Term Paper on "Health Care in the U.S"

Term Paper 20 pages (7032 words) Sources: 20

[EXCERPT] . . . .

The Spanish System

The health care system in Spain is still reeling from the recent global recession. High unemployment rates are expected to continue, which places a strain on the ability to support the national health care system (OECD, 2011b). The ability of the national health care system in Spain to provide services depends on an inflow of taxes from the people. Anything that harms the economy also harms the national health care system. The same is true in the United States, only the impact is not as great, because the system is not entirely dependent upon government funds.

The national health care system and Spain is known as the SNS. It is operated by the National Ministry of Health and Social Policy. It is structured as a hierarchy that has a central governing agency at the top that manages strategic areas such as policymaking and equitable functioning of the system across the nation. It is then broken down into 17 regional ministries who must report to the central governing body (Garcia-Armesto, Abadia-Taira, & Duran et al., 2010). The National Health System Interterritorial Council has final decision-making authority in the adoption of policies regarding the SNS (ISPOR, 2009). However, individual regions do have decision-making authority to fill the needs of their own citizens.

The reimbursement process for pharmaceuticals is governed by the Spanish Medicine Agency. They will only reimburse for pharmaceuticals that are approved and that meet certain site criteria in terms of safety and effectiveness. This is similar to the role of the Food and Drug Administration (FDA) in the United States (ISPOR, 2009). Reimbursement depends on the severi

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ty of the disease, the therapeutic value and efficacy of the product, the price of the product, and the budget impact on the SNS compared to other similar products.

Every patient must see a "gatekeeper" physician to be referred to a specialist.

One of the key complaints about the Spanish health care system is about long wait times to see a specialist. This can be especially traumatic for those that have been sent to specialists to see if they have a serious disease. The wait can seem to be extensive for some. Wait times of up to eight months have been reported to get the results of a simple gynecological test (Expatica, 2004). This argument is also used as one of the key points of contention on the topic of a national health care system is mentioned in the United States.

In a recent study, it was found that wait times varied from region to region. This study also found that wait times varied depending on the type of consultant that you went to see. An average wait time in Castilla, La Mancha is 23 days. Wait times for the same test results in Canary were up to 140 days. This is a dramatic difference. On average, the national wait time is around 65 days for most tests (Expatica, 2004). It seems to be more difficult to see an allergist than a neurologist. The difference is the patient load for the particular specialty. There are many more people who need to see allergists than neurologists (Expatica, 2004).

In 2009, the population of Spain was 40,525,002 with a GDP per capita in 2008 of $34,600. The average life expectancy for females was 84 and 78 for Males. Infant mortality rates were low ("International Health Systems," n.d.). The national health care system covered 99.5% of primary care, inpatient surgery, outpatient surgery, long-term disease management, emergency care, and some drugs if they were deemed necessary ("International Health Systems," n.d.). From this perspective, it would appear that Spanish national health care system was a success in promoting the health of its citizens. However, some services such as mental health, dental, and long-term care coverage did require some out-of-pocket expense or supplemental insurance. Care of the elderly is underdeveloped in Spain. Therefore, many children tend to care for their parents well into old age. The national health system is financed through taxation and funds allocated to the various regions in Spain ("International Health Systems," n.d.).

Comparison Shopping

The Spanish system of health care may rank among the best in the world, but that is not say that it does not have its problems as well. The Spanish system looks very different from the U.S. system not only on the outside and on the inside as well. For instance, many Americans are used to having a certain amount of "creature comforts" in the health care setting. For instance, they are used to padded chairs and soothing mood music in the waiting room. By comparison, one of the oldest and biggest hospitals in Spain has hard plastic chairs and no music (Socolovsky, 2009). The Spanish system is considered to focus more and function than comfort. This does not reduce the effectiveness of the treatment process is as one can see from the national health averages. Spanish citizens are not accustomed to having the same amenities in the public system that they have in private sector providers. They expect an efficient, but stark an appearance from the public Healthcare System. The difference between the U.S. And Spanish systems stems from the need to be competitive in the U.S. system, and the need to spend tax payer dollars wisely in the Spanish System.

It might be noted that in the private sector in Spain patients will find more amenities and comforts. The treatment procedures and medical care is the same in both the public and private sectors in Spain. The patient expect to pay considerably higher prices in the private sector but they also expect more amenities. It cost is a concern, many Spanish citizens will utilize the public health system, rather than to pay for the comforts provided by the private sector system. The private sector must compete with the public sector to attract patients who could get the same services from the public sector for free. Use of the private sector services in Spain is a sign that a person is more concerned about comfort than price. There is no difference in terms of delivery of service or quality of service in either the public or private sectors of the Spanish system.

U.S. health care providers must compete with other private health care providers to attract patients and remain profitable. This is not so in the Spanish system. The Spanish health care system is funded entirely by taxpayer dollars. They do not have to attract patients. Therefore, the focus in the Spanish system is on providing the best quality health care at the lowest cost to the government and consequently the Spanish citizens. The attitude in the Spanish health care system is different. Spanish health care providers are a government service provider just like any other government department. This gives them a different attitude towards what is important in their facilities. By comparison, U.S. health care providers must pay more attention to the marketing and business end. This does not mean that they do not.pay attention to the medical needs of the patient, it simply means that they must spend money on advertising.

Due to the need to include advertising and creature comforts into health care delivery, the U.S. health care system cannot operate as efficiently as the public system in Spain. This is one of the main differences between the government subsidized program and one that operates on the open market. The private system and Spain closely resembles that of the United States, only they cannot justify raising prices significantly above that offered by the public system, or no one would use their services. The private system and Spain faces many more challenges than that of the United States. They are and are far greater government control.

Thus far, we have surmised that the patient experience in the U.S. health care system and the one in Spain are different in terms of amenities and comforts. Spanish citizens have the option of paying extra to be treated in privately operated clinics. Many patients stated that the medical treatment is good in the public facilities, but the personal service is inconsistent (Socolovsky, 2009). Whether someone decides to use the public health care system or the private one is simply a matter of personal choice.

The most common complaint about the system in Spain is that there is a long wait to see specialists or to undergo certain procedures. However, in a recent survey it was found that Spain has one-third fewer deaths caused by a long wait to access health care than in the United States (Socolovsky, 2009). By comparison, Spain spends less and provides better quality service to its citizens than the United States. The life expectancy in Spain is one of Europe's highest and the health care system is credited as one of the key factors (Socolovsky, 2009). Patients that choose to use Spain's public health care system do not expect the amenities that they would receive at private health care facilities, but they expect… READ MORE

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Quoted Instructions for "Health Care in the U.S" Assignment:

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This scholarly paper will summarize the U.S. healthcare system. Included in this paper should be: an overview of our system, a comparison of our system to another industrialized nation (Spain), a critique of our healthcare system, and your assessment of changes needed. The paper should be no more than 15-20 pages in length. Will need to use the sources provided by literature matrix. Teacher states to cite what is not our idea and/or if we have a paragraph that is not our idea to make sure to cite at least every 3 sentances or so. Here are 15 articles of which most have a weblink.

AUTHOR WEB LINK TITLE

No Author OECD HEALTH DATA 2011 How Does the United States Compare http://www.oecd.org/dataoecd/46/2/38980580.pdf No Author OECD HEALTH DATA 2011 How Does Spain Compare. http://www.oecd.org/dataoecd/46/7/38980294.pdf OECD HEALTH at a Glance 2009 http://www.oecd.org/document/14/0,3746,en_21571361_44315115_44216846_1_1_1_1,00.html No author Medicare.gov The Official U.S. Government Site for Medicare http://www.medicare.gov/ No Author US Department of Health & Human Services Centers for Medicare & Medicaid Services https://www.cms.gov No Author InsureKidsNow.gov Connecting Kids to Coverage http://insurekidsnow.gov/chip/index.html No Author THE WHITEHOUSE WASHINGTON http://whitehouse.gov/ Duran, A., Lara, J.L., and Waveren, M.V. Health Systems in Transition-Spain Health System Review World Health Organization http://www.euro.who.int/__data/assets/pdf_file/0005/96386/E89491.pdf No Author Ispor Global Health Care Systems Road Map http://www.ispor.org/htaroadmaps/spain.asp No Author US Census Bureau Health Insurance in the United States www.census.gov/prod/2011pubs/p60-239.pdf No Author Expatica Waiting to be seen: How the health service varies across Spain http://expatica.com/nl/health_fitness/healthcare/waiting-to-be-seen-how-the-health-service-varies-across-spain-12569.html CHAPLIN WHITE TRENDS Health Care Spending Growth: How Different Is The United States From The Rest Of The OECD? http://content.healthaffairs.org/content/26/1/154.full GERARD F. ANDERSON ND BLANCA K. FROGNER Health Spending In OECD Countries: Obtaining Value Per Dollar No Link Tanner, M. Policy Analysis The Grass Is Not Always Greener A Look at National Health Care Systems Around the World www.cato.org/pub_display.php?pub_id=9272 No Author kaiserEDU.org Health Policy Explained http://www.kaiseredu.org/Issue-Modules/International-Health-Systems/Spain.aspx?p=1 World Health Organization http://www.photius.com/rankings/world_health_systems.html

Need to use these articles provided above and may use others not listed. Here is a rubric

Scholarly Paper Rubric

Objectives Needs Improvement Average Performance Good Performance Exemplary Performance

Quality of Articles Included 1 point

Paper does not contain empirical evidence and/or scholarly opinions. Sources used are not credible. 15 points

Paper contains some empirical evidence and/or scholarly opinions. Many sources are not credible. 21 points

Paper contains mostly empirical evidence and/or scholarly opinions. Most sources are credible. 30 points

Paper always contains empirical evidence and/or scholarly opinion. All sources are credible.

Thoroughness of Information Included 1 point

It is evident that the student did not thoroughly research various aspects of the US healthcare system. Few major topics were explored. 15 points

Reveals a restricted thoroughness of the various aspects of the US healthcare system which is limited to information that could be derived from only online material. Many important aspects were omitted. 21 points

Reveals an adequate understanding of most important aspects of the US healthcare system. Provides information derived mostly from credible and scholarly sources. 30 points

Reveals a solid understanding of all important aspects of the US healthcare system. All information is derived from credible and scholarly sources.

Student’s Critique of US Healthcare System and Needs Analysis 1 point

Provides no evidence of thoughtfulness regarding the state of the US healthcare system or analysis of changes needed. 15 points

Provides restricted evidence of thoughtfulness regarding the state of the US healthcare system and analysis of changes needed. 21 points

Offers a good critical analysis of the state of the US healthcare system and analysis of changes needed. 30 points

Offers an excellent critical analysis of the state of the US healthcare system and analysis of changes needed.

Organization 1 point

Poor organization, numerous APA, grammar and/or spelling errors. Sources are not cited. 5 points

Paper is somewhat organized but needs improvement. Has five or more APA, grammar and/or spelling errors. Some sources are not cited. 7 points

Clear organization of paper. Has less than five APA, grammar and/or spelling errors. Most sources are cited. 10 points

Clear organization, grammatically correct and free of APA and spelling errors. Always cites sources.

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