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However higher costs does not mean better quality of life, health statistics in Spain show higher life expectancies (82.2 years), lower mortality rates (10.9/1000), and overall lower incidences of population major diseases (diabetes:9.0%, cardiovascular diseases: 23.15%, obesity: 23.95%) compared to US [life expectancies (78.6 years) mortality rates (13.9/1000), major diseases (diabetes:10.85%, cardiovascular diseases: 15.6%, obesity: 31.7% ) (National Center for Health Statistics, 2013; World Health Organization, WHO, 2012).
Differences come from lifestyle habits, the Spanish have an active lifestyle and Mediterranean diet, and the US a sedentary lifestyle coupled with unbalanced diet (Borkan, et al., 2010; The Department for Professional Employees, DPE, 2013; National Center for Health Statistics, 2013; WHO, 2012). Health Care Financing: Comparison between US and Spain The US has hybrid healthcare financing: government medical subsidy is combined with private or group insurance for payments: private funding ( insurance or individual’s out-of-pocket payments) amount up to 50% of the total health care spending, with the rest from federal (38%) and local or state funds (12%) (DPE, 2013).
For Spain, after healthcare reform financing is also shared, but the government pays up to 74% of the expenses, the rest is paid by individuals or employers (Legido-Quigley, et al., 2013). Spanish healthcare relies more heavily on taxes than US healthcare, contributing to lower healthcare costs per person compared with the latter (WHO, 2012). Health Care Administration: Comparison between US and Spain The US principal agency in healthcare provision is the Department of Health and Human Services (HHS), which works with other agencies (e.g. Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, etc.) to improve the population’s health through research and development, establishment of quality standards, among others (National Center for Health Statistics, 2013).
In Spain the Spanish National Institute of Health (Instituto Nacional de Salud, INSALUD) similarly functions as the HHS in providing the public with quality health services, however unlike HHS it is decentralized and delegates power over regional health communities (Borkan, et al., 2010). Health Care Personnel and Facilities: Comparison between US and Spain Only around one-fifths of the healthcare facilities in the US are government-owned and the rest are private institutions, accounting for high healthcare costs per individual (DPE, 2013).
A low physician-to-patient ratio of 24 physicians per 10,000 people promotes high healthcare costs but less quality services (Holtz, 2008; National Center for Health Statistics, 2013). In Spain, healthcare facilities are mostly government-owned and subsidized, and physicians and nurses are salaried, which reduce additional costs per individual (Borkan, et al., 2010). Also, services are better due to a higher physician-to-patient ratio, 39 per 10,000 persons (WHO, 2012). Access and Inequality Issues: Comparison between US and Spain US ranks first in terms of health care responsiveness due to its state-of-the-art health care delivery system, which contributes to an increase in preventable deaths (Holtz, 2008; WHO, 2012). Spain’
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