Health care around the globe
 
Source: USA TODAY, Andrew Seaman, 9/22/2009
 
A look at how other developed countries provide and pay for health care compared with the U.S. system, based on the most recent information available:
 
United States
The U.S. health care system operates through a combination of public and private insurers. Two of the largest government-run insurance programs are Medicaid and Medicare, which are funded by income taxes and available to low-income citizens and the elderly. Those not in government-run programs must find coverage through the private market, from their employer or go uninsured. Care is largely provided by private doctors at private facilities.
 
Germany
Germany requires people making less than about $70,000 a year to have health insurance, which is operated by more than 200 competing, non-profit insurance companies. Those making more than $70,000 a year have the option to be under the mandatory health care, or they can buy private insurance or go uninsured. The system is funded through an income tax. Care is provided by private doctors and a mix of private and public hospitals.
 
Sweden
Sweden provides universal health care coverage. The program is funded through central and local taxes and co-payments on services. The national government regulates the system, but the local governments organize the care facilities. Doctors can be government employees or private practitioners because the local governments can decide what system is best for their community. In most cases, hospitals are owned and operated by the local government.
 
Canada
Canada provides universal health care; however, many Canadians purchase insurance to supplement the government program. The program is funded through general taxation, and any supplemental insurance is paid out-of-pocket. The majority of doctors are not employed by the government. Hospitals can be either public or private, but their budgets are negotiated with the government.

Italy

Italy offers health care to all residents. Funding for the health care system comes from a mix of income taxes, local taxes and co-payments. Care is delivered through private doctors. Most hospitals are government-run. There are some private and for-profit hospitals.

Spain

Spain provides universal health care coverage; however, a small portion of the population purchases supplemental health insurance. The funding comes from taxes and out-of-pocket payments. The national government decides the direction of the system, while the local governments determine how the care is delivered. Doctors are private practitioners, and the majority of hospital beds are government-owned.

Australia

Australia provides health care to citizens, permanent legal residents and visitors from certain countries. The care is funded by an income tax and rebates to a supplemental insurance program. Care is provided by private doctors. Public hospitals provide free care, while private hospitals tend to cater to people with private insurance.

Netherlands

Everyone living or working in the Netherlands is required to purchase health insurance. Insurers are required to offer a government-mandated standard package and provide coverage to all. The government gives subsidies to companies that take on high-risk clients with chronic illnesses and severe disabilities. Minors, the unemployed, the elderly and people who are not able to pay for insurance are covered through a government fund, which is paid for through income taxes. Care is provided through private doctors and care facilities.

United Kingdom

The U.K. offers health care to all people "ordinarily resident" in the country. Most services are free or available with a small co-payment. The main source of funding is general taxation. Doctors and hospitals are generally employed and operated by the government; however, there are private practitioners who may or may not be reimbursed by the government.

France

France provides health care for all living in the country — legally and illegally. The main source of funding is payroll and income taxes; however, the government implements some cost-sharing techniques, including co-payments and extra billing. Care is provided by private doctors, even though the majority of hospitals are owned by the government.

Sources: McKinsey; The Commonwealth Fund; Organization for Economic Cooperation and Development; Central Intelligence Agency; The Harris Poll; Spanish Ministry of Health and Consumer Affairs

PHYSICIAN COMPENSATION - The median earned by selected doctors in the USA in 2008, by specialty:
 
Specialty Median income
Geriatrics $179,344 
Family medicine $190,182 
Pediatrics & adolescent $193,964 
Internal medicine $199,886 
Urgent care $200,904 
Sports medicine $205,026 
Psychiatry $206,431 
Orthopedic-medical $209,000 
Infectious disease $220,601 
Pediatric intensive care $228,434 
Neurology $229,119 
Allergy and immunology $233,894 
Gynecology $234,197 
Emergency care $256,879 
Pulmonary disease $267,148 
Gynecology & obstetrics $283,110 
Hematology & medical oncology $301,809 
Ophthalmology $305,301 
General surgery $337,595 
Dermatology $344,847 
Trauma surgery $352,339 
Anesthesiology $352,959 
Radiation therapy $395,166 
Transplant surgery, liver $415,428 
Orthopedic surgery $450,000 
Cardiac & thoracic surgery $497,307 
Orthopedic surgery, joint replacement $520,000 
Neurological surgery $581,258 
Orthopedic surgery, spine $611,670 

Source: Cejka Search
 

BY THE NUMBERS: How the U.S. health care system stacks up against other countries on some key financial and medical indicators
 
USA Germany Sweden Canada Italy Spain Australia Netherlands United Kingdom France
percentage of health expenses as a share of Gross Domestic Product, 2007  16% 10.4% 9.1% 10.1% 8.7% 8.5% 8.7%³ 9.8%¹ 8.4% 11%
percentage of health expenses paid with public funds, 2007  45.4% 6.9% 81.7% 70% 76.5% 71.8% 67.7% 62.5%**  81.7%  79%
Life expectancy at birth, 2009{+1} (in years)  78.1 79.3  80.9  81.2  80.2  80.1  81.6  79.4  79  81 
Infant mortality rate per 1,000 live births, 2009{+1}  6.3 4  2.8  5  5.5  4.2  4.8  4.7  4.9  3.3 
percentage of people who want to completely change the health care system, 2008  33% 17%  NA  12%² 20% 12% 18%² 9%² 15%  15% 
Inpatient surgical procedures per 1,000 population, 2004  90  79  62  45 53 51 51 40 63 NA
Hospital bed occupancy, 2005  67%  76% NA 90% 76% 71.6% 71% 64% 84% 75%

1—estimate; 2—2007; 3—2006;

**—2002 Sources: McKinsey; The Commonwealth Fund; Organization for Economic Cooperation and Development; Central Intelligence Agency; The Harris Poll; Spanish Ministry of Health and Consumer Affairs
 

Comments: (175)
 
 
texas42 (2 friends, send message) wrote:9/25/2009 3:56:50 PM
artbcpa (0 friends, send message) wrote: 1d 11h ago

The staff of USA Today spends hundreds of hours researching the issues regarding health care and commenters with no or few facts to back up their agendas want us to believe they know more. Right! The statistics being bandied about here in the comments section bear no resemblance to the size of the problem. What about all the people who are underinsured or are paying exorbitant prices for poor insurance? I am one of those who is covered by the California state insurance plan for those who are "uninsurable", at least according to insurance companies whose ONLY INTEREST is in making a profit. That concept may be OK for an automobile or refrigerator, but is that really how we want our citizens to receive their health insurance coverage. And to those who complain that government beauracrats will be making decisions on health care, remember that under the current system it is not doctors and patients who are making those decisions, but insurance company executives and employees who have NO INTEREST in your welfare. So instead of defending a broken system, why don't you try and help us fix the system through a genuine debate of the issues, rather than name calling and presenting false arguments.
=================

The funny thing is that you think a government buearocrat, who is not elected, but appointed and gets paid the same no matter how much he improves your life, has an incredibly secure job, a good pension, and whose only concern is to make his numbers look good to his boss is going to do a better job.

Long story short, I think there are lots of things that can be fixed in the healthcare. None of those things are going to be addressed by this congress (or any congress that might get elected any time soon).

The whole "public option" won't improve competition. Over-regulating the insurance companies out of business isn't going to improve choice.

1. We need to make insurance companies more competative. Today we have more of a monopoly system. Open up states borders.
2. We need to make insurance portable. The idea that your insurance should be tied up with you job is stupid. It limits your choice as a consumer, limits competition, and the obvious downfall of losing your coverage when you loose your job. Why people like it, I don't know. That means that individuals should get the same tax breaks as companies for buying insurance. A better solution would be for companies to pay the money into a "healthcare savings" account that is the employee's and they can use it for drastic medical costs
3. Insurance is insurance. It shouldn't be used for healthcare maintenece. It is for disasters. A high deductable and a very high catastrophic policy should be mandatory for all Americans to buy.
4. Tort reform.. . duh
5. Get illegals out of the country. Make a way for productive members to stay and become American citizens. Get the rest out. That means making some requirement of legal parents to become American citizens for children.
 
 

Long story short, socialized healthcare is very good at health maintenece. Giving out birth control and handing out antibiotics for the sniffles.

It stinks at the expensive stuff like surgery and cancer. And forget about new drug development. The US provides over half of the new drugs in the entire world. We subsidize them. We pay higher prices so they don't have to. Isn't that cool? (not).

 
 
 
 
texas42 (2 friends, send message) wrote:9/25/2009 3:40:53 PM
That mortality rate is apples to oranges.

European countries don't count babies that die before a certain trimester. The US does.

 
 
 
 
kpasa01 (0 friends, send message) wrote:9/25/2009 3:33:23 AM
Hmm..... Two main things to look at here when you see these numbers. Life expectancy. We are the lowest, not because we have a poor healthcare system but, because we, as Americans, are the fattest and laziest group up there. Now, look at the number of inpatient surgical procedures. This number only shows that we ARE fat, lazy and unhealthy. The poor eating habbits of Americans has worked itself into our genes and now we are fatter and more at risk for cardiovascular problems than any other country.
Also, if universal healthcare is so good in these other countries, why do some of them have a secondary supplimental insurance?
artbcpa
You complain about your insurance provider so much, which is a state ran insurance (government ran) and you just want another type of government ran insurance in its place? Your argument contradicts your reason. If you want to see a change, don't use a government band-aid. Hit the insurance companies where it hurts. Make lobbying and any form of it illegal. Hit the pharm companies where it hurts, by getting rid of their puppet known as the FDA. Ther is no reason why prescription drugs should cost so much. Do some research rather than listening to all the BS you hear about universal healthcare and how "good" it is. Just look at medicare and medicaid. Both of them are in the hole. Big Time! They are both ran by the government. Do you want your insurance company to be that much of a cluster f***?
Just look at other statistics that are self evident. Obesity in America is a pandemic. Heart disease is the number one killer. Don't you think for just a single second that our poor eating and lifestyles have something to do with that? So you want the government to try to take on that burden? As a healthcare worker, I see these poor habbits all of the time. Plenty of repeat customers, simply because they are either non-compliant with their meds or because they use their meds as a crutch and an excuse for their poor eating habbits.
Where are your statistics that support it? And I don't want to hear, "I want quality heatlhcare!" Hey, newsflash! It is a FEDERAL LAW that if you walk into an emergency room, you cannot be refused care. Don't worry about paying for it either. Typically only around 10% of people that walk into an emergency room actually pay for their services. I have seen multiple free surgeries done, including heart transplants. What's your excuse now?
I don't want a socialist band-aid. I want the insurance companies to live by this motto: "I pay you, so you pay for me!"
 
 
 
 
Ricardo Head (2 friends, send message) wrote:9/24/2009 12:47:51 PM
Another reason health care costs are so high here is that Americans are fat and unhealthy to begin with compared to the rest of the world. We eat fast food garbage every day and our idea of exercise is pushing the carts around Target or Wall Mart.
 
 
 
 
cfnnv (0 friends, send message) wrote:9/24/2009 10:40:21 AM
obcoach (0 friends, send message) wrote: 2h 54m ago
Convincing: numbers we in the US have a broken healcare system. Only Doctors and Insurers benefit.

NOTE - We spend more of our country's wealth (16% of GDP), have a lower life expetency, higer infant mortality rate, and ironically have more inpatient surgical procedures (probably due to doctors wanting to bill for unnecessary procedures) than any other of the 9 industrial countries listed.
------------------------------------------------ ------------------------------------------------ ---------------------------------------------- I don't know about our Healcare system but our Health care system does need some work. But I'd like to address your note. I spent time in France last year so I can compare our lifestyle and theirs. Here in the US I'm on low end of the greedy stressful always in a hurry lifestyle. In France I would be on the high end. I believe that contributes to our lower life expectancy. And the infant mortality can be directly attributed to the number of high risk pregnancies. You don't see the early teen pregnancies their you see here. You don't see the welfare mothers constantly getting pregnant and having kid after kid to get more money from the government. And I believe the doctors do more procedures because 1- the people expect and ask them to do more. and 2- They are covering their butt because of all the malpractice suits.

 
 
 
 
 
kjbnice (0 friends, send message) wrote:9/24/2009 8:11:12 AM
Bobby, I like most of your ideas except the first one. Profit drives innovation; innovation finds cures. Its the fastes, easiest way to better health care
 
 
 
 
 
Bobby 49 (0 friends, send message) wrote:9/24/2009 7:58:04 AM
Subject the entire system to this basic premise...It is immoral to make a profit from the sick and dying.Eliminate attorneys from the system in any way shape or form .Dont spend any health care monies on those who dont care about their own health or give them a grade on how they take care of themselves and reduce their risk factors and mete out care accordingly.
This will fix the system.
 
 
 
 
 
jobcoach (0 friends, send message) wrote:9/24/2009 7:15:55 AM
Convincing: numbers we in the US have a broken healcare system. Only Doctors and Insurers benefit.

NOTE - We spend more of our country's wealth (16% of GDP), have a lower life expetency, higer infant mortality rate, and ironically have more inpatient surgical procedures (probably due to doctors wanting to bill for unnecessary procedures) than any other of the 9 industrial countries listed.