008). In 2007, the cost of employee-based insurance cost about $12,000, nearly matching the wages for minimum wage employment (Seshamani, Ambrew & Antos, 2008). Adding to the burden of high insurance payments is the fact that these have to be paid with higher service and deductions (Seshamani, Ambrew & Antos, 2008). This issue also has an impact on the senior citizens of the United States (Seshamani, Ambrew & Antos, 2008). Elderly Americans, in the current scenario, have to accumulate about $300,000 dollars in non-Medicare covered health costs (Seshamani, Ambrew & Antos, 2008). These costs have contributed to the access of health care by many Americans (Seshamani, Ambrew & Antos, 2008). Citizens who are covered by employer-based health insurance in 2006 fell five percent, from 66 percent to about 61 percent in the six-year period preceding 2006 (Seshamani, Ambrew & Antos, 2008). But how is health insurance in the United States given? The United States offers a variety of avenues of health insurance coverage both from public funds and from the private sector (Uretsky, 2008). In a report released by the United States Census Bureau in 2003, it found that about 6 out of every 10 Americans were covered by employer-based health insurance, about 3 of the 10 from the government, and the remainder with no insurance (Uretsky, 2008). In 2001, it was found that the United States spent more of its Gross Domestic Product (GDP) than any other developed nation in the world (Uretsky, 2008). For that period, America spent more than 13. 9 percent of its GDP, compared to Japan, which spent about 7. 8 percent; Canada, 9. 4 percent and the United Kingdom, 7. 6 percent (Uretsky, 2008). It should be interesting to note that even if the United States outpaced Japan in terms of health care spending, the United States ranks just 24th in the world for life expectancy (Uretsky, 2008). Life expectancy in the United States is about 70 years old, while the valedictorian on the list, Japan, comes in at about 74. 5 years for its citizens (Uretsky, 2008). Memberships in life insurance and access to adequate health care have been shown to work together (Devi Sridhar, 2005). The availability of health insurance is essential to instances and times that people would be able to rely on medical care in relation to the overall health of the person (Sridhar, 2005). Lack of available health insurance will take a toll on a person’s physical well-being (Sridhar, 2005). The individual will not be able to go to medical facilities for preventive medical treatment, fill out prescriptions, and will likely be receiving that medical treatment in the latter stages of a disease (Sridhar, 2005). Unlike the United States, Cuba, on the other hand, is not prone to the failures of the private and public fund problems found in the United States (Harvard Public Health Review, 2002). Cuban authorities exercise complete administrative, budgetary, and operational responsibility for the delivery of health care services for all its citizens (Harvard, 2002). The Cuban health care model is purely derived from the government, defining it as a public health care system seeking to provide universal health care coverage for all Cubans (Oxford Journals, 2008). It has been seen as a model of matching few available resources with the needs of the people in getting adequate medical care, often getting extremely high marks (Oxford, 2008). Compared to other developed nations, the United States has the distinction of being the only one that does not provide the availability of universal health care to its citizens (John Battista and Justine McCabe, 1999). In the developed world, it is found that 28 of the industrialized nations practice a â€Å"single- payer system, while Germany practices a multi-payer system akin to the proposed system of the President Clinton (Battista, McCabe, 1999). This would lead most observers to take a second look at the health care system of the United States (Battista, McCabe, 1999). In the analysis of the American health system, it is good to debunk some of the fallacies and errors that have been around the effective and quality of the United States system of health (Battista, McCabe, 1999). The United States, though having one of the best health professionals and an exceptional system of delivery and technology, still lags behind some of the industrial world’s health system (Battista, McCabe, 1999). In fact, if several factors in health care statistics are considered, the report card for the United States is a dismal failure (Battista, McCabe, 1999). Several of these factors would evidence how the system of health care in the United States has failed to give an improving system to its citizens. In 1960, America ranked 12th in terms of infant mortality (Battista, McCabe, 1999). In 1990, the United States ranked 21st in the world, settling at 23rd in recent times (Battista, McCabe, 1999). A central issue in the United States health system is the issue of universal health care. A current misconception of arguing against the consideration of universal health care is the prohibitive costs associated with it (Battista, McCabe, 1999). The opponents for the policy of a single payer system are of the belief that institutionalizing the policy avers that the country might end up paying too much (Battista, McCabe, 1999). In fact, the United States is already paying about 40 percent more than any other country in health care spending per capita (Battista, McCabe, 1999). Two of the top priorities currently in the area of health care are the ever increasing costs in the provision of health and the decreasing levels of access to health care (Sridhar, 2005). This fact is continuing to drive a wedge between those that can afford to provide for their health care needs and those that can ill-afford to purchase or do not have the means and the opportunity to be covered by insurance (Sridhar, 2005). This problem of individuals not covered by the health care system in the United States is expected to expand also to affect the insured patients (Sridhar, 2005). The issue seems to be in how the universal system of health care would operate (Sridhar, 2005). Many opponents of the policy are criticizing the system as an added layer of the bureaucracy and might result in the centralization of the health care system (Sridhar, 2005). But the current practice of Americans in purchasing their health-care needs might be more expensive than the provision for universal health care (Sridhar, 2005). At present, and as mentioned earlier, Americans are covered by health insurance in three ways: it is a benefit to workers and retirees, through government programs and the purchase of non-government insurance (Uretsky, 2008). But is the opposition to the universal, or single-payer, heath insurance system justified? The main opposition as again mentioned is the cost of the system (Battista, McCabe, 1999). In addition to the seeming â€Å"overspending† of Americans on health care, the institutionalization of the single payer system could means savings (Battista, McCabe, 1999). According to studies done by the Congressional Budget Office and the General Accounting office, it shows that with the practice of the single-payer system, the United States can accumulate $100 to $200 billion a year in health care savings, with the coverage expanding to cover uninsured individuals and improving the quality of services offered (Battista, McCabe, 1999). The Cuban Health System: Making do with less, and then some As mentioned earlier, the health care system of Cuba is completely run and operated by the government (Seshamani, Ambrew & Antos, 2008). This health care system provides not only diagnostic procedures, but also preventive, therapeutic and ameliorative treatments for the people of Cuba (Harvard, 2002). The Cuban health system is also distinguished as the one possessing the highest ratio in terms of people to doctors (The London School of Economics and Political Science, 2003). These health practitioners are trained in the country’s 21 medical educational facilities (London, 2003). In turn, the family physicians, as they are called, 20,000 of them, are tasked to administer the health care system of the Cuban government, one family physician to about 600 people (London, 2003). It should also be noted that these achievements in the field of health acre by the government in Havana have been done in the presence of an economic embargo imposed by the United States since 1961 (Harvard, 2002). The embargo put severe restrictions on the ability of Cuba to source out funding for its health car initiatives (Harvard, 2002). Since these sanctions covered even the importation and food items and medical supplies, the Cuban government practiced a system of preventive cure as a means to cushion the impact of the embargo (Harvard, 2002). In essence, the family physicians, at least in epidemiological terms, serve their fellow Cubans in the best way that they know how (London, 2003). Not only do the family physicians provide excellent preventive care, they also make it a point to provide treatment and diagnostics to prevent the onset of diseases upon the people (London, 2003). These family physicians are usually stationed in the nation’s consultorios, or small clinics situated in small neighbourhoods that they are assigned to. These doctors usually reside in the space above the clinic or just nearby (The Social Medicine Portal, 2006). These physicians attend to the patients who come in the morning to the clinic, then set out in the afternoon for home visitation for patients who are unable to come to the clinic (Social Medicine, 2006). For complicated and more delicate cases, the people can go a facility called a â€Å"polyclinic† (Social Medicine, 2006). These polyclinics, numbering about 400 scattered throughout the nation, function similar to a hospital’s outpatient department (Social Medicine, 2006). Some outpatient procedures are administered here in the polyclinic, but the facility is mainly geared for consultation sessions with specialists (Social Medicine, 2006). Also, acupuncture, physical therapy sessions and ultrasound procedures are conducted in the facility (Social Medicine, 2006). This is the first level of health care in the island nation; the second tier of care being administered by local and regional health care facilities (Social Medicine, 2006). The Cuban health system is one that can be characterized as an undivided, cohesive and devolved system that caters to the health and well-being of the people (Francisco Rojas Ochoa & Leticia Artiles Visbal, 2007). Also, the right to universal health care is guaranteed as a responsibility of the government under existing Cuban jurisprudence (London, 2003). In stark contrast to the Cuban guarantee of the right to free and adequate health care for its citizens, the United States does not obligate the government to deliver universal health care to is people as one of their rights as citizens of the United States (Battista, McCabe, 1999). This resiliency and dedication of Cuba to provide for its citizens was also seen as one of the reasons that health care delivery was not too affected by the economic crisis in the 1990’s (Oxford, 2008).