PBS’s film, Critical Care: America Versus the World, was quite informative and provided me with a great comparison of the United States’ healthcare system and insurance coverage to other counties around the world. The film also provides an explanation on why the U.S. has left millions of people without health insurance, despite being one of the richest counties in the world. The U.S. is one of the leading innovators, yet so many people in our country do not get the medical care they need. I believe that everyone deserves a right to healthcare, regardless of their income level or job status. In America, that is not the case. I enjoyed touring the healthcare systems of the United Kingdom, Switzerland, Australia, and Canada. It is interesting to see how these countries can provide care for everyone, while spending less money doing so.
In America, quality of care can vary substantially depending on the area. For example, we see in Houston, TX that a boy born with half his heart functioning normally can survive due to our country’s advanced technology and innovations. This patient gets a second chance at life because of the access to care in his area. However, in North Houston there are greater range of disparities that influence the community’s health outcomes. People in this area are disproportionately uninsured and if they can get medical care, it is often too late for a positive health outcome. It shocks me that the U.S. spends about 1/5 of the economy’s expenditures on healthcare, yet so many people lack the care they need. Cost of medical care is a huge concern for many people living in the U.S. and a large reason why many do not seek care. It was sad to see the patient in North Houston be diagnosed with late-stage cancer that caused her to have limited use in one of her arms, resulting in the loss of her job and home. Only if she could afford health insurance, she could have received care a lot earlier. In future healthcare reform, we need to have coverage for everyone at affordable costs. One way of doing this is by strengthening the Affordable Care Act and raising income level of subsidies so more people can purchase health insurance. The U.S. would also benefit from expansion of Medicaid.
In the film, I learned that many countries’ healthcare systems are built around the population’s social values, which is not the case in the U.S. In the United Kingdom everyone has access to care regardless of their income level. I love this approach because income level should not determine your health. This demonstrates their values that healthcare is a right. Their government is the single payer and covers all costs for the healthcare system. Because of the UK’s National Health Service, going to the doctor is essentially free and is most people, unlike Americans, do not have to worry about the costs of going. People in the UK tend to have better health outcomes, longer life expectancy, and lower disease rates showing that universal healthcare works. Private insurance is also an option in the UK, but only 10% of people will buy private insurance, mostly to avoid long wait times.
Switzerland is another country that has achieved universal healthcare. What is unique about their system is that there is a wide array of health insurance options, and everyone is covered. Health insurance in Switzerland is a bit more expensive, but residents agree that the care they receive is very good and worth the cost. Health insurance here is also separated from employment, which benefits people who lose their job, especially during the COVID-19 pandemic. In America, the lack of separation between employment and health insurance left many with no health insurance when losing their jobs during the pandemic. This is something I had not though of before watching the film. I like how the government mandates basic coverage and sets the prices for medications and procedures, instead of leaving it up to the pharmaceutical companies and healthcare providers to do so. It is also great that the Swiss look out for those who can’t necessarily afford coverage, like homeless people.
The next healthcare system we explore is Australia, which includes a combination of public and private insurance coverage. Medicare is their public insurance and is paid for by taxes and available for everyone. One negative aspect about their public coverage option is that there are long wait times, like the UK’s structure. However, 50% of the country buys private insurance as opposed to 10% of people in the UK. What is great about Australia’s system is that the two options are meant to work together, so those who can afford private insurance can take some of the weight off the public system. Like Switzerland, the government sets prices for drugs and treatments, which makes it easier and more affordable for people to access. If Australia can get more funding for subsidies, more people can buy private health insurance, which could help prevent more people from dropping their insurance.
Lastly, we dive into Canada’s healthcare system, which includes a single payer funded by taxes and is controlled by their provinces and territories. It is interesting to see how Canada handled the COVID-19 pandemic and had a much lower death rate than the U.S. They benefited from coordinating between hospitals and shifting patients around. Hospitals in the U.S. have too much competition to have been able to do this, resulting in complications dealing with the surge of patients in the hospital.
Some lessons I learned from the comparison between these countries is that universal healthcare can be achieved without spending the amount of money on it that we do in America. It is evident that universal coverage does save lives because people can seek preventative care and early treatment, resulting in better health outcomes. The film makes great arguments through interviews with those in the healthcare sector, as well as those living in the community.
Hi Maddy, thank you for your review of the documentary. I found the video to be enlightening as well, seeing multiple different health systems in comparison. The discrepancies of what people have access to even within our country has always been disturbing to me. I knew that the US system was behind the curve on providing coverage but seeing how other countries have such different processes in place made that stand out even more. I agree with you that everyone should have access to care so I’m hoping future legislation – including additional talks regarding Medicaid expansion in North Carolina – will help pave the way for improvements. I liked the idea of universal healthcare in the UK and Switzerland, though it was it was disappointing to hear the concerns that still exist related to delayed receipt of funds for certain procedures. While that may be understandable from a triage perspective (provide services for the most time sensitive or serious services first) it still would be frustrating if a need arose, and it wasn’t able to be provided in a timely manner. I really did like the idea, though, of separating coverage from employment – it sounds like a simple step forward, though I’m sure nothing would be “simple” about making changes! Australia and Canada’s systems were interesting to learn about as well, with the coordination of facilities in Canada standing out to me. It would be wonderful to see such collaboration here, but hospitals compete across so many levels and I do not see that being changed any time soon. I do hope that we are all able to learn some lessons from other countries when it comes to providing more comprehensive healthcare, but I also feel like it would take much more political cohesion than what we’ve been able to demonstrate as a nation, especially in the last decade. Thank you for your insight on this documentary – it sounds like we took away some similar thoughts.
Layne
Hey Maddy. I really enjoyed reading your blog post and I agree with the observations you made. I believe everyone really benefited from the analysis of other healthcare systems across the globe and how it compares to ours here in the US. I loved the observation you made about how the quality-of-care citizens receive can be directly correlated to their area. As mentioned in your review, the differences between the quality of care can be separated by mere miles. Patients in the Metro Houston area easily has access to a wider range of healthcare resources and facilities compared to the population in the northern Houston area. This reminds me of the healthcare landscape in the Charlotte Metro area. With Atrium Health and Novant Health having a heavy presence in the region it makes access to healthcare relatively convenient. However, the further you move from the area, the more health disparities become more prevalent, such as; proximity to the closest medical facility, lower socioeconomic status and lack of coverage. Your blog post reminds me of the underlining theme of this course, which is how much the healthcare industry is fueled by capital, like every other industry in our nation.
I also appreciate you pointing out how the healthcare system in other industrialized nations are structured around their social values. For example, you emphasized how every citizen in the United Kingdom has medical coverage, no matter of their socioeconomic status. I have always believed that access to healthcare treatment is not a privilege, but a human right. Citizens should be able to at least receive adequate care, no matter their of race, religion or socioeconomic status. As we can see, there is a direct correlation between the healthcare statistics of industrialized countries who’ve implemented an effective healthcare system, compared to the statistics produced by ours.