Health Systems Comparison Discussion

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Health Systems Comparison Discussion

The health systems concept varies between countries worldwide. The variation is influenced by factors such as geography, culture, disease epidemiology, and resource availability. Inherently, each country tunes its implementation to these factors to realize the preventive, curative, and rehabilitative benefits of healthcare. The article explores specific differences among the USA, Canada, and Germany, based on the five parameters of the structure, expenditure, resource allocation, quality indicators, and outcomes.

Comparison Matrix

Healthcare structure is run at the national and at the state level, where specific policies can be made. Most organization is loose and left for the individual states (Makeeba et al., 2017). Healthcare is largely privately owned, hence most people (42M) are either uninsured or underinsured (Ridic et al., 2012). Its medical system is called Medicare, which trickles down to the population through its provincial and territorial organization (Marchildon, 2019). Hospitals are regionally distributed as local, district, and base depending on case complexities they handle (Marchildon, 2019). Provisions for health administration are stipulated under the 1984 Canada Health Act. Its structure is based on principles of social insurance and solidarity, whose formal origins are in the Sickness Insurance Act of 1183 (Ridic et al., 2012). Healthcare is managed in a stepwise fashion, where the state legislates, provincial governments plan and manage hospitals and worker associations, and local governments run local facilities (Busse et al., 2017). Healthcare management is much decentralized.
Health insurance is both private (70%) and public (26%). Public insurance is in the form of Medicare and Medicaid from the federal government (Ridic et al., 2012). Payment is through multiple have third-party involvement and even use of prepaid health plans (Makeeba et al., 2017). However, physicians are paid using a government-fixed fee-for-service basis. Healthcare costs are settled using a government-run national insurance program (NHI), which is universal (Ridic et al., 2012). Out-of-pocket payments by consumers are minimal, and patients do not get involved in the reimbursement processes (Yu & Zhang, 2017). Importantly, physicians are significantly autonomous and their payments are on a fee-for-service basis, which is reviewed periodically (Marchildon, 2019). Almost everyone has access to medical care, since having health insurance is anchored in law (Ridic et al., 2012). Low-income earners join sickness funds for their insurance needs, while the higher ones opt for private insurance Busse et al., 2017). There is, however, no restriction in joining either, voluntarily. Also, other cadres are recovered by public assistance, student insurance, and police officers insurance. The sickness funds, which are largely self-regulating, account for about 70% of healthcare spending.
It allocates the highest amount to health, at 18% of GDP or $3.5T, with the amount being both privately and publicly pooled (Ridic et al., 2012). Its per capita spending is also highest at $11072. The allocations are financed by general taxes, which was $265.5B, or about 11.5% of Canada’s GDP (Ridic et al., 2012). Capita spending stands at $5418. Allocations are both government and individual-driven and amounted to $499.8B or 11.7% of Germany’s GDP (Ridic et al., 2012). Its capita spending is at $6646.


The USA has 2.7 physicians per 1000, 3.7 hospital beds per 1000, and an average hospital stay of 7.1 days. It also has more MRI units and CT scanners than Canada, but not Germany. Canada has 2.1 physicians per 1000, 4.7 hospital beds per 1000, and an average hospital stay of 8.4 days. Germany has 3.5 physicians per 1000, 9.3 hospital beds per 1000, and an average hospital stay of 12.0 days. It also has more MRI units and CT scanners than the USA.
The USA has the highest infant mortality and lowest life expectancy of the three (Makeeba et al., 2017).




Importantly, patient satisfaction with the systems is the least in the USA.

Parameters in Canada are in the intermediate area for life expectancy and mortality rates between the three (Marchildon, 2019).


Importantly, patient satisfaction with the systems is greatest in Canada.

Germany has the lowest infant mortality and highest life expectancy of the three.




Importantly, patient satisfaction with the systems is intermediate in Germany.