Comparison of USA Healthcare System with OECD Members

This study compares the healthcare system of the USA with that of Canada and Germany and recommends changes to the American system. It also discusses the similarities and differences in structures, approaches, and concepts of the systems.

Running Head: USA HEALTHCARE SYSTEM 1
USA Healthcare System; Comparison with OECD members
Student’s Name
Institutional Affiliation

USA HEALTHCARE SYSTEM 2
Table of Contents
Introduction...............................................................................................................................................3
Comparison; Health Care System vs. Canadian Health Care System..................................................3
Comparison; Health Care System vs. Germany Health Care System...................................................4
Similarities and Differences in Structures, Approaches, and Concepts of the Systems.......................4
Germany.................................................................................................................................................4
Canada...................................................................................................................................................5
Reforming the USA Health Model...........................................................................................................6
Justification................................................................................................................................................6
Impact of the proposed reforms on the Management of HealthCare Systems in the U.S....................7
Conclusion..................................................................................................................................................8
References..................................................................................................................................................9

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Introduction
Despite the fact that the U.S. being one of the most economically advanced nations in the
world, it lacks a uniform health system (Message et al., 2016). The U.S. system is unique in its
own ways, but has no universal healthcare coverage for its citizens as compared to two OECD
countries; Germany and Canada (US Bureau, 2015). The US system cannot be described as
anything more than a hybrid system because it cannot be said to be a national health service or a
multi-payer national health insurance system. Neither can it be referred to as a single-payer
system (Message et al., 2016). This study is going to look at the comparison of the healthcare
system of the USA with that one of Canada and Germany and then recommend changes to the
American system.
Comparison; Health Care System vs. Canadian Health Care System
Past discussions recommend that the USA should adopt the Canadian health care model.
The models of health care for Canada and U.S. are very different. Unlike Canada, U.S. is a
multi-payer and an entirely private funded system. Canada is a single- payer and is funded by the
public ("Comparing the U.S. and Canadian Health Care Systems", 2018; Ridic, Gleason & Ridic,
2012). It is claimed that the two models are similar culture-wise, that makes the Canadian model
to be a potential future model for the U.S.
The Canadian system does a lot while spending less. The GDP spent for health in the
USA is 16 % while in Canada it is 10.4% (Ridic, Gleason & Ridic, 2012). However, with that
being the case, Canada health care is way better than the USA’s when the death rate of infants
and life expectancy are used to assess performance (Sawyer & Selena, 2018). All citizens in
Canada have universal access to healthcare. That compared to the USA model is a different case

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with the latter not being fully inclusive in care for all of its citizens. In fact, 20 % of non-elderly
Americans is not under governmental health insurance (Ridic, Gleason & Ridic, 2012).
Comparison; Health Care System vs. Germany Health Care System
Like Canada, Germany spends less in its healthcare system as compared to the USA, but
has better health care outcomes (Sawyer & Selena, 2018). There is a concept of solidarity in
Germany whereby the young pay for the old in the same way the rich pay for the poor. The same
case with the healthy paying for the sick and the unmarried paying for families (Ridic, Gleason
& Ridic, 2012). The pharmaceutical pricing and use in Germany is strongly restricted than in the
US. In Germany, a pharmacy must be operated by a pharmacists and consumers must get
prescriptions for medications.
There is universal health care coverage in Germany for all the qualified people (Ridic,
Gleason & Ridic, 2012). However, both systems are faced with challenges of low life
expectancy. In the US, there is poor health care access and coordination, cost effectiveness and
equity. In Germany, there are challenges in coordinating care and controlling costs.
Similarities and Differences in Structures, Approaches, and Concepts of Systems
Germany
Germany depend heavily on work-based social insurance contributions characterized by
different degrees of sharing costs by patients something that cannot be seen in the USA
(Papanicolas & Smith, 2013). Here, all citizens must have a health insurance policy by law.
Those earning less than $ 35,000 are supposed to enroll in sickness funds to assist in their health
care coverage, and those whose income exceed that limit may choose to enroll in private
insurance programs. This kind of model is not like in the USA where there is no a national

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mandatory health insurance for all citizens. The model is similar to the USA only in the case of
private health insurance.
In the past, the German system has tried to link health spending increases to the increase
in workers’ salaries (Janssen, Swart & Lengerke, 2013). However, rationing is un-heard-off in
USA. There are sickness associations in Germany which give funding to physicians and allowing
the private hospitals to negotiate with sickness funds guided by some public laws. Moreover,
competition is regulated in Germany. The Government’s work in Germany is to supervise and
facilitate the national standards for the health system. One similarity between German’s and
USA’s framework is the introduction of cost controls (Papanicolas & Smith, 2013). Physicians in
Germany are salaried and without admitting privileges unlike in the U.S.
Canada
Canada like America covers all medically essential and suitable services plus also debate
the restriction of openly distinct coverage. Canada does not have home care and drugs within its
public system. However, it has a national health insurance program called Medicare unlike the
USA (Munro, 2016). Also, seventy percent of Canadian health bills is from national and
provincial common incomes. The public healthcare budget is itself an upper limit. The system
also has waiting lists. Physicians’ organizations and private hospitals directly bargain for
compensation with agencies of government since healthcare is provided by these private
institutions. USA differs from Canada in that the government also provide care to certain groups
of people. Canadians are however similar to insured Americans in the use of physician services
because their rate of private coverage is similar.

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Reforming the USA Health Model
In order to reform the poorly performing USA healthcare model, there are certain reform
principles that should be considered (Obama, 2016).
First is ensuring that there is an appropriate health care coverage is by all U.S. citizens
even those with monetary constraints. Secondly is ensuring that families and individuals have
tragic health coverage. To add on that there also needs to be reforms in improving the quality of
health care and safety (Kushniruk, Bates, Bainbridge, Househ & Borycki, 2013). Moreover, there
should be a reform that leads to easy access to suitable healthcare that is a private and public
supportive effort.
Additionally, the system should allow individuals as well as employees to purchase extra
insurance services. There needs to be a reformed system that has an extensive cost management,
and less complicated administration. Good reforms come with deep research and that
necessitates the providence of funds for research of health services, education and a detailed
health information technology setup and execution. There also needs funds for the public health
sector to include other effective medical services that covers mental health matters, preventive
measures as well as mental health services. Last, but not least reforms should extend to all-
inclusive medical liability (Shi & Singh, 2015).
Justification
It is clear that the USA healthcare system is faced with many challenges that push for the
need for reforms. There is a huge number of Americans that is not insured who are faced by
challenges in catering for the unplanned costs. The quality of care in the USA is certainly low
and not as efficient as a country like USA should be. It is discouraging that Americans have poor
health coverage despite the government spending more money per individual on health care as

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compared to any other nation in the world. There should be necessary reforms put in place to
ensure that the number of uninsured Americans go down instantly. That can be by introducing
universal insurance program for all Americans of all age and not just a few particular group of
people.
Moreover, Reforms should focus on the often overlooked preventive care that has
resulted to more costs incurred in treating complex and advanced diseases (Giaimo, 2018).
The American reform program will help improve the quality and value of care. Poor
quality healthcare, high costs and the extreme population without health insurance cover are the
common experiences of many Americans today. Many American do not receive the necessary
healthcare and above that others receive unnecessary care that may even turn to be harmful. It is
sad when many Americans overstay in hospitals or have to pay unending visits to specialists.
That is how low the quality of care is at the USA.
By considering people of all classes, the system will improve the health status of the
entire America. It will also protect individuals and families from extreme financial ruin. Quality
health care will reflect an ideal outcome for the resources exhausted. The highlighted reforms
will also ensure an improved personal health responsibility.
Research reforms are necessary to solve the gaps in evidence that lacks in major areas
affecting health services. There is limited evidence to show the efficiency of treatment and
procedures. There is also not enough evidence to show how to inform specialist providers about
the effectiveness of various treatments. Limited error detection also comes with limited available
evidence.

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The Impact of the proposed reforms on the Management of HealthCare Systems in the U.S.
The proposed changes in the model of the U.S. healthcare system can inspire changes to
the managers in many ways. First managers may think of restructuring the model so that it can
compare to that of Canada and Germany. The reforms are an eye opener on how the GDP
invested in the healthcare sector will be put to better use in ensuring that the American healthcare
investment reflects on the health care outcomes. Managers will be able to develop research
models to look into the key areas of how to improve the current system. Moreover, managers
will be inspired to push for governmental full support of the insurance programs for all citizens.
Moreover, managers could find some meaning on investing funds to the public health sector.
Conclusion
In conclusion, the USA model of healthcare requires instant repair so that it can reach to
the standards of other OECD countries like Germany and Canada. The system lacking a
universal health insurance policy for its citizen is not reasonable despite it being a high spender
on the health of an individual; citizen. The high percentage of GDP invested in health should
reflect an efficient system with improved health care for all. By so doing, America could reach to
high levels of care as per international standards and to the class of nations like it.

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References
Bureau, U. (2015). Health Insurance Coverage in the United States: 2014. Retrieved from
https://www.census.gov/library/publications/2015/demo/p60-253.html
Comparing the U.S. and Canadian Health Care Systems. (2018). Retrieved from
http://www.nber.org/aginghealth/fall07/w13429.html
Giaimo, S. (2018). Reforming Health Care in the United States, Germany, and South Africa:
Comparative Perspectives on Health Perspectives in Comparative Politics (pp. 34-79).
Palgrave Macmillan US.
Janssen, C., Swart, E., & Lengerke, T. (2013). Health Care Utilization in Germany: Theory,
Methodology, and Results (pp. 102-231). New York: Springer Science & Business
Media.
Kushniruk, A., Bates, D., Bainbridge, M., Househ, M., & Borycki, E. (2013). National efforts to
improve health information system safety in Canada, the United States of America and
England. International Journal Of Medical Informatics, 82(5), e149-e160. doi:
10.1016/j.ijmedinf.2012.12.006
Message, P., Statement, D., Staff, D., AFL-CIO, D., Unions, A., & Constitution, D. et al. (2016).
The U.S. Health Care System: An International Perspective. Retrieved from
http://dpeaflcio.org/programs-publications/issue-fact-sheets/the-u-s-health-care-system-
an-international-perspective/
Munro, D. (2016). Casino Healthcare. Cork: BookBaby.
Obama, B. (2016). United States Health Care Reform. JAMA, 316(5), 525. doi:
10.1001/jama.2016.9797

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Papanicolas, I., & Smith, P. (2013). Health system performance comparison (pp. 14-273).
Maidenhead: McGraw Hill Education.
Ridic, G., Gleason, S., & Ridic, O. (2012). Comparisons of Health Care Systems in the United
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10.5455/msm.2012.24.112-120
Sawyer, B., & Selena, G. (2018). How does the quality of the U.S. healthcare system compare to
other countries? - Peterson-Kaiser Health System Tracker. Retrieved from
https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-
compare-countries/#item-five-year-survival-rates-certain-cancers-higher-u-s-comparable-
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Shi, L., & Singh, D. (2015). Essentials of the U.S. health care system (pp. 25-350). Jones &
Bartlett Publishers.