Thursday, December 20, 2007

Health care systems

In reading back issues of Newsweek today I came upon an article describing the "medical tourism," the phenomenon where people travel to other countries for medical procedures. Before this article I had associated "medical tourism" with people going to Mexico for transgender surgery before it was legal here and people getting vanity procedures in various exotic locations. Apparently many people go to Singapore becaues their medical system is just that good. People from India and other Asian countries go there for various surgeries because of the good care and because of the availability of organs for transplant and people from the US will go there because they can get the same procedures (with high quality) for a fraction of the cost.

I had heard about Singapore's health care system during some conversation about the ills of America's privatized health care, but I hadn't realized that it was so good that people would fly across the world to take advantage of it. I examined Singapore's Ministry of Health page and concluded their health care system is organized and friendly. (They even have a thing where you can compare the costs of treatments at different hospitals.) From their website, "Primary health care includes preventive healthcare and health education. Private practitioners provide 80% of primary healthcare services while government polyclinics provide the remaining 20%. However, public hospitals provide 80% of the more costly hospital care with the remaining 20% by private hospital care." Also, for those who care about numbers, "In 2005, Singapore spent about S$ 7.6 billion or 3.8% of GDP on healthcare. Out of this the Government expended S$1.8 billion or 0.9% of GDP on health services."

I also looked up the World Health Organization's ranking of world health systems. (A total of 190 countries are ranked.) The ranking method compares each country's sytem to what the experts estimate to be the upper limit based on resources etc. It also compares each country to other countries. The assessment was based on the following 5 indicators: overall health of population, health inequalities within the population, overal level of health system reponsiveness, distribution of responsiveness within the population, and distribution of the health care system's financial burden within the population. (Read the report.)

The United States is 37th, behind Costa Rica and before Slovenia. (Shameful, no, that with all of its educational and technological resources the US is not further up?) While one might wonder if the US is so behind due to inquality (still inexcusable), I'm inclined to believe the overall level is not as high. If you are curious, Postpartum Impression is a New York Times piece on the French health care system.

The top 10 are:
1         France
2         Italy
3         San Marino
4         Andorra
5         Malta
6         Singapore
7         Spain
8         Oman
9         Austria
10        Japan

Not trying to push my values onto you or anything, but here's a quote from WHO's report:
"It is especially beneficial to make sure that as large a percentage as possible of the poorest people in each country can get insurance," says Dr Frenk. "Insurance protects people against the catastrophic effects of poor health. What we are seeing is that in many countries, the poor pay a higher percentage of their income on health care than the rich."

"In many countries without a health insurance safety net, many families have to pay more than 100 percent of their income for health care when hit with sudden emergencies. In other words, illness forces them into debt."

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