The United States is the only industrialized nation that doesn't have an extensive system of government guaranteed health services. Although the details of their systems vary, all industrialized countries other than the United States have a system of health care that guarantees benefits to all their residents.

Health reformers in the United States have often focused on Canada, our northern neighbor. Doctors in Canada are private, self-employed, fee-for-service practitioners. But, instead of being paid directly by consumers or individual insurance companies as in the United States, they are paid by a national health insurance system on a common fee schedule.

The fee schedule is negotiated in each province between provincial officials and the medical association. Hospitals also operate on budgets provided by the provincial government. Although Canadians pay higher taxes than U.S. citizens do, they pay a smaller proportion of their gross domestic product for medical services.

Great Britain began its National Health Service or NHS, in 1948; becoming the first Western society to offer free medical care to the entire population. General practitioners, who work out of a solo office or in a group practice, are the major health care providers in Great Britain and are paid a certain amount each year for each patient who is restricted by legislation. Patients may choose their own doctors.

When a patient needs special treatment or hospitalization, the general practitioner refers the patient to a specialist, who is paid a yearly salary by the government. Physicians may also take private patients, who tend to receive faster treatment and more luxurious facilities. Again, even though the British pay higher taxes than Americans, a smaller proportion of their GDP is devoted to medical expenses. In addition, survey data indicates that Britons overwhelmingly consider the health service to be a success.

Even though they are much poorer than the United States, most developing countries also provide free health care to their citizens. For instance, Kenya is a very poor country toward the bottom of the global stratification ladder. Yet it has a national health service that owns hospitals and employs doctors and other health workers and guarantees health care to all citizens.

Similar systems are found in other poor countries in sub-Saharan Africa and throughout the world. Unfortunately, because of the sharp differences between cities and the rural areas, only relatively small proportions of the population receive high quality health care. The best equipped hospitals and clinics are in the cities, where the most educated and wealthiest citizens live.

In addition, there are far from enough medical personnel. Kenya has only one doctor for every 20,000 citizens. In contrast, the United States has one doctor for about every 400 citizens.

Source From: Discovering Sociology, Stockard, 2000

© 2004 by the AfroStaff