Comparison of the American Health Care System and the Norwegian Health Care System - Research Paper Example

?Comparison of the American Health Care System and the Norwegian Health Care System The American Health Care System: Background The structure of the American health care system has a totally different way for things to work as compared to the structure of the Norwegian health care system. When an American citizen feels the need of health services in the USA, the financial burden of the services are supposed to be borne entirely by the citizen. The citizen in turn completely relies on the provider of health care insurance. This is why insurance companies are so readily used in the USA when it comes to health care. In the USA, the cost of treatment for anyone in need of medical attention is fairly high. Hospitals in the USA are generally quite efficient and well-equipped with the advanced technology, and can thus provide high quality treatment in a wide array of medical fields. The income of the doctors in the USA is much more than what the American citizens get on average. There exists amongst the doctors, a sense of strong discrimination against the socialized medicine in the USA. Socialized medicine is a term used to refer to a public system of health insurance in which the government pays the doctors for providing medical attention to everybody irrespective of the presence of any pre-existing condition. Socialized medicine is quite common in a vast majority of the European countries. Medicaid and Medicare are the only two federal programmes of health care insurance in the USA. Medicaid and Medicare were both established by the Social Security Act in the year 1965. The Social and Rehabilitation Service (SRS) administered the State Medicaid programs whereas the Social Security Administration (SSA) took the responsibility of the Medicare. Both SRS and SSA were placed under the control of the Department of Health, Education, and Welfare (HEW). Effective coordination between Medicaid and Medicare was ensured by the creation of the Health Care Financing Administration (HCFA) under HEW in the year 1977. HEW was divided into the Department of Health and Human Services (HHS) and the Department of Education in the year 1980. The name of HCFA was changed to Centers for Medicare & Medicaid Services (CMS) in the year 2001. Medicare Medicare provides the retired and the elderly with almost free health care services. Full cost of some treatments is not recovered by the elderly people, particularly when they are expensive. Medicare is particularly applicable to people over 65 years of age, patients of the End-Stage Renal Disease (ESRD), and people with disabilities below 65 years of age. Almost 12.3 per cent of the total population of the USA fulfills these criteria. It is estimated that by the year 2030, the population of elderly Americans would reach approximately 71.5 millions. Increase in the population of elderly Americans directly imparts the need to increase the federal funds of Medicare. Medicaid Medicaid compensates the families with little or no resources, low income, and the poor for medical assistance. Medicaid was established as a program in nearly the same time as Medicare. In the year 1965, Medicaid was made the law of the USA. Funds for the Medicaid are provided by the Federal as well as the State governments so that the states can be enabled to provide long term health care services to the citizens who fulfilled the eligibility criteria established for the Medicaid. The Norwegian Health Care System There are both the private profit-making and non-profit-making agencies working in the Norwegian health care system. In a vast majority of cases, services in the private sector are completely engrossed in the public system. Non-profit-making agencies in the Norwegian health care system particularly include hospitals and trusts. The National Insurance Scheme provides insurance to all Norwegians. This Scheme is a single-payer, tax-funded, and universal system of health care. Norway has a much more centralized system of health care as compared to several countries including Spain, France, Japan, and Italy. The Norwegian Insurance Scheme covers 100 per cent of the Norwegian citizens. Funding for the National Insurance Scheme comes from the revenues of general tax. No tax has been assigned to the health care in Norway, and the total financial burden of the Norwegian tax makes up to 45 per cent of the gross domestic product (GDP). “The organizational structure of the Norwegian health care system is built on the principle of equal access to services: all inhabitants should have the same opportunities to access health services, regardless of social or economic status and geographic location” (Johnsen, 2006, p. 1). The Norwegian government establishes a global budget to minimize the overall expenditures of health care as well as the capital investment. Physicians in the Norwegian hospitals as well as all kinds of health care organizations in Norway are paid their salaries. Some specialists are provided with free-for-service payments. The Norwegian government establishes the reimbursement rates for the physicians, which deprives the physicians of the right to charge more than the reimbursement rate that has been centrally set by the government. Since all Norwegians are covered by the Norwegian Insurance Scheme, patients select their physicians from a list provided by the government. These general practitioners refer individual patients to the specialist services. In Norway, there is no copayment for the stay in hospital or the health care center, though small copayments exist for the outpatient treatment. Current Issues The American Health Care System People who are neither eligible for Medicare nor Medicaid in the American health carte system have to bear all the expenses of the medical health services by themselves. This gives a discriminatory shade to the American health care system. In order to protect themselves from the risks of financial loss for getting ill, and to reduce the cost of treatment, people belonging to the working class in the USA gain insurance from private schemes. Numerous preferred provider organizations (PPOs) and health maintenance organizations (HMOs) in the USA are doing good business with the premiums gained from the health-conscious working class Americans. HMO provides the voluntarily enrolled Americans with comprehensive health care services at a price that is predetermined. Members of the HMO pay fixed fees to the organization periodically and HMO provides them with health care as frequently as required by the members in return. Likewise, PPO develops contracts with dentists, doctors, doctors as well as the providers of health care services which are used to provide the members with health care at discounts. Such schemes are mostly run by deducting money from the wages of the working class Americans. In spite of its advancement in terms of technology, and the high quality of care, the American health care system has conventionally been one of the most criticized health care systems by the people in general. A vast majority of the Americans i.e. almost 66.66 per cent are of the view that reducing the cost of medical services and treatment needs to be the government’s top priority. The second major issue of the American health care system is that it is indeed, the costliest health care system in comparison to all countries around the world. In the year 2002, Americans on average spent as many as $2000 per individual on the healthcare services per annum. Of this amount, roughly $1000 were spent on the insurance, almost $500 were spent on the medical services, whereas the rest were spent on the medical supplies and drugs. Up to 12 per cent of the gross national product (GNP) of the Americans is spent on the health care services. Even the Americans who have purchased insurances are often not aware of all the hidden costs charged to them by the private insurance companies. In the year 2008, money spent of health care in the USA was much more than most of the other countries of the world. “In both dollar figures and as a percentage of GDP, no country came within 70 percent of U.S. spending ($7,538 per capita, 16% GDP). This higher spending does not seem to simply reflect higher income” (Squires, 2011, p. 9), whereas in Norway, spending on the health care was only up to 8.5 per cent of the GDP. The Norwegian Health Care System Despite the centralization of the Norwegian health care system, certain issues do persist, the chief amongst which is that it is not very suitable for the rich patients. Waiting times for the patients in Norway are significant, which is why many affording Norwegians opt for foreign medical treatment. Patients in Norway who want to have a hip replacement commonly have to wait for up to four months. “Approximately 23 percent of all patients referred for hospital admission have to wait longer than three months for admission” (Walt, 2009). Such long waits are not only very inconvenient for the patients, but also affect the quality of health care. Pros and Cons of the American Health Care System and the Norwegian Health Care System Comparison of the American health care system and the Norwegian health care system leads to the conclusion that it is hard to consider one better than the other as the health care systems in both the countries have their own pros and cons. If the American health care system is good in terms of quality of health care, immediacy of health care, and the convenience of the patients, it is discriminatory in nature and good health care is not equally accessible to people of all colors, genders, and financial status. On the other hand, although the Norwegian health care system is nondiscriminatory and unbiased and the provision of good health care is for all Norwegians equally, yet the medical treatments are very time consuming and often inconvenient for the patients. Role of Government Role of the government as regulator in the Norwegian health care system is stronger as compared to that in the American health care system, since the system is more centralized and nondiscriminatory in the former as compared to the latter. In the USA, the government as well as the private insurance companies are taking measures to make the American system of health care more focused on primary care rather than a specialist focused system. “The “patient-centered medical home” model—in which a patient can receive targeted, accessible, continuous, coordinated, and family-centered care by a personal physician—has gained particular interest among U.S. experts and policymakers as a means to strengthen primary care” (Thomson et al., 2011, p. 116). The government’s efforts are directed at establishing more patient-centered medical homes in an attempt to minimize the unjustified expenditures, enhance the safety and decision-making of the patients, and improve the delivery of health care everywhere in general. Social and health services in Norway are generally supervised by the Norwegian Board of Health, whose responsibility is to oversee the citizens’ health needs and social services, and ensure the delivery of services in due compliance with the standards established by the government. The Norwegian Board of Health also extends collaboration to eradicate the mistakes and failures in the health care system. The Governmental Regional Boards locally supervises the health care system. Rules pertaining to the rights of patients in Norway include three groups; the right of being a patient, rights as patients, and the procedural rights. Patients in Norway who think that they have been denied any of these rights have the option to ask the supervisory authority for help. The County Medical Officer in the county then supervises the patients’ health services on the state’s behalf so as to make sure that the patients’ rights are granted. My Views The health care system in place in the USA is one of the finest systems in terms of quality, though this positive attributed of the American health care system is balanced by the high cost of treatment and health care services. One of the positive aspects of gaining membership of such organizations as HMOs and PPOs in the USA is that a person exactly knows where to go and who to approach whenever he/she requires medical attention. People are provided with the opportunity to select their primary care physician, who they consult for routinely check-ups and care. People are referred to the specialists by the very primary care physicians when required. This saves the time and energy it takes to select the best physician or specialist for the people. However, the American health care system certainly has some drawbacks, which should principally not exist given the USA happens to be amongst the richest countries in the world. Good health care and affordable medical coverage is the right of all citizens, and not only the richest. Unfortunately, this is not the case in the USA. Probably, if the health care system in the USA is made public rather than private, many of its shortcomings would be eradicated. Today, a lot of Americans do not have any health coverage because of disability or low income. These differences can be eliminated by a public health care system. Owing to the fact that all of the Norwegians are covered by the Norwegian Insurance Scheme and the quality of, and approach to health care is the same for everybody, the waiting lists are often long enough to motivate a considerable population of the Norwegians to pay out-of-pocket and make a visit to a foreign country in order to gain medical attention. While the system of health care established by the Norwegian government is unbiased, private insurance companies are still making money out of the curiosity of some Norwegians to gain medical attention on priority basis. In Norway, the responsibility of selecting the general practitioner rests entirely with the patients as the selection has to be made from the list provided by the government. Patients have to do a little homework in order to decide which general practitioner suits them best. There is a lot of difference between the American health care system and the Norwegian health care system. In Norway, when an individual is in need of the health services, they are delivered to the individual by the government. The government not only makes sure that the health services are provided, but also provides them free of cost to the citizens by personally bearing all the costs associated with the process. One factor that particularly provides the American health care delivery system with an edge over the Norwegian health care delivery system is that the American patients have instant access to medical care unlike the Norwegian patients. In addition to that, some patients in Norway are denied health care just because the treatment is too costly. Whether the health care system of one country is better or worse than the other really depends upon the financial status of the patients. People belonging to different financial statuses have different views about the health care systems in the two countries. Particularly, for the rich, the American health care system is better than the Norwegian health care system since they can get instant medical attention of a very high quality unlike in Norway, whereas for the poor, the Norwegian health care system is better since they have equal access to high quality medical care as the rich.   References: Johnsen, J. R. (2006). Health Systems in Transition. The European Observatory on Health Systems and Policies. 8(1). Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0005/95144/E88821.pdf. Squires, D. A. (2011, July). The U.S. Health System in Perspective: A Comparison of Twelve Industrialized Nations. Retrieved from http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Jul/1532_Squires_US_hlt_sys_comparison_12_nations_intl_brief_v2.pdf. Thomson, S., Osborn, R., Squires, D., and Reed, S. J. (2011, Nov.). International Profiles of Health Care Systems, 2011. Retrieved from http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2011/Nov/1562_Squires_Intl_Profiles_2011_11_10.pdf. Walt. (2009, Oct. 31). The Grass Is Not Always Greener: A Look at National Health Care Systems Around the World – Part 7 – Norway. Retrieved from http://www.drwalt.com/blog/?p=870. Read More