Introduction
The paper aims to examine, compare, and contrast the health care systems of the United States and Austria. Austria possesses one of the most advanced health care systems in Europe, which includes a complex and supported system of social security services, accessible and affordable health care facilities; Austrian social insurance is based on “statutory insurance, solidarity, and self-governance” (Federal Ministry of Health, 2010, p. 7).
Health Statistics and Costs
The following discussion will provide the reader with information regarding health statistics and costs in the United States and Austria. Life expectancies, mortality rates, major health conditions and diseases, health care expenditure per capita will be addressed.
The United States
Life expectancy in the United States is 78.8 years, whereas the mortality rate is 23.7 deaths per 100,000 population (infant mortality rate is 5.82 deaths per 1,000 live births) (Centers for Disease Control and Prevention, 2016). Major health conditions include cancer (second cause of death), obesity, cardiovascular diseases, and diabetes. Health care expenditure per capita is USD 9,990 (2015), and health care expenditure (% of gross domestic product) is 17.8% (2015) (Centers for Disease Control and Prevention, 2016).
Austria
Life expectancy in Austria is 82.9 (female citizens) and 77.4 (male citizens) years. The mortality rate is 9.6 per 1,000; the infant mortality rate is 3.8 deaths per 1,000 births (Federal Ministry of Health, 2010). Major health conditions are malignant neoplasms (cancer), circulatory system’s diseases, musculoskeletal system’s diseases, injury, poisoning or other external causes, diseases of the digestive system, etc. Health care expenditure per capita is USD 4.013 (EUR 3 360) (in 2009). Health care expenditure is 10.3% of the gross domestic product, i.e., approximately EUR 27.9 billion or USD 33.3 billion. The country’s total GDP in 2009 was USD 330.7 billion (EUR 276.89 billion).
Comparison of countries
Life expectancy in Austria is higher only for female citizens, and the mortality rates are lower due to a smaller population. Health care expenditure per capita is greater in the USA both from a financial and GDP percentage perspective. Cancer and cardiovascular diseases are major causes of death in both countries.
Health Care Financing
The sources financing the health care system in both countries will be discussed. The discussion will provide information about private and public sectors, funds, and The Affordable Care Act (ACA).
The United States
The health care in the United States is financed via private health insurance (33%), public health insurance (41%; Medicare accounts for 20% and Medicaid for 17%), out-of-pocket investment (11%), public health activities (3%), investment (5%), and other payers (8%) (California Health Care Foundation, 2016). Thus, the system is financed via both the public and private sectors. Public funds are collected via direct taxes paid by households, indirect taxes paid to the government via third parties, and financing through foreign sources (only when the funds go through recipient governments) (World Health Organization, 2017).
Private funds are collected from corporate-funded health services, out-of-pocket spending, individual contributions, and community-based insurance. The Affordable Care Act is financed via different channels: fees for health insurance providers, fees for pharmaceutical manufacturers and importers, as well as taxes for device manufacturers and importers. High-cost employer-sponsored health plans and increased Medicare taxes for high-income households together with taxes on indoor tanning services and individual responsibility requirements to obtain health insurance are also sources of financing (Insure the Uninsured Project, 2012).
Austria
The country’s health care system is financed via income-based social insurance contributions, public income (taxes), and private payments (indirect and direct co-payments) (Federal Ministry of Health, 2010). Public sources (social health insurance funds, the Federal Government, provincial and local governments) generate approximately 76% of total health expenditure, and 24% are produced by households, private health insurance companies, and private non-profit organizations.
Comparison of countries
Austrian health care system relies on public income more heavily than American does. Social insurance in Austria and the ACA in the USA are important sources of health care funding, but the latter is more dependent on taxes than the former. Taxation of high-cost insurance programs and households is lacking in Austria, while it also does not have a program similar to Medicaid since social insurance is provided to citizens with different incomes.
Health Care Administration
The discussion will touch upon the government agencies that regulate the provision of health care services and benefits. A comparison of the administrations of both countries will be provided as well.
The United States
U.S. Department of Health and Human Services oversees the provision of healthcare services to citizens. Administration for Children and Families provides assistance for families, child support, and child care. Administration for Children and Families regulates and ensures the provision of healthcare services to children. Eldercare Locator provides services for elderly citizens to help them live independently and supports caregivers (USA.gov, 2017). Indian Health Service ensures and regulates health services provided to Native Americans and Alaska Natives. Office for Civil Rights, Department of Health and Human Services protects American citizens from discrimination in different healthcare programs.
Austria
The Federal Ministry of Health oversees, regulates, and ensures the provision of services to citizens of various backgrounds. It cooperates with the Main Association of Austrian Social Security Institutions (HVB) to regulate the provision of pension, health, and accident insurance. The Federal Health Commission is the executive body of the Federal Ministry of Health, whereas the Regional Health Funds implement instructions at the provincial level.
Comparison of countries
The provision of healthcare benefits is more divided among agencies in the USA rather than in Austria; Austria chooses a more formal and less divisional approach to it, basing it on social security services. The American health care system is based on horizontal and vertical hierarchy among government agencies.
Human Resources
The total number of nurses, physicians, and hospitals will be presented in the section. Their availability in both countries will be discussed as well.
The United States
The number of nurses per 100,000 population is 843 (American Association of Retired Persons, 2014). The average number of physicians is 221 per 100,000 population, the number of hospital beds is 437, and the number of hospitals is 6.7 (Peters, 2015).
Austria
The number of nurses per 100,000 population is from 200 to 1000, the number of physicians is approximately 505, the number of hospital beds is 700, and the number of hospitals is 10 (Eurostat, 2014; Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012).
Comparison of countries
Fewer nurses, physicians, hospitals, and hospital beds are available to American citizens possibly due to a larger population and current workforce shortage, as well as increasing burnout and stress levels among representatives of this occupation in the USA.
Conclusion: Access and Equity Issues
Illegal residents, including refugees, are the main uninsured population in Austria. These individuals experience health disparities due to a lack of access to Austrian social insurance. Health promotion and access to healthcare are less available to different migrants (from ex-Yugoslavia, Eastern Europe, the Middle East) in Austria (Ingleby, 2012). In the US, Blacks, Asians, and Hispanics receive worse care than Whites and face more barriers to health care (Agency for Healthcare Research and Quality, 2011; Betancourt, Green, Carrillo, & Owusu Ananeh-Firempong, 2016). Poor people also have worse access to healthcare in the USA compared to high-income people. As can be seen, both countries have not addressed the problem of discrimination in the healthcare system directly and cannot overcome barriers that worsen the quality of life of different minorities, including migrants and refugees.
References
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