Political Economy Of Health In America & China
Health care system nowadays is well-developed in most countries all over the world. There is a lot of attention paid to providing the necessary medical support and treatment to individuals in all spheres of medicine, including primary care, secondary care, supporting the higher level of public health. Without any doubts the health care system is closely related to social and economic situation in any country. It is considered to be vitally important for defining of the general physical and psychological health and well-being of the citizens of this country. Various countries have to work out their concrete health care policies, plans for their societies. The main aim of the established health care organizations is to guarantee the sufficient level of support for health care needs of the population. Based on the two countries – America ad China, it is possible to compare the health care systems, their functioning, their flaws and achievements, the relations, which exist between social and economical factors and the degree of health care development.Political Economy Of Health In America & China
The formation of the universal health care system, which was supposed to receive the financial support from the government and correspondingly be controlled by it – took a rather long period of time in America. One of the differences of the health care system in America from those in other European countries was the fact that those countries started from introduction of social insurance, like for example this was in Germany in 1883. A lot of other countries followed their example, and as a result most of them managed to create at least the initial form of the universal health care. In the United States during this period the government didn’t push for introducing of compulsory forms of insurance, mostly these were voluntary and private programs. However, at the beginning of the Progressive Era – early 20th century – the necessity to improve the social conditions of the working class became evident. “However unlike European countries, there was not powerful working class support for broad social insurance in the US The labor and socialist parties’ support for health insurance or sickness funds and benefits programs was much more fragmented than in Europe.” (Burnham, 2014). Theodore Roosevelt supported the health care insurance, stating that citizens of the country should not be sick and poor, still his initiative was too weak and not widely supported. It was until in the year 1915 the American Association of Labor Legislation launched the health insurance campaign. Six years later, they created a social welfare committee, which held the first conference in 1913. The bill, which was the result of these efforts, actually didn’t foresee the insurance for the workers, who earned less than $1200 annually. In 1914 physicians were involved into the process of making the bill, three years later, when the compulsory health insurance was finally proposed, most of the state medical societies didn’t accept it. The main problem was related to way of providing payment to physicians.
Their major concern was related to the provision of health insurance for not only health services, but also for funerals, which might have negative impact upon their business, which actually was based on the provision of paying death benefits. The national health insurance was repeatedly widely discussed in relation to the well-known Wagner-Murray –Dingell Bill. According to this bill national health insurance along with payroll tax became obligatory.Political Economy Of Health In America & China
The period of reconsideration of health care issues coincided with the Cold War and Communism during the period of Truman’s presidentship. This was the moment, when national health care appeared in the center of the national politics and was strongly supported by the president. “Compulsory health insurance became entangled in the Cold War and its opponents were able to make “socialized medicine” a symbolic issue in the growing crusade against Communist influence in America” (Burnham, 2014). The innovation of the Truman’s suggestion was however on the contrary not aimed at providing health care for the needy people, rather making it a single egalitarian system for all people. Still there again was no success, as there was a system of insurance for those, Immediately after his inauguration, Obama declared about his plans to fulfill the necessary health care reforms. However this led to arising of further acute debates upon the issue.
One of the unique features of China in relation to health care is the fact that this country has actually the longest history of medicine records in comparison to any other country all over the world. Methods and traditions of medicine here are more than two thousand years old. Nowadays it is possible to distinguish two options – traditional and western medicine in China. Still the traditional approach served the basis for the building of the health care system there.
Starting from the year 1949 The Ministry of Public Health worked upon health-care activities, aimed at establishment of health care policy. There were special programs worked out for providing the health care for the workers of state enterprises of such facilities as hospitals. The situation in the rural areas was much worse, as there were usually a couple of bare foot doctors, which were to provide health care services to 1000 persons. One of the initial steps of the government was to provide the additional training for those doctors along with subsequent exams. Afterwards the township health centers were founded. “Utilization of health services in rural areas has been shown to increase as a result of the rise in income in rural households and the government’s substantial fiscal investment in health” (Blumenthal, Hsiao, 2005). In urban areas the personnel of the factories had the chance for medical support at health station. In case of necessity,
They preferred to go to the commune health care centers instead of visiting barefoot doctors. This resulted in a number of bare foot doctors leaving their positions and there were no other doctors of health care institutions to substitute them. This situation led to the collapse of the cooperative medical programs. Farmers made an attempt to organize voluntary health insurance programs, however taking into consideration their lack of experience and ability to administrate, they were not successful. At the same time the health care providers sold medicines and made only paid injections, which in its turn led to disregards of the patients’ rights and problems with diseases.Political Economy Of Health In America & China
The beginning of the 1950s could be characterized by greater attention to public health and the necessary preventive steps in treatment. This was also the moment of the consideration of the relations between spread of some diseases and the level of sanitation and hygiene. The quality of water was also discussed under these terms, thus deep-well constructions for waste were built. Consolidation of these efforts brought their positive results, as such serious diseases as cholera, typhoid fever, scarlet fever were almost forgotten. The situation with the public health was certainly related to the political and economic factors, thus after the failure of the Great Leap Forward, millions of people experienced lack of normal nutrition. Only in 1961, when Liu Shaoqi became the president, the situation with nutrition was improved.
Situation with public health care system after 1990s started to change. Most of the big cities had hospitals, which were specialized in various fields of medicine; they were equipped with modern facilities, at some places even with introduction of foreign facilities. However the cost of the top quality medical care was rather high. There were also public hospitals, which are less expensive. Separately should be mentioned the traditional Chinese medicine centers, which were located in various parts of the country. At the same time the situation in rural areas was far from being optimistic – “in rural areas, most healthcare is available in clinics providing rudimentary care, with poorly trained medical personnel and little medical equipment or medications, though certain rural areas have far higher-quality medical care than others” (Brown, Theoharides, 2009). Because of the poor level of services in rural areas, people had to travel to public hospitals in cities,
s because of cholera, only bottled water was allowed. Another problem was related to the so-called “black ambulances” – illegal private services, which appeared because of the insufficient number of ambulances in big cities. Those private ambulances were working purely on commercial basis, the staff had no required qualifications and skills, medical equipment was also missing. “A cross-sectional study between 2003 and 2011 showed remarkable increases in health insurance coverage and inpatient reimbursement were accompanied by increased use and coverage” (Brown, Theoharides, 2009). However the general urbanization had a serious impact upon the situation in health care, as it offered additional opportunities for the people in China to have access to improved health care.Political Economy Of Health In America & China
Certainly the health care systems in both America and China have their strong and weak points. Talking about the US, it is necessary to mention, that along with sufficiently high level of the cultural, political-economical, social level of development of this country, unfortunately there are still problems with delivering of health care, which are the results of the numerous sociological, economic and political dilemmas. Being based purely on private business, the health care of this country became one of the most expensive in comparison to other countries. At the same time it is necessary to mention, that the qualitative level of the provided health care in America is one the highest in the whole world, unfortunately around 16 % of Americans don’t have their insurances and thus are not able to take their advantages of the health care. This is evident, that welfare is closely related to the health care. This is one of the tasks of the government to find the ways of regulating the situation, as “With total health-care spending significantly exceeding $1 trillion annually, the provision of medical and health care is one of the largest industries in the United States. There are, nevertheless, many inadequacies in medical services, particularly in rural and poor areas” (Johnson, Stoskopf, 2010). The situation is that the United Sates spends a sufficient part of its gross domestic product on health care in comparison to other industrialized countries, still there is no guarantee for health care provision for each citizen. Another serious problem of the 20th and 21st centuries is related to the increasing cost of the drugs.
The situation in China is in ways similar to the situation in America, as starting from the 2010 the health care system of the country is developing the quality of care, contributes to regulating of the safety and quality of the medical services provided, introduces innovations into various spheres of medicine. The government is working upon producing a plan for achieving of the status of a “moderately wealthy” country. Still the problematic issues, related to public and private sectors in relation to insurance and health care provision remain controversial and sophisticated. “Future growth of private insurance plans, specialty clinics, and private hospitals in China hinges on the resolution of a complex two-sided dilemma. For insurers to expand and sell price-differentiated plans, clinics need to offer high-quality services covered by the insurance. Public hospitals, which bill patients at government-set prices at the point of service are not equipped to handle post-hoc private insurance reimbursement” (Blumenthal, Hsiao, 2005). This dilemma is very close to the situation in America, when there seems to be a serious need of finding the mutually advantageous compromise between the role of the state in the health care system and insurances and the roles of private enterprises. Political Economy Of Health In America & China
which had a strong impact upon formation of the health care systems in America and in China, it is possible to conclude, that certainly health care is specific in each country, as it is shaped under the influence of the above mentioned factors; both countries are in the process of working out and implementation of the healthcare reforms, which would be beneficial for the society, for business and for the whole country in general. One of the key differences however lies in the actual reasons, why those reforms were needed in both countries, the major motivation for China to take care of the increased access to the health care insurance was a part of the protection means, which were needed for reduction of the high costs of the medical care, which were crucial for individuals. At the same time the big part of the rural areas of the country had also had its impact upon the ability of the rural people to participate in insurances. In the Untied States the situation was different, because the main stimuli for the necessity of the reforms was related first of all to improvement of the access of all citizens to medical insurance, as this could help to get health care in lower-cost settings.Political Economy Of Health In America & China