A functional healthcare system is crucial to the development of any country. An effective healthcare system ensures that a country's citizens are empowered enough to combat any illnesses. This, in turn, reduces financial burdens on both the country and the people, mainly due to the presence of a reliable workforce ( Goh & Marimuthu , 2016 ). Ultimately this results in a robust economy since a country's economy is dependent on the strength of its economy. Countries with sound healthcare systems, such as those in the developed world, are likely to have higher GDPs. Conversely, those in the less developed and developing world often have inefficient healthcare systems. This adversely affects their economies in turn. Poor economic performance subsequently weakens these countries' healthcare systems due to a decline in the amount of funds directed into the healthcare sector. Moreover, less funding implies that fewer jobs end up being created, further reducing the money and workforce available. In underfunded healthcare systems, treatment of illnesses is difficult and this lowers the peoples' productivity, which ultimately affects the nation's overall economic performance. Further, foreign investment is considerably stifled by a weak healthcare system. For instance, such earners as tourism may be profoundly affected. Against this background, this paper is aimed at comparing the U.S. healthcare system with that of Germany and Canada.
The healthcare system in the U.S. is not uniform, making it highly unique compared to other advanced nations. The country lacked universal health care coverage before enacting legislation that mandated healthcare coverage for all its citizenry. The U.S. healthcare system can be conceptualized as a hybrid system ( Akinlaja , 2016 ). This is because it does not operate as a national health service, multi-payer universal health insurance fund, or a single-payer national health insurance system. A significant percentage of spending comes from such private funds as households and private businesses. Likewise, the federal government accounts for a more substantial proportion of healthcare spending compared to local and state governments. Often, while care may be financed publicly, it is delivered privately ( Reinhardt et al., 2004 ). A significant percentage of the country’s population has a form of health insurance with a majority of these being covered by private health insurance plans. Others are covered by the government through Medicare, Medicaid, Veterans Administration, or any other military care. Despite these efforts, a considerable number of U.S. citizens have no health insurance.
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Germany has been lauded for being amongst the countries with the most impressive healthcare systems in the world. This is mainly in the context of cost and quality ( Ridic et al., 2012 ). There are hundreds of non-profit public insurance providers, also referred to as ‘sickness funds,’ which collectively cover up to 90% of the population. A significant proportion of the remaining 10% is often high net worth individuals who opt for private health insurance options. The average insurance by an individual to the public insurance providers is based on his or her gross income. Likewise, premiums are not dependent on risk. They are also not altered by an individual’s family size, marital status, and health. In Germany, doctors are viewed as private entrepreneurs and thus are compensated by their insurers each time they perform a procedure or see a patient ( Ridic et al., 2012 ). To streamline this, the government regulates their operations. Further, general revenue from the government covers children's premiums. This is based on the premise that children, who are the country's next-generation, ought to be the whole country's fiscal responsibility as opposed to being the sole responsibility of their parents.
The responsibility of delivering and organizing health services as well as supervising providers in Canada rests on territories and provinces. Subsequently, these provinces and provinces establish regional health authorities which are tasked with the responsibility of locally planning for and delivering publicly funded services ( Akinlaja, 2016 ). Such authorities fund and deliver community, hospital, long-term care, and public and mental health services. The territorial and provincial programs are co-financed by the federal government and have to adhere to provisions of the Canada Health Act. This act set the standards for all diagnostic, physician, and hospital services. For a provincial health care insurance plan to receive federal cash contributions for healthcare needs, it has to be administered publicly, universal, boast comprehensive coverage, be portable across all provinces, and be highly accessible ( Akinlaja, 2016 ). The efficacy and safety of the health products, pharmaceuticals, and medical device are regulated by the federal government. The federal government also finances health research and administers a wide array of services for particular populations. The Canadian healthcare is either financed publicly or through private health insurance ( Ridic et al., 2012) . The forms of care delivered include primary care, outpatient specialist care, after-hours care, mental health care, long-term care, and social support. The hospitals are either private or public, and are predominantly non-profit entities.
There are several similarities between the healthcare systems in the U.S, Canada, and Germany. The three countries boast unwavering commitment towards providing their citizens with quality healthcare. As a result, the countries have invested significantly in their respective health care systems. The healthcare experiences in the three countries also bear some similarities. For example, coverage in Germany is offered via numerous independent and small plans. This is similar to the U.S., where employee groups and independent insurers often reach agreements with minimal government intervention ( Ridic et al., 2012) . The U.S. has explored using mandated coverage targeting uninsured working citizens. Similarly, Germany uses a mandated approach in situations where the law requires coverage for specific conditions. Germany also adopted cost controls that in principle are similar to the prospective payment in the U.S. The fixed budget used to pay physician associations by sickness funds in Germany shares similarities with the prospective payment schemes in the U.S. In this case, Germany has sought to reduce health expenditures using approaches that are similar to those used in the U.S.
The health care systems in the three countries differ in various ways. For instance, while the U.S. has a multiplayer healthcare system, Canada boasts a single-payer system. A single-payer system aids in fostering both uniformity and equal distribution of healthcare in Canada while the multi-payer system in the U.S. makes this problematic ( Akinlaja, 2016). Germany, on the other hand, makes use of ‘sickness funds’ that are responsible for financing, delivering, and paying for healthcare. This system merges decentralized decision-making and power with a functional negotiating system taking place at the local, state, and federal levels (Ridic et al., 2012). Compared to the U.S., more people in Canada and Germany are covered by health insurance. This is particularly the case since a higher number of people in the U.S. cannot the cost of healthcare compared to Germany and Canada. The key driving factor for this phenomenon is the fact that the cost of healthcare in the U.S. is higher than that of Germany and Canada (Ridic et al., 2012). More citizens in the U.S. are also not covered by any insurance, and thus have limited access to medical care. The average cost of healthcare in Germany per-capita is less than half that of the U.S. This is because as opposed to the U.S, Germany's system is not centralized health insurance plans but instead depends on private, for-profit, or private insurers whose regulation the government takes very seriously. Due to the availability of numerous options, U.S. citizens enjoy different levels of healthcare coverage in comparison to Canada and Germany. The level of the citizenry's satisfaction with their respective healthcare system also varies significantly.
The role of a comprehensive and functional healthcare system in strengthening a country’s economy cannot be overstated. This is because a healthy workforce is key to achieving a country’s development agenda. Germany, Canada are some of the countries that have recognized this need. The healthcare system in these countries, while bearing several similarities, also boasts numerous differences. The U.S. has a hybrid system because it does not operate as a national health service, multi-payer universal health insurance fund, or a single-payer national health insurance system. Germany uses sickness funds while t he responsibility of delivering and organizing health services as well as supervising providers in Canada rests on territories and provinces . The countries are similar with regard to their commitment to fund and boost the quality of their healthcare system, healthcare experiences, and in controlling the cost involved. On the other hand, they differ in terms of the payment system, coverage, cost, and satisfaction.
References
Akinlaja, M. O. (2016). The United States and Canadian System of Healthcare: A Comparative Study (Doctoral dissertation).
Goh, C. Y., & Marimuthu, M. (2016). The path towards healthcare sustainability: the role of organisational commitment. Procedia-Social and Behavioral Sciences , 224 , 587-592.
Reinhardt, U. E., Hussey, P. S., & Anderson, G. F. (2004). U.S. health care spending in an international context. Health Affairs , 23 (3), 10-25.
Ridic, G., Gleason, S., & Ridic, O. (2012). Comparisons of health care systems in the United States, Germany and Canada. Materia socio-medica , 24 (2), 112.
