Term Paper on "Global Health Care"

Term Paper 24 pages (6545 words) Sources: 1+

[EXCERPT] . . . .

Martens, Pim. (200). "Health Transitions in a Globalising World: Towards More Disease or Sustained Health?" Futures, Vol. 34, Issue 7, p. 635+

In this journal study, Pim Martens argues that the concept of 'transitions' is useful for addressing and defining the current and future health status of the world as directly related to the process of globalization. Martens begins by a discussion of the current factors that affect human health and then discusses the health transitions evident throughout history. Next the focus is on trends and developments in health and disease among various populations of the world. He measures these trends according to the following three suppositions of future ages:

the age of emerging infectious diseases the age of medical technology the age of sustained health (Martens, 2002, p. 635).

More specifically Martens attempts to define global and regional dynamics that might influence health and disease trends. He concludes that managing health variations and transition effectively in the future will require "a micro and macro approach" that takes into consideration the social, cultural and behavioural determinants of health (Martens, 2002, p. 635).

In his work Martens claims that socio-economic change and public health initiatives as well as technology have contributed to a shift in health and disease toward the positive. To support this premise he points out that the average life expectancy is doubled across the globe and infant and mortality rates have sharply declined.

However, Martens also points out large health disparities that exist around the world. He suggests that the "pattern of infectious diseases" is less stable and a trend toward anti-microbial resistance is evident throughout the world; he also notes that in certain poor countries and in Sub-Saharan Africa diseases such as HIV / AIDS are actually severely reducing life expectancy (Martens, 2002, p. 635).

Martens points out that though life expectancy is generally on the rise, fertility rates are declining and health inequalities still exist between poor and wealthy populations (Martens, 2002). Further, he suggests that the future health of individuals will depend on the process of globalization and environmental influences (Martens, 2002).

Martens poses the question: "given the current and anticipated socio-economic and environmental trends, will sustainable healthy life be possible in the future" (Martens, 2002, p. 635). He then goes into a lengthy discourse about the forces that affect health, and includes a discussion of trends in developing countries where health gains are taking place thanks to knowledge transfer of information about vaccination and sanitation. Increased literacy, family spacing and improved nutrition are also cited as reasons for improved health conditions among developing countries. In Western populations Martens proposes that health changes are more directly related to social and environmental factors as well as technological medical interventions (Martens, 2002).

Martens goes on to examine trends in health status against a background of forces such as economical and social factors, as well as cultural influences. He notes that critical to good health is access to sufficient quantities of food and water, and notes that individuals living in urban areas or poor countries still struggle with water and sanitation issues (Martens, 2002). He also notes that more than a third of the world's population lives in areas where the water supply is short due in part to large population growth (Martens, 2002). Such inadequacies of supply often impact health in a negative manner. Malnutrition is also a global risk factor for disease and still a growing problem in the developing world (Martens, 2002).

Martens also suggests that social factors including literacy and education impact health, and that globally there is a trend that people with more education generally receive better health care (Martens, 2002).

With regard to economics, Martens claims that rapid economic growth and wealth have globally enhanced life expectancy, which he attributes to improved income levels which are generally associated with lower mortality (Martens, 2002). Again he makes the connection here that wealth is a direct influence or factor in health care, and can bring about improvements when used appropriately (Martens, 2002). After a certain economic level has been attained however, Martens notices a trend that health is determined by other factors including poverty, which is present even in the wealthiest societies.

Martens proposes a conceptual framework for defining health care trends which he calls the 'health transition' suggesting that health trends can be defined by transitional stages. The first stage according to Martens is characterized by mortality associated with "epidemics, pestilence and famine," usually resulting from a lack of economic means to provide adequate health care services. In this type of environment Martens suggests that infectious diseases are most common, causing high mortality rates (Martens, 2002). The next stage he describes as the age of "receding pandemics" where a fall in mortality rates is evidenced and life expectancy climbs during increased economic growth (Martens, 2002). During this stage Martens proposes that social factors become important and the introduction of modern healthcare techniques and technology are common.

Next Martin proposes that a trend follows toward chronic diseases, where infectious diseases are virtually eliminated allowing chronic disease to surface (Martens, 2002). He suggests that this stage occurs at different times for different nations and in developed and developing countries, driven primarily by social factors including economic factors (Martens, 2002). Further he states that most developed countries are now in this stage of heath and disease, where fertility rates are low, and disease patterns are chronic rather than infectious (Martens, 2002). This includes European countries, North America and Asia.

Martens also suggests that most developing countries are still in a state of infectious disease where the fertility rate is still high, and that most poor countries will likely stay in this state unless economic factors shift favorably to allow for better care, access to supplies and information about health care.

Thus, one may conclude that according to Martens synopsis, the trends in health care vary from developing countries to non-developed ones, and that even within developed and non-developed countries variations exist within systems. He presents the idea that many factors contribute to health care, not simply the health care system in and of itself.

2:Topic - Canada's healthcare and how it differs from U.S.

Armstrong, Hugh; Armstrong, Pat; Fegan, P. (1998). "The Best Solution: Questions and Answers on the Canadian Health Care System." Washington Monthly, Vol. 30, Issue 6, p. 8

In this extract the journal authors compare the United States Health Care system to the Canadian Health Care system in an attempt to determine which works better and what improvements can be made to both. The article begins by pointing out that most consumers favor a plan much like that in Canada, because it provides universal coverage to all citizens. The Canadian plan is also touted as having strong "practical appeal" for physicians because it has offers a freedom of choice of doctors for patients, which for most is much more appealing than life under the direction of an HMO (Armstrong et. al, 1998, p. 8).

The authors point out that while most physicians in Canada initially opposed universal coverage for fear that it was too socialistic (a concern also voiced among American physicians) that in fact the universal coverage actually worked quite well and offers a better life and more choices for physicians and patients. The primary focus of the article and message sent by the authors is that many aspects of the Canadian system work well and should be considered for adoption by American officials.

The authors then attempt to analyze the costs of health care. In the United States they point out that health care is privatized. They examine health care costs from many different perspectives, including looking at the cost of health care goods and services as "a percentage of all goods and services exchanged" i.e. The Gross Domestic Product (Armstrong et. al, 1998, p. 8). They authors note that Canada spends approximately 10% of the GDP on health whereas 14% is allocated for health in the United States. In addition Canadian's are noted for spending a little over $2,000 per person or about half of what Americans spend per person for health care. This study is similar to many that examine the costs of health care in the United States vs. The costs of health care in Canada.

The authors then suggest that the optimal way to view the Canadian system is by focusing on public costs and the 'share paid for from the public purse.' The authors suggest that the proportion of public money spent in Canada and the United States is similar with regard to health care, but Canadians end up ahead because they manage more services and a wider range of services for their dollar. Also noted is the fact that in the U.S. less than 30% of Americans are covered by government program such as Medicare, Medicaid and military care plans combined (Armstrong, 1998, p. 8).

Next the authors look at health care spending from an individual perspective, and note that most Canadians pay almost nothing… READ MORE

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