The US is without doubt the biggest economy in the world and currently one of the nations that mark the pace for others especially the developing countries. Further, the United States healthcare sector is the biggest in the world with American companies supplying drugs all over the world. On the other hand, Portugal is relatively a smaller economy, rated lower than the biggest 40 economies of the world and beaten even by the African nation of Nigeria in Nominal GDP. However, the American citizenry must have been amused by the fuss occasioned during the passage of the Patient Protection and Affordable Care Act (PPACA), popularly known as Obamacare. Even with the passage of this Bill, the American healthcare system is far from catering for the needs of its populace more so the vulnerable populations who include the poor, disabled, those undergoing prenatal care, and children among others.
America can be termed as the world’s centre for capitalism with every government from the very beginning of the Union having great reluctance to interfere with private industry even if the interference saves American lives. This is the genesis of the American healthcare system from the perspective of the vulnerable community. However, the American healthcare system is among the biggest industries in the world. From a research perspective, under the superintendence of the Federal Drug Authority (FDA), the US pharmaceutical companies invest billions of dollars in research and development of perhaps the best and most innovative drugs in the world (NHS Choices, 2016). Further the nation also has some of the best medical institutions in the world; both private and public. The John Hopkins Hospital for instance has a reputation for having some of the best Neurosurgeons in the world while the Mayo Clinic is a global authority on heart conditions (NHS Choices, 2016). Finally, the US also has some of the best medical learning institutions in the world complete with a rigorous, well-structured medical academic system (Shi & Singh, 2015).
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From the perspective of pharmaceutical advancements, medical institutions and medical training, Portugal’s ratings are a far cry from that of American. Indeed, Portugal is a major beneficiary of American pharmaceutical products, American hospitals and even American training centers (Ridic, Gleason & Ridic, 2012). Indeed, the Harvard University has a medical training programme called Harvard Medical School’s 2016 Portugal Clinical Scholars Research Training (PTCSRT) Certificate Program. It is designed specifically for Portuguese medical practitioners and sponsors by the Portuguese government through the Fundação para a Ciência e a Techologia (FCT) (Harvard Medical School, 2016).
However, what the Portuguese lack in material medical apparatus, it makes up for through the commitment of the government to cater for its populace. Each and every citizen of Portugal, including short term visitors of the European Union, has a guaranteed access to full medical care from outpatient services, to inpatient services and even specialized treatment (Ridic, Gleason & Ridic, 2012). For the vulnerable community, these services are available absolutely free. For the working community, the government has a medical insurance program that is based in all the 5 regions of Portugal and superintended by the central government. This is the Portuguese National Health Insurance system (NHI) (Tavares, 2016). The main sources of funding for this system include taxation from employers and employee, contributory programs by the citizenry and donations from willing individuals or corporate organization (Tavares, 2016).
Unfortunately, the opposite is true for the American healthcare system. For starters, Obamacare is an employer employee contributory system where the employee and the employer both contribute towards an insurance package. The employer’s contribution is capped at 60% thus the employees also shoulder a great portion of the fund (Shi & Singh, 2015). With the working poor forming a major portion of the American workforce, Obamacare is a major burden to the least paid working population. Further, the insurance system is only available to those who are working and earning an income. Workers who prefer can however, pay a penalty instead of joining the mandatory insurance system with an exception to the families whose 8% of income is lower that the penalty hence are exempted (Shi & Singh, 2015). Finally, some states have even opted out of the expansion of the insurance system to accommodate Medicaid.
The upshot of the foregoing is that all the Portuguese citizens get access to proper medical attention with emphasis on the vulnerable communities (NHS Choices, 2016). It also has all levels of medical care from the ordinary day to day medical attention through to specialized treatment if guaranteed by the state. In the United States, capitalism is still adhered to in the provision of healthcare services with the rich having access to the best available medical health facilities (NHS Choices, 2016). The very poor, including the underclass has little or no access to medical care at all. This also applies to the millions of illegal immigrants currently residing in the US.
Between the rich and the very poor in the US whose situation has been outlined above lie the working community and the middle class. These two groups are not guaranteed medical care but are by rule of law paying penalties for not being part of an insurance system. These individuals therefore only get the level of healthcare they can afford (Shi & Singh, 2015). The rest are part of an insurance system receiving only the level of medical attention available within the scope of the insurance cover. With the healthcare services currently so expensive in the United States, these individuals or insurance companies have opted to outsource healthcare service to third world countries. Indeed, this has even been perfected into an industry called medical tourism where the ailing Americans travel to far countries such as India, Brazil and Chile in search of low costs medical services (Shi & Singh, 2015). Therefore, the American healthcare system is the bigger industry but the Portuguese citizens get by far the overall better average healthcare irrespective of their social status.
References
Harvard Medical School. (2016). Portugal clinical scholars research training . Retrieved from <http://hms.harvard.edu/departments/portugal-clinical-scholars-research-training-program/>
Ridic, G., Gleason, S., & Ridic, O. (2012). Comparisons of health care systems in the United States, Germany and Canada. Materia Socio-Medica, 24(2): 112–120.
Tavares, A. I. (2016). Portuguese Health System, an Overview and a SWOT Review. Open Public Health Journal, 9 , 16-30.
Shi, L., & Singh, D. A. (2015). Essentials of the US health care system. Jones & Bartlett Publishers.
NHS Choices. (2016, August 5). Country-by-country guide . Retrieved from http://www.nhs.uk/NHSEngland/Healthcareabroad/countryguide/Pages/healthcareinPortugal.aspx
