This paper presents a comparative analysis of the healthcare systmens in the US, United Kingdom, Japan, India, France, and Japan based on ten parameters. The parameters addressed in the paper include coverage, funding, costs, providers, integration, markets, analysis, supply, satisfaction, role of the government, system strengths, and system weaknesses.
Coverage
The citizens of the United Kingdom, Japan, India, France, and Japan are entitled to health coverage. It means that the countries believe that the presence of care in the country is not sufficient and that the citizens should be in a position of obtaining the care. It is evident, therefore, that the five countries believe in the dignity of human life and that is why they try as much as possible to ensure that people obtain care and refrain from the fear of having to spend much of their savings to access care (Papanicolas, Woskie, & Jha, 2018). The provision of coverage means there is no need for anyone to suffer financial adversity because they sought care, which forms the moral foundation of universal coverage.
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Despite the availability of coverage in the mentioned nations, they tend to debate the scope of the coverage, which then varies among the nations. For example, in the United Kingdom, drugs and care lie outside the public system. In Japan, for instance, dental and eye care forms part of the supplementary coverage. Nevertheless, the cultural and moral foundations of universal health insurance seem to be lacking in the US because the country has close to 40 million uninsured people. It is worth noting that close to 85% of the US population has medical coverage. It means that close to 15% of the population lacks coverage, which a sizeable number. The safety nets that cater to people without insurance act as a serious hindrance to care coverage. Strategies aimed at promoting universal care coverage have failed in the US.
Funding
In the United Kingdom, Japan, India, France, and Japan, the national governments have the authority to set statutory frameworks that finance universal care coverage. For instance, in India, the states have to meet centrally and define the conditions for sharing the national funding of the care budget. The UK's national budget for care referred to as the National Health Service depends mainly on the general revenues. Close to 70% of Japan's health bill stems from national and provincial interests (Tait et al., 2016). France mainly relies on social insurance that is work-based because it supports its social insurance from the general revenues. None of the mentioned approaches has proven superior to the other. France varying degrees of cost sharing by the patients.
The United States depends on major funding from the federal government. The only negative effect of the approach is that it has to be on a consensus basis and often attracts serious feuding on the mode and the merits to implement the strategy. It attracts opposition from the proponents of universal coverage that is funded by federal government, aided by local and state governments because of the lack implementation strategy. While contingent believes that leaving it a single player, the federal government, is sufficient, the other contingent prefers multiple players that include the local and the state governments. Furthermore, others believe that the success of Medicare and Social Security in other countries is testimony to that model. The prospects of universal coverage, as envisioned in the Obamacare, are diminishing and may not be realized even with increased funding. Some contingent argues that such a system is replete with profound waste that eventually will make it unsustainable.
Costs
United Kingdom, Japan, India, France, and Japan spend a relatively smaller share of their national resources on healthcare compared to the US. Minimization of the cost of healthcare has been the desire of nations across the globe. Towards this end, the health care cost model pursued by the United Kingdom has been hailed as one of the best in the world in recent times. The infusion of cash by the National Health Service, especially the one pursued under the leadership of Tony Blair, has been a model for various countries including Japan, India, and Canada. United Kingdom, Japan, India, France, and Japan pay their care providers relatively less, and they tend to provide less specialized services compared to the US. It is worth noting that all the mentioned nations, including the US, are pursuing strategies that will permit negotiations between care providers and stakeholders to reduce the cost of care provision.
The mentioned strategies seem to be utterly inadequate in addressing the fundamental problems that nations across the globe tend to face. The challenges associated with the cost that the nations face include but not limited to technological progress, wage pressure, inflation, increase in population, and rising popular expectations. United Kingdom, Japan, India, France, and Japan have capped the spending on healthcare. France and Japan, for instance, have a cap on the amount of spending on healthcare. In terms of cost, the UK has seen the spiraling of the cost of care and the strategy to cut on the cost of care by cutting down cost led to long waiting lists since people had elective referrals to see specialists. India developed the rationing strategy to improve access to specialists, which is not an option in France and Japan. Containing the cost of care is not easy, but the United Kingdom, Japan, India, France, and Japan have done it. The US should emulate the model by Britain, which is the most copied and applied in the world.
Providers
United Kingdom, Japan, India, France, and Japan constantly experience conflict between the providers and the policymakers. Providers tend to engage in heated negotiations with policymakers for funds, especially on the degree of funding provided by the insurance companies. In the United Kingdom, Japan, India, France, and Japan, organizations and care facilities have the propensity of directly negotiating with government agencies. In France, for example, the unions of physicians bargain on separate platforms with the sickness funds as the sate mainly plays the role of the mediator. The providers often need more pay while the funders tend to squeeze. It is worth noting that the budget makers in the United Kingdom, Japan, India, France, and Japan tend to spend more than they would ordinarily prefer compared to the budget makers in the US.
Compared to the medical professionals in the United Kingdom, Japan, India, France, and Japan, the US medical profession is quite entrepreneurial and lucrative probably than anywhere else in the world. Collective negotiation by the US care providers has been just a dream that has never been realized. The payer and provider model in the US is bifurcated. Medicare, which is the primary payment model, shifted from one that borrowed from the private sector to one that is currently steered by commissions and the Congress. It is imperative to note that the physicians have a voice in the operation of Medicare. The private providers enforce policies and strategies that ensure that the providers are efficient.
Integration
The United Kingdom, Japan, India, France, and Japan rely on fragmentation ad the model of their care provision, which has caused a serious uproar within the nations. Fragmentation often leads to the overuse of medical and care services that require better management of care and the next best alternative would be integration. Conventionally, the mentioned countries except for Japan, have allowed the care providers to practice as they pleased and that has led to serious inconsistencies and complaints since the cost of care went up due to lack of regulations. The objective is to currently seek efficiencies in provision and production that will undoubtedly require innovation in terms of the organization of care. For example, the United Kingdom seeks presently to hold funds among general practitioners by regulating their payments and other hospitals trusts. Such a strategy will lead to the availability of funds that will be channelled to primary care. The government intends to unite primary care with community health.
Additionally, the objective is to unite the mentioned level of care with social services to come up with an integrated care system. On the other hand, the US relies majorly on the integration of its care system that is based on a fee-for-service system masterminded by Medicare. Integration helps in the management of the healthcare service due to the central control that is provided by Medicare overseen by Congress.
Markets
The United Kingdom, Japan, India, France, and Japan treat health care a social service while the US treats it more like a commodity that that attracts pay based on the service offered. All of the mentioned nations, as evidenced by UK’s internal markets, Japan’s regulated competition, India’s community care centres, and France’s networks imply that the countries are moving towards free health care markets that might allow the providers to determine the price of the service offered based on various factors such as expertise and technological investment. The UK is the most market friend of the mentioned nations. The other nations have seemingly realized that competition is challenging due to the free trade that currently defines the civilized world. It means that they are open to competition and have done as much as they can to break any barriers that may hinder competition. The health care in the countries is defined by various factors that include but not limited to free competition even from foreign players, better management, free consumer information, and measures of the standards of quality.
On the other hand, the US has embraced free markets and competition to find a solution to its healthcare problems. It is worth noting that free competition within the managed health care market, such as that of the US improves the efficiency and effectiveness of the system, which are the hallmarks of improved care systems. Such a system has the propensity of mitigating certain aspects of poor care, such as under service, inadequate financing, and geographical segmentation of markets. The mentioned factors tend to damage public interest in the care markets. In contemporary setting, with the rising cost, it may be challenging to incorporate the uninsured 40 million people living in the US.
Analysis
United Kingdom, Japan, India, France, and Japan show strong and increasing curiosity to apply analytical tools that include analysis of cost-effectiveness, assessment of the use of technology, reports cards, and evidence-based medicine. The mentioned tools are often essentials in helping the policymakers to assess and subsequently determine the performance and then suggest workable recommendations. France and the UK have new agencies such as ANAES (UK) and Agence Nationale d’accréditation et d’evaluation (France) help in conducting and evaluating medical studies. In the US, which is the origin of many of the mentioned tools, there is professional resistance that prevents efficient implementation of the tools. It is, therefore, important to note that the US and the mentioned nations converge when it comes to the application and the implementation of the tools. The implementation of the tools is less than satisfactory in the US as well as in the United Kingdom, Japan, India, France, and Japan.
Supply
The United Kingdom, Japan, India, France, and Japan use public planning and authority to control the distribution and the number of physicians and hospitals. Contrary to popular belief, the application of such a model does not limit the numbers of physicians and the hospitals that operate within the country but tend to improve the quality of care since it permits thorough vetting of care providers and the facilities that offer care. The restriction involves the control of the number of care providers based on the population of the country in question, and the admission rates, the length total inpatient beds stay within the hospital, and hospitals day per capita (Cheng et al., 2014). In the mentioned parameters, France is way ahead of the US. It is worth noting that the mentioned parameters do not imply, in any way, that the healthcare system in France is ahead of that of the US. The specialist services in France are ahead of those found in the US, but prove that France registers cost in care that is beyond that registered by the US.
Programs present in the US such as the provision of certificates of need is inefficient since the system relies mainly on the professional preferences and market forces to determine the levels of supply that may meet the demand within the market forces. The fact that the provision of care surpasses the notion that health care is a community affair makes it difficult to avoid the current entrepreneurial nature of healthcare within the US. Other stakeholders, such as the private sector have to play an essential role in ensuring the rollout and accomplishment of care systems. Physicians and hospitals need better facilities, the best equipment, deeper penetration of the market, and improved accessibility of remote sites to enhance service delivery to the community. Such requires an investment that, in turn, requires the input of various groups. Therefore, in the future, cost pressures to ensure universal coverage may surpass disciplinary powers imposed by the market forces.
Satisfaction
United Kingdom, Japan, India, France, and Japan record high levels of satisfaction with the levels of health care services. Not many people in the mentioned countries perceive national health insurance as favourable. On the other hand, the US healthcare insurance presents the most serious challenges to healthcare providers throughout the country. The fact that close to 40 million people living in the US lacks health insurance is a worrying trend (Molimard & Colthorpe, 2015). It means that a formidable number of people within the US cannot afford the healthcare provided quality coverage. It means that the provision of care in the US has serious disparities that hinder access and the quality of care. The cost of certain the US is quite high compared to the cost of care in countries such as United Kingdom, Japan, India, France, and Japan, which then diminishes the levels of faith and satisfaction that the people may have in the system.
The public opinion about the American healthcare system registers considerable dissatisfaction, meaning that the majority of the people want the system changes substantially. The people are in support of major gangs in the healthcare system. Majority of the citizens are of the opinion that the current system does not yield anything different mandate that can lead to fundamental changes that may lead to better health outcomes in the country. America has undergone an intense period of opinion polling and lobbying. However, still, the policymakers are not sure of what exactly the people want and what they think would best serve the interest of the country.
The Role of Government
The United Kingdom, Japan, India, France, and Japan recognize the role of government in reliable healthcare systems. The government is the pillar that drives the relative success of the countries that is way above the others. The UK is the pioneer of socialized medicine that promotes coverage to all of her citizens. The efforts by Japan and France to change their medical infrastructure to ensure that coverage of every citizen had the support of government and were so far the most successful in the world. India’s constitution reserved the healthcare duties to both the states and the central government, and the result has been phenomenal. Indi currently has one of the most affordable healthcare systems in the world that attracts various patients globally. The central government of Indi uses its financial muscle to leverage care in different provinces across the country.
The United Kingdom, Japan, India, France, and Japan have realized that health policy should be centralized in their capital cities. India and Japan have devolved systems that control their health services and oversee their policies on matters that touch on health. Healthcare requires a mixture of constitutional, social, and political structures that help in its administration (Cohen et al., 2015). The federal administration of systems may be slow due to the various levels of authority that it passes, but it is compatible with universal coverage. I seem that the ideal system is the one created by France and Britain. The two countries have created regional bodies that encourage coordination and deliberation of the various levels of care within the country. The lack of coverage of 40 million Americans points to the lack of proper leadership or government structures in the US care systems.
The Strengths of the Healthcare Systems
United Kingdom, Japan, India, France, and Japan tend to have strong systems in that they have, to an extent, provided social coverage to a more significant fraction of their population. The countries believe that the presence of care in the country is not sufficient and that the citizens should be in a position of obtaining the care (Diouf et al., 2016). It is evident, therefore, that the five countries believe in the dignity of human life and that is why they try as much as possible to ensure that people obtain care and refrain from the fear of having to spend much of their savings to access care. Additionally, the cost of care in the mentioned countries is relatively down due to socialized medicine, especially in the UK. Nevertheless, the US beats the countries in the integration of care services since the mentioned ones are fragmented, meaning that there no clear control structure like the US.
The Weaknesses of the Healthcare Systems
The main weakness of the health system in the US is the high cost of care. The cost of care due to lack of modern technology, subsidies, and cost-saving structure make it difficult for people to access care. Additionally, the high cost of cover is the cultural and moral foundations of universal health insurance seem to be lacking in the US because the country has close to 40 million uninsured people. It is worth noting that close to 85% of the US population has medical coverage. It means that close to 15% of the population lacks coverage, which is a sizeable number (Mossialos et al., 2015). The commercialization of the healthcare system in the US diminishes the probability of different groups of people, particularly the ones from low-income neighbourhoods to access care.
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