Health Care Systems Around the World: A Comparative Guide

606 Pages·2013·16.48 MB·English

by  Sarah E. Boslaugh

HEALTH CARE SYSTEMS
AROUND THE WORLD

HEALTH CARE SYSTEMS
AROUND THE WORLD
A Comparative Guide
Sarah E. Boslaugh
Kennesaw State University
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London EC1Y 1SP Health care systems around the world : a comparative guide /
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[DNLM: 1. Delivery of Health Care--organization & administra-
tion. 2. Cross-Cultural Comparison. 3. Health Policy. 4. Health
Status. 5. World Health. W 84.1]
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CONTENTS
About the Author .............................................viii
Introduction ........................................................ix
Country Rankings ............................................xiii
Chronology ........................................................xxi
Countries
Afghanistan..................................................................1 Canada........................................................................80
Albania..........................................................................6 Cape.Verde..................................................................85
Algeria...........................................................................8 Central.African.Republic...........................................87
Andorra......................................................................10 Chad............................................................................90
Angola.........................................................................12 Chile............................................................................92
Antigua.and.Barbuda.................................................15 China..........................................................................96
Argentina....................................................................18 Colombia..................................................................101
Armenia......................................................................20 Comoros...................................................................103
Australia......................................................................23 Congo,.Democratic.Republic.of.the........................106
Austria........................................................................27 Congo,.Republic.of.the............................................108
Azerbaijan...................................................................30 Costa.Rica.................................................................110
Bahamas.....................................................................33 Côte.d’Ivoire.............................................................113
Bahrain.......................................................................35 Croatia......................................................................116
Bangladesh.................................................................38 Cuba..........................................................................119
Barbados.....................................................................40 Cyprus......................................................................122
Belarus........................................................................43 Czech.Republic.........................................................124
Belgium.......................................................................45 Denmark...................................................................127
Belize...........................................................................48 Djibouti....................................................................130
Benin...........................................................................50 Dominica..................................................................132
Bhutan........................................................................52 Dominican.Republic................................................134
Bolivia.........................................................................55 Ecuador.....................................................................137
Bosnia.and.Herzegovina............................................58 Egypt.........................................................................139
Botswana....................................................................59 El.Salvador................................................................142
Brazil...........................................................................62 Equatorial.Guinea....................................................145
Brunei.........................................................................65 Eritrea.......................................................................147
Bulgaria.......................................................................67 Estonia......................................................................149
Burkina.Faso...............................................................69 Ethiopia....................................................................152
Burundi......................................................................73 Fiji.............................................................................156
Cambodia...................................................................75 Finland......................................................................158
Cameroon...................................................................78 France.......................................................................161
Gabon.......................................................................166 Micronesia................................................................300
Gambia,.The.............................................................168 Moldova....................................................................302
Georgia.....................................................................171 Monaco.....................................................................304
Germany...................................................................173 Mongolia..................................................................306
Ghana.......................................................................177 Montenegro..............................................................309
Greece.......................................................................181 Morocco....................................................................310
Grenada....................................................................184 Mozambique............................................................313
Guatemala................................................................186 Myanmar..................................................................316
Guinea......................................................................189 Namibia....................................................................319
Guinea-Bissau..........................................................191 Nauru........................................................................321
Guyana......................................................................194 Nepal.........................................................................323
Haiti..........................................................................196 Netherlands..............................................................325
Honduras..................................................................200 New.Zealand.............................................................329
Hungary....................................................................203 Nicaragua.................................................................332
Iceland......................................................................205 Niger.........................................................................335
India..........................................................................208 Nigeria......................................................................337
Indonesia..................................................................212 North.Korea..............................................................340
Iran...........................................................................215 Norway.....................................................................342
Iraq............................................................................218 Oman........................................................................346
Ireland.......................................................................220 Pakistan....................................................................348
Israel.........................................................................223 Palau.........................................................................352
Italy...........................................................................226 Panama.....................................................................354
Jamaica.....................................................................230 Papua.New.Guinea...................................................356
Japan.........................................................................232 Paraguay...................................................................359
Jordan.......................................................................235 Peru...........................................................................361
Kazakhstan...............................................................238 Philippines................................................................364
Kenya........................................................................241 Poland.......................................................................368
Kiribati......................................................................244 Portugal....................................................................370
Kuwait.......................................................................246 Qatar.........................................................................374
Kyrgyzstan................................................................248 Romania...................................................................377
Laos...........................................................................251 Russia........................................................................379
Latvia........................................................................253 Rwanda.....................................................................382
Lebanon....................................................................255 Saint.Kitts.and.Nevis................................................384
Lesotho.....................................................................258 Saint.Lucia................................................................386
Liberia.......................................................................261 Saint.Vincent.and.
Libya.........................................................................263 the.Grenadines.....................................................388
Liechtenstein............................................................266 Samoa.......................................................................390
Lithuania..................................................................267 San.Marino...............................................................392
Luxembourg.............................................................270 São.Tomé.and.Príncipe............................................394
Macedonia................................................................272 Saudi.Arabia.............................................................397
Madagascar...............................................................275 Senegal......................................................................399
Malawi......................................................................277 Serbia........................................................................402
Malaysia....................................................................280 Seychelles..................................................................404
Maldives....................................................................283 Sierra.Leone..............................................................406
Mali...........................................................................285 Singapore..................................................................409
Malta.........................................................................288 Slovakia.....................................................................411
Marshall.Islands.......................................................290 Slovenia.....................................................................414
Mauritania................................................................292 Solomon.Islands.......................................................417
Mauritius..................................................................294 Somalia.....................................................................419
Mexico......................................................................297 South.Africa..............................................................421
South.Korea..............................................................425 Tunisia......................................................................471
Spain.........................................................................428 Turkey.......................................................................473
Sri.Lanka...................................................................431 Turkmenistan...........................................................476
Sudan........................................................................433 Tuvalu.......................................................................478
Suriname..................................................................436 Uganda......................................................................479
Swaziland..................................................................439 Ukraine.....................................................................483
Sweden......................................................................441 United.Arab.Emirates..............................................485
Switzerland...............................................................445 United.Kingdom......................................................487
Syria..........................................................................448 United.States.............................................................492
Taiwan.......................................................................451 Uruguay....................................................................498
Tajikistan..................................................................453 Uzbekistan................................................................500
Tanzania....................................................................456 Vanuatu....................................................................502
Thailand...................................................................459 Venezuela..................................................................504
Timor-Leste.(East.Timor).......................................462 Vietnam....................................................................506
Togo..........................................................................464 Yemen.......................................................................509
Tonga........................................................................467 Zambia......................................................................512
Trinidad.and.Tobago................................................468 Zimbabwe.................................................................514
Bibliography ...................................................519
Resource Guide ..............................................525
Glossary ..........................................................529
Index ................................................................537
ABOUT THE AUTHOR
Sarah E. Boslaugh,.Ph.D.,.M.P.H.,.has.over.20.years.of.experience.in.statistical.analysis,.grant.writing,.and.teach-
ing;.her.employers.and.clients.have.included.the.New.York.City.Public.Schools,.Montefiore.Medical.Center,.Saint.
Louis.University,.and.Washington.University.School.of.Medicine..She.served.as.editor-in-chief.for.the.Encyclo-
pedia of Epidemiology.(SAGE,.2007),.and.has.published.three.additional.books:.An Intermediate Guide to SPSS
Programming: Using Syntax for Data Management.(SAGE,.2004),.Secondary Data Sources for Public Health: A
Practical Guide.(Cambridge.University.Press,.2007),.and.Statistics in a Nutshell.(O’Reilly,.2nd.ed.,.2012)..
Boslaugh.received.her.Ph.D..in.measurement.and.evaluation.from.the.City.University.of.New.York.Graduate.
Center.and.her.M.P.H..from.Saint.Louis.University..She.is.currently.a.grant.writer.and.journalist.for.the.Center.
for.Sustainable.Journalism.at.Kennesaw.State.University.(Georgia);.as.a.journalist,.she.specializes.in.data-based.
articles.and.explaining.statistical.principles.to.the.general.public..Her.research.interests.include.comparative.
health.care.delivery.systems,.quality.of.life.measurement,.and.gender.and.sexuality.issues.in.health.care.delivery..
In.her.spare.time,.she.reviews.films.and.books.for.PopMatters.(http://www.popmatters.com).and.Playback.St..
Louis.(http://www.playbackstl.com).
viii
INTRODUCTION
Everyone.has.an.interest.in.health,.as.reflected.in.tru- Health.is.a.state.of.complete.physical,.mental,.and.
isms.such.as.“at.least.you’ve.got.your.health”.and.“if. social.well-being.and.not.merely.the.absence.of.
you’ve.got.your.health,.you’ve.got.just.about.every- disease.or.infirmity.
thing.”.If.all.people.have.an.interest.in.health,.at.least.
their.own.health.and.that.of.their.families,.it.then.fol- This.broad.definition.of.health.has.been.adopted.in.
lows.that.every.government.has.an.interest.in.health. principle.by.many.nations.that.have.integrated.social.
care.delivery.because.the.many.wonderful.achieve- services.systems.including.not.only.medical.care.but.
ments.of.modern.medicine.are.only.useful.when.they. also. other. services,. such. as. old-age. pensions. and.
are.delivered.to.the.people.who.need.them.. income.support..Other.nations.prefer.to.maintain.a.
There.are.many.different.ways.to.organize.and. number.of.separate.services,.each.with.its.own.sources.
deliver.health.care.to.a.population,.and.to.some. of.funding.and.eligibility.requirements..Both.systems.
extent,.each.country’s.method.of.organizing.health. can.produce.good.results.or.bad.results—the.details.
care.delivery.is.unique.and.based.on.its.specific.situ- of.how.a.specific.system.is.organized.and.executed.are.
ation,.including.its.history.and.culture,.the.amount. crucial.when.making.comparisons..
of.money.it.has.to.spend,.and.the.value.it.places.on. The.second.statement.comes.from.the.Universal.
different.outcomes..It.is.not.surprising.that.public. Declaration.of.Human.Rights.proclaimed.in.1948.by.
discussions.about.health.care.often.become.heated. the.United.Nations.General.Assembly:.
because.the.demand.for.health.services.is.theoreti-
cally.unlimited,.yet.no.government.has.unlimited. Everyone.has.the.right.to.a.standard.of.living.
resources..Designing.and.running.a.health.care.sys- adequate.for.the.health.and.well-being.of.himself.
tem.therefore.requires.making.difficult.choices.that. and.of.his.family,.including.food,.clothing,.hous-
are.almost.guaranteed.not.to.please.everyone,.at.least. ing,.and.medical.care.and.necessary.social.services.
not.all.the.time.. and.the.right.to.security.in.the.event.of.unemploy-
Discussions.about.health.and.health.care.often. ment,.sickness,.disability,.widowhood,.old.age.or.
draw.on.two.key.statements.from.international.orga- other.lack.of.livelihood.in.circumstances.beyond.
nizations.that.formed.after.the.conclusion.of.World. his.control.
War.II..The.first.is.the.definition.of.health,.as.stated.in.
the.Preamble.to.the.Constitution.of.the.World.Health. Some.governments.include.the.right.to.health.in.
Organization.(WHO),.adopted.in.1946.and.entering. their.constitutions,.while.in.others.it.is.a.tacit.expec-
into.force.in.1948:. tation.that.those.who.need.medical.care.will.receive.
ix