HEALTH SYSTEMS – A COMPARATIVE STUDY.

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Running head: HEALTH SYSTEMS – A COMPARATIVE STUDY
Health Systems – A Comparative Study
Name of the Student
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1HEALTH SYSTEMS – A COMPARATIVE STUDY
Table of Contents
Introduction................................................................................................................................2
1. Governance and Structure of Health Care Systems in Canada, Singapore and Japan........2
1.1. Canada.........................................................................................................................2
1.2. Singapore.........................................................................................................................3
1.3. Japan................................................................................................................................4
2. Critically Comparing Health Care Systems in Japan, Canada and Singapore....................5
3. Understanding Health Care Systems in Canada, Japan and Singapore using the
Framework of Efficiency, Effectiveness and Equity.................................................................7
4. Recommendations to Improve the Health Care Systems in Canada, Singapore and Japan8
4.1. Provision of Free or Subsidized Medical Services for Specifically Vulnerable
Sections of the Canadian Population in Canada....................................................................8
4.2. Free Medical Emergency Services in Singapore.........................................................9
4.3. Provision of Medical Care and Facilities in the Medium of English in Japanese
Hospitals and Clinics............................................................................................................10
Conclusion................................................................................................................................10
References................................................................................................................................12

2HEALTH SYSTEMS – A COMPARATIVE STUDY
Introduction
Health systems around the world, especially in the developed countries are
characterized by a number of similar characteristics. Health systems refer to the system of
medical and health care services that are offered to citizens of a country, that is, the system
that citizens can take recourse to in order to seek treatment when suffering from ailments
(Fitzpatrick, 2015). The health systems of developed nations are vastly different from the
health care systems that are seen to exist in developing countries (White, 2015). This report
points out the many similarities and differences among the health systems of Canada,
Singapore and Japan. The report describes the health systems in detail, points out how they
are similar and different at the same time and analyzes the health care systems in each of the
countries using the framework of efficiency, effectiveness and equity.
1. Governance and Structure of Health Care Systems in Canada, Singapore and
Japan
1.1. Canada
The universal system of health care is known to be followed in the country of Canada.
Those who are citizens of the country can benefit from public insurance medical schemes
using which they do not have to pay for most of the medical services that are provided in the
country (Morgan, 2015). The universal health care system as applicable in the country of
Canada is one that is paid through taxes and the waiting period associated with waiting for a
public medical insurance card is not too long either. One does not have to wait for three
months in order to get the public medical insurance card in hand. There are excellent private
medical services that people of Canada can also avail over and above what is made available
by the government (White, 2015). All the provinces in the country of Canada are known to

3HEALTH SYSTEMS – A COMPARATIVE STUDY
provide free medical services in the event of an emergency. Apart from government
insurance plans, that give people in Canada access to basic medical services, there are
additional insurance schemes that can also be procured and which are known also as extended
health plans. Some of the common types of insurance plans that citizens of Canada can avail
in addition to the basic medical services provided to them, are insurance plans that cover the
cost for dental care, prescription medication, prescription eyeglasses, ambulance services and
physiotherapy (Socias et al., 2016). Working professionals in Canada can avail additional or
extra insurance schemes from the companies that they are working for. In certain instances,
the Interim Federal Health Care Department in Canada is also seen to provide medical aid,
assistance and coverage for refugees and asylum seekers (Fitzpatrick et al., 2015).
1.2. Singapore
The health care system that is prevalent in the country of Singapore is also similar to
the health care system that is found to be in place in the country of Canada. It is a universal
health care system with medical services, assistance and coverage being provided by both the
public and the private sector. Health care costs in Singapore are largely met through
government subsidies, national schemes on health insurance, cost sharing as well as
compulsory savings (Yin & Ye, 2018). The health care policies are those that are adjusted by
the government on a regular basis in order to make sure that people benefit from the most
through such policies instead of finding them inadequate (Ong et al., 2016). The standard of
health care in Singapore as such is known to be quite high, given that Singapore is a
developed nation in Southeast Asia and the healthcare structure in the country is akin to the
type of healthcare structure that one can see in place in First World Countries like Canada
and the United States of America (Carroll & Frakt, 2017). There are many statutory boards
that are in place in Singapore that are in charge of the administration of healthcare services in

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the country. These include the Dental Council, the Medical Council, the Pharmacy Council,
the Nursing Board, as well as the Optometrists and Opticians Board. The healthcare
institutions in the country are becoming increasingly expensive in terms of the facilities and
services that they provide due to the rising standard of medical care in the country (Mossallos
et al., 2018).
1.3. Japan
The healthcare system in the country of Japan is of a very high standard, with the
people of the country supposedly having the longest life span (Bloom, 2017). Japan is one of
the leading countries of the world as far as the use of technology is concerned and is seen to
provide its people with state of the art infrastructure when it comes to hospitals and clinics.
The universal health care system is what is followed in Japan as well. Healthcare services in
Japan are provided by both the public and the private sector, with the public health care
insurance facilities being paid through the system of public taxation in the country. It is
important to remember that there is no family doctor system that is prevalent in Japan, and
people who want to get themselves assessed and treated medically, will have to visit a state of
the art hospital or clinic for this specific purpose (Reich, 2015). One major barriers faced by
international populations who want to access the healthcare services in the country is
language. While the Japanese government has been undertaking efforts to provide medical
services in the medium of English, this has proven to be difficult to do (Miyata et al., 2015).
Employers in Japan are known to provide their works with health care policies and insurance
schemes. Both self employed and salaried professionals in Japan are expected to sign up for
the national health insurance schemes, with the insurance premium being subtracted
automatically from the salaries of such persons. Japan is a country that provides free medical
screening processes for certain infectious diseases as well as for pre natal care. The public

5HEALTH SYSTEMS – A COMPARATIVE STUDY
usually pay for thirty percent of the medical costs while the rest is covered by the insurance
schemes (Mossialos et al., 2015).
2. Critically Comparing Health Care Systems in Japan, Canada and Singapore
When it comes to analyzing the health care systems that are prevalent in Canada,
Japan and Singapore, it is crucial to remember first that all the countries follow the universal
system of health care. All of the countries have a public insurance system in place that covers
the medical costs of those who subscribe to such insurance policies in the first place. As such,
the standard of medical care that is provided in the country of Canada is of a very high
standard, as is the standard of health care services that are prevalent in Asian nations like
Singapore and Japan. The citizens of all the three countries get to benefit from a universal
health care system and simply need to sign up for the government insurance schemes in order
to benefit from getting medically examined and treated either for free or for very subsidized
prices. In spite of the rising costs of health care in Canada, Singapore and in Japan, the
universal health care mode system that is in place means that people can always fall back on
the public insurance schemes that are provided by all of the three countries in order to avoid
spending a fortune on medical services and in order to keep themselves healthy and fit all
round the year by going for regular checkups and medical examinations (Mossialos et al.,
2015).
The universal model of health care that is seen to be in place in Canada, in Singapore
and in Japan implies, that the citizens of these countries get to benefit from insurance
schemes that are provided by their employers. It is the employers who take the responsibility
of signing up their employees for either nationalized private medical insurance schemes that
people can fall back on, in order to avail free or subsidized medical assistance and treatment
whenever they need to (White, 2015). The biggest advantage of this is that employees do not

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have to save money to afford medical treatment in Canada, Singapore and Japan (Yin & Ye,
2018). The money needed for paying the premium of the public insurance policies gets
subtracted from the salaries of the employees, which in turn is used by the companies to pay
for the medical insurance schemes that the employees can benefit from, over the long term.
The availability of public and private insurance schemes implies that the public of Canada,
Japan and Singapore do not have to worry about meeting the basic costs of health care. This
is taken care of through the mode of taxation that is prevalent in these countries over and
above whatever is paid as premium for the national insurance policies (Bloom, 2017).
Out of all the health care systems that have been mentioned, it is the country of
Canada that offers the maximum benefits to its citizens where health care is concerned. This
is because the country of Canada is seen to offer free medical services in the event of an
emergency. People who run into accidents or mishaps can get admitted into hospitals and into
the ER department and have services rendered for them without having to pay any money as
a deposit at the time of enrolling in the hospitals (Socias et al., 2016). The health care system
of providing free medical services in the event of an emergency is also something that is
practiced uniformly in all of the Canadian states. All residents of Canada, be it people living
in Alberta, New Brunswick, Ontario, Quebec and other states, can benefit from free medical
attention and immediate care should they run into a medical emergency on the road or
elsewhere. What is particularly notable for the health care system that is offered in Canada is
the fact that the federal health care program in the country is one that extends to the refugees
and hapless asylum seekers as well (White, 2015). It is not only the privileged people of this
developed country who get to have their health costs covered by the government through the
mode of taxation. Those seeking asylum in the country, and who have been given the status
of a refugee or one waiting to be granted status of a refugee, can also avail the health care
services that are provided by the interim federal health care program in the country. No

7HEALTH SYSTEMS – A COMPARATIVE STUDY
refugee or forced migrant has to suffer from lack of medical attention and care when living in
a country like Canada (Fitzpatrick et al., 2015).
3. Understanding Health Care Systems in Canada, Japan and Singapore using the
Framework of Efficiency, Effectiveness and Equity
If one has to analyze the health care systems in Canada, Japan and Singapore using the
framework of efficiency, effectiveness and equity then it can be said that it is the Canadian
system by far which is seen to be the most efficient and the most equitable and therefore the
most effective. Canada, Singapore and Japan are all seen to follow the universal system of
health care and the public and private coverage of insurance costs that is provided in all of
these countries are those that are paid for through the system of public taxation (White,
2015). However, when it comes to providing medical services entirely for free, then it is only
Canada that is seen to make such a unique facility available for its people and not Singapore
and Japan. Citizens of Japan and Singapore can avail subsidized health care services that are
provided through the use of public and private insurance schemes. However, the service is
something that will still have to be paid for by the patient or his family at the end of the day
(Bloom, 2017). The health care policies and practices offered by private and public sectors in
Japan and Singapore are of a very high standard with the state of the art infrastructure and
facilities being accessible for those who are willing to or are able to pay enough money to use
such facilities (Yin & Ye, 2018). For working professionals who are unable to spend
exorbitant sums on health care, there are health insurance schemes that cover some of the
costs, that is, at least sixty to seventy percent of the costs that are incurred for health care,
while the remaining thirty percent is paid by the public, as seen in the country of Japan.
However, it is the health care system in Canada is one that does not require its people to pay
any money at all for medical services provided the person is in medical emergency and in

8HEALTH SYSTEMS – A COMPARATIVE STUDY
most cases, is unable to seek medical attention himself and has to be admitted into the
hospital by another person. It still means though that the person undergoing emergency
medical care in Canada does not have to pay any money at all for the medical treatment and
assistance that is provided to him while he is in critical or emergency care, irrespective of the
state in Canada where he lives (Fitzpatrick et al., 2015). This makes the health care system in
Canada the most efficient and effective, given that the health care system in the country has
the scope of providing free medical services for its people, albeit only in a situation of an
emergency. What also makes the Canadian health care system the most equitable compared
to the health care systems that are prevalent in Singapore and in Japan is that this is a health
care system that can also be accessed by refugees and asylum seekers and not just the citizens
of the country or those staying in the country legally on a residence permit or on a visa.
Refugees and asylum seekers in Canada, who have been compelled to seek out the shelter and
assistance of the Canadian government because of precarious conditions prevailing in their
own countries, such as government persecution, leading them to flee their own nation and
arrive in Canada for protection, can also access this universal system of health care in
Canada. The interim federal health program in Canada provides refugees with the scope of
getting medical treatment and help and without having to compensate financially in order to
do so (Fitzpatrick et al., 2015).
4. Recommendations to Improve the Health Care Systems in Canada, Singapore
and Japan
4.1. Provision of Free or Subsidized Medical Services for Specifically
Vulnerable Sections of the Canadian Population in Canada
The health care system in Canada should aim at providing free medical services or
subsidized medical services not only in the situation of an emergency but also all round the

9HEALTH SYSTEMS – A COMPARATIVE STUDY
year to specific vulnerable sections of the Canadian population like the homeless people,
people who belong to the transgender community who suffer from sexual diseases and people
who suffer from medical conditions such as HIV aids. Transgender people face a lot of
discrimination in medical institutions and clinics around the world, and the surgeries that they
have to undergo for the purpose of a sex change can run into lots and lots of money. The
Canadian health care system should look at providing subsidized health care services for
transgender people at least so that they are given the option of feeling comfortable in the kind
of human body that they want to feel comfortable in, without having to spend a fortune for
this purpose. Similarly with regard to homeless people, the Canadian government should
make an effort to provide them with free medical services over and above emergency
situations, much in the same way that they help refugees, so that the homeless can lead a life
of dignity and with more physical and mental peace and security than they are currently able
to (White, 2015).
4.2. Free Medical Emergency Services in Singapore
Singapore is a country that is faced with rising health care standards which in turn are
accompanied by rising costs in health care. While there are many insurance schemes that are
made available for public use in Singapore by both the private as well as the public sector,
efforts need to be made on the part of the government of Singapore to make free medical
services accessible to the citizens of the country, in medical emergencies at least, much in the
same way that Canada does. This is because Singapore is one of the most developed and
prosperous nations in Southeast Asia and even in the world today, and has the financial
capital that is needed in order to make such a facility available to the public (Yin & Ye,
2018).

10HEALTH SYSTEMS – A COMPARATIVE STUDY
4.3. Provision of Medical Care and Facilities in the Medium of English in
Japanese Hospitals and Clinics
When it comes to the country of Japan, efforts though already being undertaken in
this respect should continue to be made to make health care services accessible in the
medium of English. There is a substantive international population residing in the country of
Japan that is unable to access the major health care facilities that are accessible across the
length and breadth of the country because of the fact that they are not able to communicate in
the Japanese language and also because of the fact that the medical care and service providers
in the country are not familiar with the English language. So it becomes really difficult to
make medical facilities available to foreigners in Japan, which is not ideal at all, and which
can change immediately if the government trained its medical staff and professionals all over
the country on how to communicate in English with international patients (Carroll & Frakt,
2017).
Conclusion
Thus, the health care services that are provided in all the countries of Canada,
Singapore and Japan are of quite a high standard and worth being modeled on by health care
systems in other parts of the world. The health care governance and structure in Canada,
Singapore and Japan is quite effective and efficient with the Canadian health care system
proving to be the most equitable of the health care systems that have been discussed. This is
because the Canadian health care system provides free medical services in the event of an
emergency in all the different Canadian states with the medical care system being accessible
in the country for refugees and asylum seekers as well. The Singaporean health care systems
although based on the universal health care model, need to be made more equitable in the
way that the Canadian health care system is given that Singapore is a country that is highly

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advanced economically, while Japan needs to pay special attention to making its medical
system far more accessible than what it is at the moment.

12HEALTH SYSTEMS – A COMPARATIVE STUDY
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