Health Care Economics in US, UK and China - Literature review Example

Health Care Economics in US, UK and China Introduction There have been efforts in the past decades to promote universal health care coverage by designing a health care system that provides financial protection to all citizens. Universal health care agenda has been driven by a desire to integrate health economics in line with Primary Health Care (PHC) goals of providing accessible, affordable and equity health services. This paper will focus on three countries health care economics and assess the impact of health expenditure and coverage. The paper will examine comparative analysis of UK, US and China medical systems paying attention to GDP, proportion allocated to health and effects of existing health economics on life expectancy, morbidity, and mortality. Comparative Analysis of US, UK and China The US health care system has been herald by many experts as blueprint structure that has continued to promote universal access to health care. This is due to its medical insurance policy that covers both working class and vulnerable groups. Funding health care has been number one priority, unlike the UK and China health care financing; the US has the highest spending of its GDP on health care services. Evidently, the fiscal year 2012/13 saw the US government spent 17.9% of its GDP amounting to $ 8.362 per person on health care financing (Friedman et al., 2013). On the other hand, the UK spends up to 9.6% of its GDP on health sector alone. In comparison to the US, the UK still experiences administrational bottlenecks that have continued to derail universal health care financing. In essence, the UK health sector spends approximately $ 3.48 per person; many persons remain uncovered by the hospital insurance schemes making accessibility of health services unbearable to consumers (Harrington & Newman 2012). China, on the other hand, continues to expand its health care GDP proportion despite the vast population. Today, China spends 5.1% of its GDP on health care financing (World Health Organization 2013). As compared to both United States and United Kingdom, China experiences two key health care financial challenges. Firstly, the country population continues to explode while the GDP remains relatively stable. The biggest proportion of GDP in China is directed to other sectors of the economy leading to out-of-pocket financing. Kominski (2014) observes that today, the US healthcare scheme is the largest in the world covering up to 67.8% health insurance cover to the citizens. The private sector accounts for 46.9% of the total health care financing. Small proportion of population finances health care from the out-of-pocket type of health care financing. The UK medical coverage through insurance schemes accounts for 56.2%; however, unlike the US its health care financing is dominated by the public health sector. Moreover, the UK public health spending accounts for 83.86% as of 2012, this is expenditure from the recurrent and capital share from the government budget (Friedman et al., 2013). The government has continued to expand insurance coverage. China unique Health Care System Zhou & Zhang (2010) states that unlike the US and UK, China health care economics has experienced a unique expansion over the last two decades. As by 2012, the Chinese government on health care services had grown to $ 357 billion from $35 billion in early 1980s. Besides, the growth is expected to reach $2 trillion by the year 2020, which would be the largest health care expenditure in the globe (Masis & Smith 2009). Despite the increasing concern on the low GDP allocation to the vast population health, the demand for health care services in China continues to expand immensely. One of the unique feature of Chinese health economics is that it remains the most attractive market for pharmaceuticals and medical services as compared to the US and UK markets combined. This has been occasioned by two critical factors, firstly the huge population that has put pressure on the existing facilities. Secondly, the Chinese health care systems recently embarked on the health care reforms that would see an expansion of health care financing to protect the huge unemployed population and the vulnerable groups. Today, majority of the Chinese health care financing is through out-of-pocket financing with limited insurance policies cover. Health care expansion in China has witnessed a number of marked improvements in economy expenditure and market expansion. By 2006, total health care expenditure amounted to $ 156 billion that has since grown to over $ 350 billion by 2011 (Herd & Koen 2010). The main reason for this growth is increased government expenditure in financing health care. Besides, per capita health care expenditure is now at $ 261 up from $ 119 in 2006. The population with health insurance has expanded from 43% in 2006 to over 70% by 2011 fiscal year (Hollnagel et al., 2013). However, the universal health access in China remains quite low in rural communities. Hong Kong is now a major health hub in China; rural communities continue to experienced health care financing challenges. Poor health outcomes have been blamed on poor sanitation, increased cost of medication and insufficient allocation by the government. Hou et al., (2011) state that China is a destination of major multinational hospitals due to its growing demand. The expanded funding of the insurance policy in China has seen an expansion of private hospitals to supplement the government services. Public hospitals are overcrowded; the demand for health care services in the public sector is high, unlike the US and UK. Many Chinese public hospitals remain affordable to the majority of the population. In addition, the struggling rural population finds private hospital expensive health care services; the quality has been further compromised due to a huge population served by few health care professionals. Watson (2013) notes that striking difference with the US is that 60% of total health care expenditure by the population goes to the private health institutions. Surprisingly, this huge spending caters for only 15% of the total population of those seeking health care services. Besides, the US department of health has identified a number of conditions; the US government now funds TB. Effect of Health Care System to Life Expectancy With a vibrant and comprehensive medical cover, the US life expectancy has stagnated over many years at 79 years while UK is at 81 years. Despite the huge shortcoming in the Chinese health care access, life expectancy is 83 years (World Health Organization 2013). However, the difference in the health outcomes has a direct relationship with the disease patterns. Today, cardiovascular diseases remain among the leading causes of mortality in the US and UK while China battles with preventable diseases. Healthcare sector has experienced huge challenges in curbing lifestyle diseases such as obesity and hypertension in the recent years. Hence, they remain the leading causes of mortality, unlike China whose population has a lower prevalence of these lifestyle chronic diseases. Many analysts believe that the American Affordable Care Act of March 2013 will see an expansion of insurance scheme to protect all groups irrespective of socioeconomic status. Improving life expectancy has been approached by ensuring that there is policy framework that guarantees universal access to health care. The Affordable Care Act is premised on three key pillars; firstly, it ensures affordability of care. Unlike the China healthcare system, affordability has been spearheaded through community mobilization and revamped rural health centers. Similarly, the UK rural health access campaign has been borrowed from the American health care reforms. Health care financing today is a major component of comprehensive health care in U.S. Through Obama care, children under five and elderly groups are now able to access health care services free of charge. The new health care financing focuses on the Americans who are uninsured by medical schemes. In UK, the government has introduced cost-sharing health care financing scheme that ensures every citizen access health care irrespective of socioeconomic status. Infant Mortality Rate and Immunization Today, the modern health care systems have prioritized the health care of under five in the long-term strategic plan. Unlike the recent past, the rates of mortality have drastically reduced in US, UK, and China. In US, the rate of infant mortality is at six for every 1,000 live births. China is at 11 infant deaths in every 1000 live births (W.H.O 2013). Disparity seen in these two nations has been primarily occasioned by difference in hospital care systems. Besides, Chinese rural families continue to experience huge mortality rates due to inaccessibility of health care services. Unlike the US and China, the infant mortality rates have been substantially reduced. According to the United Kingdom Health Outcome Report 2013, the infant mortality rate is now at four in every 1000 live births (Friedman et al., 2013). Notably, the three countries have prioritized maternal and child health care in line with the Millennium Development Goals (MDGs) and Healthy People 2020 strategic plan. In UK, and US over 60% of total budgetary allocation has been channeled to maternal and child health care services that include immunization and care throughout pregnancy and delivery (Kominski 2014). The health care financing today focuses on the positive health outcomes of under-five; infant mortality rate is now an important marker of health care success. In addition, over 95% of fewer than five children in US and UK receive full immunization as per expanded program of immunization (Magnussen et al., 2009). The onset of PHC concept has seen categorization of persons in terms of age thus creating cohorts. This approach has been instrumental drive in UK health care reforms. The increased concern seen in the US, UK and China health care for the children and pregnant mothers is an important milestone in health care sector. Future of Health Care Systems There are increasing health concerns in China on the future sustainability of the growing population. With increasing economic crisis and rising in the cost of living, the future of the largest world population remains uncertain. In the US and UK, the cost of financing health care services is increasingly biting into the economy. With the Obama Care Scheme in the US and universal primary health care efforts in UK, the future of its population remain largely prospective. Unlike US and UK, the productivity of health care professionals remains quite jeopardized due to huge demand that do not match the resources (Mooney 2012). There are two major health systems concern in China, a growing health care demand and the absence of community-based initiatives that would ensure sustainability. There exist huge differences between the Hong Kong population and the rural China health outcomes. Driving health care outcomes towards equal resource distribution is a challenge that the Chinese government continues to battle. Moreover, the US and UK health care systems have been anchored on the strong commitment of building capacity of the health care workers. Slottje & Tchem (2010) observes that today, over 80% of public hospitals have sufficient staff similar the UK has over 60% of the hospital with substantial health workers staff. There has been increased admission in than public sector as compared to the private sector. While there is over 60% expenditure on the health care services in the private sector, the number of persons affording this private sector is quite low (Slottje & Tchemis 2010). Majority of the health care demands is addressed in public hospitals in both US, UK, and China, this is a striking similarity. Impact of Health Care Reforms With the recent reforms in the health sector, Chinese government has now expanded insurance cover to the rural populations. Zhou & Zhang (2010) decade ago, only 21% of the rural population had medical insurance cover, today over 70% of the rural population have medical cover. Using the American case study, the Chinese government recognized the importance of improving its health care outcomes by focusing at multiple factors including health care financing. Today, the immunization of rural children has improved from 78% in 1990s to over 90% by year 2000 (World Health Organization 2013). Besides, the infant mortality rates have gone down by over 10% over the past three decades. Notably, the impact of health care reforms has created a mental shift that has similar patterns in US, UK, and China. Improvement of the health care system has been premised on three integral issues, which are increasing accessibility, improving quality of health care and facilitating policy in health care financing. In these three areas, the US and UK health systems have substantially attain minimum standards. Through different models of health care financing that include efforts towards universal health care insurance cover, increased sustainable rural health programs and ensured quality of care. However, there is still huge challenges towards attaining 1:6 nurse-to-patient ratio as recommended for WHO. The current American indicators show 1:12 patient-nurse ratio while UUK 1:14, China continues to experience the biggest ratio of 1:18 patient-nurse ratio. Adequate health workforce is an important indicator towards achieving standard quality of health care. With understaffing as seen in Chinese hospitals, the pursuit of universal quality health care will remain a mirage. Although the US and UK have shown tremendous development of staff and resources allocation, there is still gaps between private and public health care services. Conclusion The US, UK, and Chinese health care systems present a hybrid combination of principles of universal health care and purposeful steps towards universal health care. Health care financing, increased accessibility and improved affordability are now the leading concern of modern health economics. Besides, the impact of huge GDP investment in the health sector has witnessed a reduction in morbidity and mortality rates. References List Friedman, L. H., Goes, J., & Savage, G. T. 2013. Annual Review of Health Care Management: Revisiting the Evolution of Health Systems Organization. Bradford: Emerald Group Publishing Limited. Harrington, J. T., & Newman, E. D. 2012. Great health care: Making it happen. New York: Springer. Herd, R., Hu, Y., & Koen, V. 2010. Improving China's Health Care System. Hollnagel, E., Braithwaite, J., & Wears, R. L. 2013. Resilient health care. Farnham, Surrey: Ashgate. Hu, R., Shen, C., & Zou, H. 2011. 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(2010). Relative efficiency evaluation of Chinese health care system based on data envelopment analysis (DEA) model. doi:10.1109/CCTAE.2010.5544840 Read More