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International Health Systems
The USA has gone its own way towards the realization of the need to create institutions of social medicine. If in the Soviet Union hygienists were responsible for social and social psychiatrists were responsible for the “moral health” before the war for public health, social psychologists were responsible for both aspects in the United States. The Society flourished and then was indeed stable. Therefore, questions about the public health of the American people did not arise. However, clinicians faced the need for an approach to the patient that could take into account such as social data as presence or absence of family, the degree of satisfaction with work or place of residence. It was important for the health care quality (Yee-Melichar, Flores, & Cabigao, 2013, p. 36). However, it is believed that the present situation leaves much to be desired. In the U.S., about 40 million people have no health insurance. Until recently, it was necessary to have insurance on the car, but the purchase of health insurance was voluntary, based on the wishes and financial possibilities. The problem with the lack of such insurance is that somehow medical care will be needed by everyone at some time. Under the federal law, if someone has suffered from appendicitis and comes to the emergency room, it must be treated regardless of the availability of insurance. It is clear that the cost of treating the uninsured falls on the hospital (if the patient lives below the official poverty threshold). As a result, the hospital system has billions of dollars in damages since the poor start to use the emergency room as a clinic. The main thing they teach doctors in America: Medicine is a business of saving lives. Keyword is a business (Roemer, 1991, 148). The basic principle in the United States, which a doctor operates under, is cost-effectiveness. That is, the doctor thinks what is cheaper: to make the analysis now or when the problems start. The paper is going to find out what the advantages and disadvantages of the American medicine are in comparison with the health system in other countries.
Russia may be taken as an example. One of the most pressing social issues in Russia is health care. Almost all Russians today have policies of mandatory health insurance, but the number of those who are completely satisfied with the service in public hospitals is extremely small. According to experts from the British fund “Apax Partners”, 69% of those polled said they were willing to pay extra to the policy OMC to obtain care of higher quality, usually in private medical clinics (Booyens, 2008, p. 47). Today, more and more people trust their health to commercial medical centers, while many go abroad for treatment. Analysts have estimated that each year more than $1 billion is spent on the treatment of Russians abroad. There are not many countrymen who will stay in Russia instead of improving their health in Europe, Israel, the U.S., or other advanced medical countries. It is thus that Russia has still a shortage of medical clinics with modern equipment and the staff who are experienced, qualified professionals. Therefore, clinics are gradually disappearing. People have begun to take care of their health and more value their own time; respectively, they want to be served better and receive a full range of medical services in one place. This means that the future of medicine lies in large multi-industry companies because only they can provide integrated service quality and modern medical care and are willing to be accountable to patients for the actions of their doctors. Consumers are becoming more demanding and selective (Johnson & Stoskopf, 2010, p. 348). We can observe increased competition, and only a large medical corporation can win it. It is not surprising because everyone deems it important that medical assistance be provided on time, with high quality, and through safe and high-level service.
No matter how great achievements of the traditional Chinese medicine have been for centuries, they have been available only to the elite. By the beginning of the PRC in 1949, the average life expectancy was 35 years and one of five born died. The situation changed with the beginning of the reign of Mao Zedong. Already in the early 1950s, system of public healthcare began building extensively at an incredible pace, modeled on the Soviet one and with the great help of the USSR. Semashko health model was then the only correct way to build healthcare in the country with a huge population and territory (Shi & Sinqh, 2012, p. 102). Hospitals and medical institutes of different levels and the first school for nurses and paramedics appeared in the cities. Central county hospitals were organized in rural districts, county clinics appeared in the villages, as well as clinics on industrial plants. What were the benefits of only 10 year-old primitive health care in which one person accounted for thousands of village midwives and paramedics? The benefits however proved to be such that the history of global health had not known and that in 2010 remained out of reach not only in the poorest countries of Africa and even India. By the middle 1960s, 80% of rural and 90% of China’s urban population gained access to a network of medical facilities. Life expectancy passed 50 years; infant mortality fell from 200 per 1,000 live births to 30. China has become one of the first countries in the world to eradicate a number of infectious diseases, particularly smallpox. Today, a high cost of treatment and medicines take a prominent place among other social problems in China. Medical costs eat up about 12 % of the family budget, second only to spending on food. The average cost of treating serious diseases now accounts for about $1000 while the average monthly income of a worker is $250. Business rushed to the industry of drugs and medical devices.
Germany has developed health care, which is considered today to be one of the most humane and social in the world. The basis of the German health care is a national compulsory insurance (GOS). Workers who worked for starvation wages, sickness, and poverty threatened the family breadwinner. Social tensions grew and the German elite had to compromise. The country had the first system of health insurance in the world. Healthy and employed citizens paid in cash (employee paid 2/3 contributions and the employer paid 1/3) not only for treatment, but also for the content of patients. Regulatory functions of the health system are divided between the central government and land authorities (Newhouse, Dearholt, Poe, Pugh, & White, 2008, p. 217). The federal authority develops a national health budget, withdraws or includes new services in the insurance package, and installs all kinds of fees, including diagnostic laboratories and doctors’ fees. Some of these problems are solved through legislation, while others are solved at the expense of the talks between two national associations represented by health insurance companies and doctors. Most German doctors treat patients with both types of insurance. The lion’s share of the salary they receive from the EIC is for servicing of a smaller flow of patients than CRP and for private patients. The “state” pays only for what the standard allows for the occasion. Patients are likely to have to wait in line to see a specialist. Hospitalization rate is not higher than in America, which is a world leader in terms of short-term nature of the queues.
Comparing the above-considered health care systems of the three countries, it is worth highlighting that the main drawback of health care in the U.S. is that 30% of the population does not have access to medicine (Reid, 2009, p. 15). The number of public clinics, hospitals, and outpatient clinics in the United States has been reduced to zero. The question remains to whether the problem will be solved by opening clinics providing public health care. Russia is a perfect example in terms of this aspect. Insufficient allocation of budget for health care leads to the fact that people, even the poor class, tend to be treated in private clinics. So, it is connected with the absence of any insurance. Of course, the problem of the U.S. health care can only be solving by improving several aspects of the peoples life. The first one is to find a solution to the problem of unemployment. Second step is to carry out the experiment by launching public health clinics. Thus, a person will have to pay for treatment a smaller amount of money, which will in general be confined to drugs, whereas the rest will be done from the budget. Of course, it will require many expenses, such as doctors salary that would become a burden of the state, but it will solve the issue of insurance registration. In fact, comparing the USA to China, private medicine cannot cure all the population. When the doctor has a stable salary from the budget and all the expenses of most clinics are paid by the state, patient treatment cost will be lowered. Fortunately, pharmaceuticals in the United States have the best education. To become successful, the project will need to be pursued in the health care system in Germany and have a private practice in half the budget. The only question that can arise in this case is what the effects of private medicine, providing everything necessary to ensure the state will be. The quality of treatment will not affect anything. Everything will come down to the level of service. Perhaps, in that case the United States will lose the lead in the reception rate and patient care, but all patients will be recovered with a minimal loss from their pocket.