1 Compare and contrast the design and functioning of the three different health systems
The types of health systems in place for most countries around the world are the product of each nation’s particular history, culture, and politics as observed by (Baker, 2012). Increasingly, there is a recognition that building up and improving the way in which main medical care is provided is vital in evaluating the health systems and how efficient governments respond to current and emerging population health demands. Findings from cross-national comparisons of medical care techniques can inform public plan, highlight areas where nations could improve, and generate standards for top rated health practices. There are a number of reasons why changes to main medical care support provision and reorienting the health program to place greater focus on medical care are needed according to the (The General Wealth Fund, 2013).
The first reason for this shift is as a result of the globally experienced disease burden, the workforce demands by medical services and the increasing rates of chronic diseases among patients. Secondly, changes in health system are being implemented to minimize the need for individuals to wait much longer in hospitals. The third reason is facilitated by the evidence that not all individuals are receiving reasonable levels of medical care services. This difference is brought about by where they live and their ability to pay for services or their medical condition.
Together these factors are placing increasing pressure on the existing services and providers, and leaving more consumers with massive debts in medical care. At the same time, increasing fiscal pressure requires state authorities to make sure the investment of community funds is accurately targeted to the right recipients and is cost-effective in nature (Irvine, Ferguson & Cackett, 2013). Whereas the plan for quality health care has been strongly rooted in the health care systems of these three countries, studies indicate that they can make increase the levels and rations of patient safety, and in turn reduce the costs of their nations’ health burdens, which are highly associated with events of adverse nature (Health Indicators OECD, 2013).
Canada as a country provides universal accessibility to medical needs and services to the 33.2 million (Johnson, & Stoskopf, 2010). The United States health-care system can be described as several systems that function both dependently and independently. For example, the states take part in funding and managing many community health programs, paying part of the Medicaid programs and shaping the healthcare business. States set rules for health insurance coverage guidelines that are not protected by self-insured company plans (Irvine, Ferguson & Cackett, 2013). On the other hand, medical devices are controlled at national government level. Rules to achieve goals of quality, access, and price control in health care may be set by community or private organizations, at any or all of the state levels.
2 Comparatively evaluate the three systems utilizing a comparative analytical framework
2.1 Policy and Management
In the United States, the health department is in charge of managing the health plans while health care service distribution falls under the purview of the trusts (Schieber, 1997). Compared to the UK, the responsibility for health and personal social services lies with the Department of Health, which manages local planning, regulation, inspection, and plan development (Reid, 2009). The secretary of state for health is directly responsible and answers to the parliament of the United Kingdom. The central government takes responsibility of setting health priorities for the NHS in general and oversees the general pool of funds. National Health Service regulators, take part in the provision of planning guidance to the health regulators in terms of service and financial networks. The ten strategic health regulators manage health care and disburse the available funds based on regions in collaboration with the department of health and the NHS (Squires, 2011). The clinical commissioning groups (CCGs) make contract with the medical professionals ensure quality delivery of health care. The NHS services have been opened up to competition from health service providers that meet the set NHS standards on prices, quality of service and patient safety, with new regulator or monitor. This has seen most hospitals and other NHS trusts being transformed into foundation trusts National Health Service, (2014).
Figure 1: NHS Structure–Adapted from https://www.nhs.uk/nhsengland/thenhs/about/pages/nhsstructure.aspx
They set social plans regarding health, education and social assistance, and other social services. The regions and areas also take charge of their various single-payer systems for the medical services and universal hospitals, paying for medical centers either directly or via the global funding for regional health regulators. Moreover, the authorities of the provincial government often settle doctor fee plans with the provincial medical organizations. Nonetheless, hardly ever do the regions directly deliver health care (Fierlbeck, 2011). Still on a similar note on policy and management, compared to the UK and the USA, the government of Canada has the jurisdiction over the health Care system, notably, through the regulation and prescription of drugs, and financing and administering health benefits for the indigenous people. In Canada, the government’s department of health also plays a critical role in health services research and public health and protection (Canadian Institute for Health Information, 2013). Just like the other countries, there are both public and private insurers in the U.S. health care system. The only unique aspect of the health system in America is the private health service providers’ dominance over their public counterpart (National Health Service, 2013).
2.2 Financing
With a price range of more than £90 billion, the NHS is the largest publicly funded health program in the world. Britain’s NHS relies mainly on general tax earnings (Marchildon et al., 2005). Canada finances its health program mainly through tax earnings, but copayments and payments from personal insurance also make a significant contribution. Tax earnings at the provincial, territorial and federal government authorities account for nearly 70% of complete health expenses. These general revenue resources come from earnings, consumption, and corporate taxes (Light & May, 1993). The provincial and territorial government authorities set the tax prices of their respective areas. Individual out-of-pocket copayments and personal insurance payments cover much of the remainder at 15% and 12%, respectively. The final 3% comes from myriad resources, such as social insurance resources, such as worker’s comp, and charitable donations (Kronenfeld, 2002). For the United States, public resources constitute 48% of health-care expenses, personal third party payer resources 40%, with the staying 12% being paid by people out of wallet. Even though the proportion of community and personal investing on medical health care is roughly comparable, only a community (30%) of the United States inhabitants is covered by the community-funding program – mainly through Medical health insurance and State health programs. Currently, the majority of Americans (54%) receive their protection from personal health insurance plan, with most privately insured people obtaining protection through an employer (Schieber, 1997).
Spending on medical health care in the U.S. in 2008 far surpassed that seen in other nations. In both dollar figures and as a percentage of GDP, no nation came within 70 % of U.S. investing ($7,538 per household, 16% GDP). This greater investing does not seem simply to reflect greater earnings. In Norwegian, the only nation studied with greater per household earnings than the U.S., medical health care investing included only 8.5% of GDP (National Health Service, 2013). Although much greater medical health care investing marks the U.S. as an outlier, containing investing development is a shared challenge among these 12 nations. From 1998 to 2008, all nations experienced an amount of development that surpassed inflation, with the development expected to continue. A recent analysis from the Centers for Medical health insurance and State health programs Services projects U.S. national health expenditure to grow at an amount of 6.1 % from 2009 to 2019 (European Observatory, 2013).
There are many forces driving medical health care investing. An annual series of Earth Fund-sponsored studies of OECD health data way back to 1999 has researched a number of potential factors, including administrative complexity, the aging of the inhabitants, the practice of “defensive medicine” under threat of malpractice lawsuits. Also, serious disease burden, medical health care supply and utilization prices, access to health care, resource allowance, and the use of technologically advanced equipment and procedures. These and other research have found, contrary to often-cited explanations, the U.S. has a relatively young inhabitants, regular or below-average prices of serious conditions, and comparatively few visits to the doctor and hospitalizations compared with other developing nations. Instead, these researches suggest reasons for greater investing include substantially greater prices and more fragmented health care delivery that leads to replication of resources and extensive use of poorly synchronized specialists.