Comparison of International Health Care Systems: Budgetary Spending & Quality - Research Paper

Introduction

A comparison of international health care systems is largely concerned with budgetary spending and the quality of health care in different countries. Most of these comparisons based on the health care expenditures of individual countries as a percentage of the gross domestic product (GDP) (Anell & Willis, 2000). According to Anell and Willis, using expenditures as a metric to compare different systems helps a country to find ways of keeping their health care expenditures to the possible minimum levels. Health care costs depend on different items such as human resources, medical equipment, medical training, research and development, drug production, and technological advancements. An international comparison enables a country to look for potential strategies from other nations to lower the health care spending in a particular segment. For a given economy to minimize its expenditures to the level of another economy there is a possibility to adopt similar strategies by the other country or improvise them to suit specific needs and conditions.

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A quality check is another significance of comparing international health care systems. Comparisons help to identify ways of meeting patients' needs to ensure satisfaction in the services delivered. Considerable variations in the needs of people from different countries help to determine how cultural diversity influences the meaning and treatment of disease (Armstrong, Fischer, Parsa-Parsi & Wetzel, 2010). Comparisons provide insights on what makes a specific health care system to work smoothly and gain acceptance from the majority of citizens. Lastly, individuals, organizations and countries learn from the similarities and differences between countries and use these aspects to improve their systems to suit the conditions of a specific country.

Approaches Taken to Effectively Manage Health Care Systems of Several OECD Countries and How They Can Be Applied to U.S. Systems

Whereas the United States depends largely on a private health system, other OECD countries use different systems that include the National Health Service (NHS), National Health Insurance (NHI), Social Health Insurance (SHI), and Etatist Social Health Insurance (ESHI) (Bohm, Schmid, Gotze, Landwehr & Rothgang, 2013). In the NHS approach, the state has the ultimate authority on the financing, regulation, and provisions of the system. Under the NHS approaches, the state governs the relationships between the key healthcare actors whereas the decisions by the private actors only influence the accessibility of services to patients because there is a leeway to choose providers. The NHI approach combines the regulation structures of NHS and tax financing, and the private actors dominate in the dimension of service provision. In the SHI system, societal actors have a dominating role to play in financing and regulating healthcare, but the private actors are the ones that provide services using profit-making strategies. On the other hand, the ESHI approach is the only mixed healthcare system with a three-level hierarchy in which the state is charged with regulating responsibility. Societal actors are in charge of financing while private actors provide services.

The United States can implement these four healthcare systems used in other OECD countries through incentives, information exchange programs, and benchmarking. The federal government can use various financial incentives such as grants and subsidies to encourage a national and societal based healthcare system. Such incentives should focus on providing sustainable long-term financing for health care. Exchange programs between the U.S. and countries with favorable approaches could be another way of implementing attractive systems. The government can adopt and set standards similar to the ones in the other OECD countries. Certifying new products that complement a particular system is necessary in the implementation process. Addressing the potential challenges that may face a certain approach is important before any other implementation step. Benchmarking begins with an understanding of the needs of the system as per the identified faults and weaknesses. The next requires an analysis of the adoption process used by the country using a certain approach to find out its viability in the U.S. Establishing common health care needs is crucial for improving comparability.

Key Reforms in the U.S. Healthcare System, Their Key Drivers and Overall Impacts That They Have in the Healthcare Organizations and Managers

Some of the main reforms that have been implemented in the U.S. healthcare system include the Health Security Act (HSA), which was enacted with the main goal of supporting universal health coverage among the Americans. HSA managed the competition between various health insurance organizations within the U.S., thus giving the government more capability to control the cost of bills in health care service and the general insurance premiums (French et al., 2016). Accordingly, the reform has played an important role in making most of the healthcare providers embrace insurance plans that in turn enhance universal healthcare among many American citizens. Therefore, insurance providers compete effectively to provide the lowest cost insurance plans that attract hospitals, doctors and other healthcare providers.

The Patient Protection and Affordable Care Act (PPAC) is another reform in the U.S. healthcare system. The approach plays an important role in supporting the introduction of new healthcare benefits and costs, hence, positively influencing healthcare providers in the country. Through this regulation, the government has managed to subsidize high medical bills. The key divers of HSA and PPAC acts are the nation's desire to enhance medical service availability and affordability to most citizens. With these transformations, healthcare organizations and managers are required to embrace suitable strategies towards improved and available medical services. Additionally, the American Health Care Act (AHCA) was enacted with the main objective of changing the employer's mandate on health care systems, and the provision of the fixed health premiums for employees rather than income-based systems. The policy enhances more funding to medical service providers and offer them an opportunity to manage high-risk and high-cost medical services needed by the citizens (Gaffney & McCormick, 2017).

Pros and Cons of Government-Run, Market-Driven, and Hybrid Approaches to U.S. Healthcare

The approaches of the U.S. on healthcare have yielded numerous benefits for the citizens. The involvement of government through the Affordable Care Act (ACA) resulted in a steady decline in the number of uninsured adults in America. Similarly, the government's involvement through ACA provided young adults (19-25) with health cover because they remain on their guardians' health plans (Dorning, 2016). The decline of uninsured individuals also helps to minimize deaths resulting from a lack of health insurance cover. ACA successfully promotes efficient service delivery by promoting competition among health insurers and boosting choice transparency for Americans. Union workers also enjoy a reprieve in the cost of health care under the U.S. system because of Medicare cover. For instance, in 2015, 95% of unionized staff in civilian workforce enjoyed Medicare privileges compared to 68% of nonunionized staff. (Dorning, 2016). The government's involvement in health care insurance saves time and enables health care providers to focus on treatment instead of wasting time dealing with insurance companies.

The US healthcare system also has numerous disadvantages that patients encounter. Despite the high coverage of insured people in America, patients still struggle with the high cost of healthcare. The high cost of healthcare is attributed to the high cost of prescription drugs, the rise of chronic diseases, and the high administrative costs of health insurance. Health insurance premiums in the U.S. are not commensurate with the quality of insurance policies (Dorning, 2016). Similarly, the high cost of the healthcare system results in more people becoming bankrupt and losing their assets. Furthermore, medical care in the U.S. has become overspecialized, inequitable, and pays little attention to primary and preventive care. Lastly, the delegation of healthcare insurance services to the private sector leaves patients open to exploitation which translates in unmanageable cost of healthcare service.

Steps Health Care Managers Can Take To Prepare for the Uncertain Future of Health Care in the United States

Adopting smart ways of growth in which, managers target ideal market positioning to identify gaps within the current capabilities. They should cross-examine operational and financial metrics to identify the most optimal structures. Examining variables to establish the next best strategies and the organizations with which to make alliances.

Recognizing and embracing the role of technology in consumerism. Health care organizations should always adjust their technological capabilities to improve the manner in which they interact and collaborate with patients. They should align quality and cost to engage patients in a way that offers greater customer experience. Recognizing and embracing an impactful technological future would help to improve patient experience.

Companies should aim at cost optimization instead of cutting costs. Such a strategy helps in reducing expenses particularly in areas with the least effect on patient care. Furthermore, they should prioritize investments with sustainable long-term outcomes. Cost optimization entails diversifying strategies to produce models of care delivery that are sustainable, efficient and effective. Through this approach, hospitals are in a better position to realize a financial stability that looks beyond the present utilize investment opportunities to grow and improve in value-based care.

Anell, A., & Willis, M. (2000). International comparison of health care systems using resource profiles. Bulletin of the World Health Organization, 78(6), 770-778.

Armstrong, E., Fischer, M., Parsa-Parsi, R., & Wetzel, M. (2010). Health care dilemma: a comparison health care systems in three european countries and the US. 5 Toh Tuck Link, Singapore: World Scientific Publishing Co Pte Ltd.

Bohm, K., Schmid, A., Gotze, R., Landwehr, C., & Rothgang, H. (2013). Five types of OECD healthcare systems: empirical results of a deductive classification. Health Policy, 113(3), 258-269. doi: 10.1016/j.healthpol.2013.09.003

Dorning, J. (2016). The U.S. health care system: an international perspective. Retrieved 11 December 2019, from https://dpeaflcio.org/programs-publications/issue-fact-sheets/the-u-s-health-care-system-an-international-perspective/#_edn51

French, M. T., Homer, J., Gumus, G., & Hickling, L. (2016). Key provisions of the Patient Protection and Affordable Care Act (ACA): a systematic review and presentation of early research findings. Health services research, 51(5), 1735-1771.

Gaffney, A., & McCormick, D. (2017). The Affordable Care Act: implications for health-care equity. The Lancet, 389(10077), 1442-1452.