How Does the U.S. Healthcare System Compare to Other Countries?

The U.S. healthcare system is a complex and multifaceted entity that has been the subject of much debate and discussion. This article delves into how the U.S. healthcare system compares to other nations, focusing specifically on Germany and Canada, in terms of access, cost-effectiveness, and quality.

Germany: A Closer Look at a Similar Healthcare System

Germany has a healthcare system that shares many similarities with the U.S. but also has a few key differences that make it function more effectively. Germany has a universal healthcare system, but unlike the U.S., it relies primarily on insurance to pay for healthcare services. However, the choice of insurance is typically made by individuals rather than employers.

One distinct advantage of Germany's system is that the insurance companies are mostly non-profits, meaning that insurance profit is not a major healthcare expense. The statutory health insurance has fixed contributions and a minimum coverage that are determined by law. These contributions are a percentage of wages, and the minimum coverage is reasonable and comparable to good U.S. insurance plans. There are no deductibles or coinsurance, and certain conditions, such as many dental problems, are not covered. However, private supplemental insurances can be purchased to fill these gaps.

While there are some conditions that are not covered, bankruptcy due to medical reasons is rare in Germany because the statutory insurance is compulsory for most individuals. This system results in almost a universal healthcare system, with an estimated 80 million people insured, of which only tens of thousands are uninsured.

Performance Metrics: Quality and Access

When it comes to quality, Germany's healthcare system ranks quite well. According to the World Health Organization (WHO), Germany's healthcare system has a similar quality of care to that of many other developed nations, with comparable infant and maternal mortality rates to those of the U.S.

However, in terms of access, the U.S. falls far behind. The ease of accessing healthcare in the U.S. can be challenging, particularly for those without adequate insurance coverage. Additionally, the costs of healthcare in the U.S. are extremely high, often far exceeding those in other developed nations. Despite the high costs, the U.S. healthcare system does not deliver the best outcomes. The U.S. has one of the shortest life expectancies among developed nations, with a difference of five to seven years compared to Canada.

Canada: A Universal Healthcare System Benchmark

Canada provides a useful comparison point, as its universal healthcare system has been in place since 1970 and is similar in many ways to the U.S. For instance, during the SARS-CoVID epidemic, Canada had a higher survival rate per capita compared to the U.S.

The U.S. healthcare system, according to the WHO, spends more per capita than any other country, more than double that of Canada or the United Kingdom. Unfortunately, for that expenditure, the U.S. gets the poorest outcomes. The U.S. also experiences a significantly higher rate of personal bankruptcies due to medical expenses, with over 600,000 cases annually. In contrast, Canada, the U.K., New Zealand, and Australia combined have fewer medical-related bankruptcies, approximately zero annually.

Reproductive Healthcare and Disparities

Another important aspect of healthcare is reproductive healthcare, particularly in the wake of the overturning of Roe v. Wade. In the U.S., this has created a bifurcated healthcare system: general healthcare and legal/medical healthcare for women. According to the CDC, this new system is already plagued with poor outcomes, with an already abysmal record that is expected to worsen.

The infant/maternal mortality rate in the U.S. is rated 77th in the world, making it the highest of the developed countries. In some states, this mortality rate is equivalent to that of third-world countries. In contrast, in Canada, women's reproductive healthcare is considered a purely medical matter between a woman and her doctor. Third parties such as insurers, lawyers, or the courts are not involved in any way, which contributes to a more straightforward and accessible healthcare experience for women.

Conclusion: Insights for Reform

In conclusion, the U.S. healthcare system faces significant challenges compared to other nations. While the German and Canadian systems demonstrate that universal healthcare can be both effective and efficient, the U.S. system continues to struggle with access, cost, and quality. Introducing forms of universal healthcare, greater control over insurance companies, and increased emphasis on reproductive healthcare can help address these issues and improve the overall healthcare landscape in the U.S.