Introduction
Health care in the US needs comprehensive reform, and one way to suggest the direction of change is to learn from other countries. A small island nation, New Zealand ranks above average in income, wealth, and health care (Cumming, 2017). Akin to the US health care, the system in place in New Zealand has not been devoid of controversy, shortcomings, and heated public debate. Yet, New Zealand has come to outperform the United States, though still working on some flaws. This essay compares the healthcare profiles of two countries – the United States and New Zealand – and discusses how the latter may have paved the way for the former’s much-needed improvement.
International Healthcare Efficiency Criteria
According to NationMaster (2020), a statistics database, New Zealand ranks fourth as per the criterion of the overall quality of the healthcare system, while the United States only ranks 23d. Top experts at the Commonwealth Fund, Schneider et al. (2017) report similar findings: New Zealand is outperformed only by three countries – Australia, the United Kingdom, and the Netherlands. In contrast, the United States shows notoriously subpar performance and closes the rating consisting of eleven developed countries. It is compelling to break the rating down to individual criteria to pinpoint what exactly makes the care process in the United States so tedious and inefficient. Probably, the most noticeable characteristic of US medicine is its costliness. NationMaster (2020) puts it in the 41st position globally while per the Commonwealth Fund, which evaluates the most developed countries, the US ranks last.
It should also be pointed out that apart from low affordability, the US does not perform well per the administrative efficiency criteria. It is readily imaginable how an inefficient administrative system may further reduce accessibility. In opposition to the US, New Zealand is among the top three performers alongside Australia and the United Kingdom (Schneider et al., 2017). Lastly, equity is defined as a small to negligible difference between lower-, middle-, and high-income adults in terms of their access to timely, patient-centered care. Again, as shown by Schneider et al. (2017), the United States demonstrates the worst performance among all the developed countries while New Zealand’s performance is solid and allows it to take the fourth position. NationMaster (2020) provides another telling piece of statistics. While New Zealanders have 6.1 hospital beds per 1,000 residents at their disposal, Americans can only count on 3.3 – almost two times fewer (NationMaster, 2020). Arguably, the availability is largely contingent on the purchasing power and place of residence of an individual, which deprives large cohorts of people of necessary intensive care.
Healthcare Outcomes
The efficiency of healthcare is measured by how policies translate into healthcare outcomes across the board since public health is the end purpose of any well-functioning medical system. Life expectancy at birth for both men and women in the United States and New Zealand is comparable, though the latter shows somewhat better figures: 82.6 vs 81 years for women and 79 vs 76.3 for men (NationMaster, 2020). However, the probability of not reaching 60 is higher in the US than in NZ: 12.9% vs 10.1% respectively (NationMaster, 2020). On top of that, New Zealand shows better performance concerning managing infant mortality than the North American nation.
One of the greatest health concerns plaguing the US is obesity, with nearly every third adult American (30.9%) weighing more than the healthy normal. In contrast, in New Zealand, it is only every fifth adult (20.9%) that is overweight or obese (NationMaster, 2020). Some of the statistics shed light on the state of sexual health and education in the two selected countries. Smith et al. (2017) writes that increased knowledge about sexuality is crucial for health and wellness. In the US where sexual education still meets a great deal of resistance, the abortion rate is two times higher than in NZ – a country that recognizes the importance of spreading knowledge (NationMaster, 2020). Apart from that, the US has an HIV rate nine times higher than NZ.
Healthcare Coverage
Generally, New Zealand residents and some work visa holders are eligible for free or low-cost healthcare services provided by the public healthcare system. The system is heavily subsidized by the government whose mission and vision can be formulated as “giving everyone ‘a fair go’ in life (Healthcare, 2020).” As per the information available on New Zealand’s official website, medical insurance fulfills the following functions: (1) it subsidizes primary medical services such as doctor’s visits as well as prescribed medication; (2) provides free public hospital services; and (3) covers services for patients with disabilities (Paying for healthcare services, 2020). The Ministry of Health (2011) emphasizes that seeing a local doctor or a GP (general practitioner) is free of charge. Though that is not the only medical service that costs next to nothing for eligible residents and visitors: they can also receive acute or emergency care. The latter includes inpatient and outpatient treatment, including X-rays and laboratory tests.
In contrast, the United States struggles with the lack of universal healthcare coverage. This is peculiar as it spends significantly more on healthcare per capita than New Zealand: US$8,607.88 vs $3,666 respectively (NationMaster, 2020). Tolbert et al. (2019) state that some progress was achieved with the introduction of the Affordable Care Act (ACA). It resulted in historic gains in the percentage of insured residence, reaching out to underprivileged communities living before the poverty line. However, in recent years, the policies have been losing their effectiveness: as shown by Tolbert et al. (2019), in 2017 and 2019, the number of uninsured individuals increased by half a million. One in five uninsured adults cannot access necessary services, especially those related to preventive health. As a result, when they do access them, it is typically an emergency leading to higher expenses and contributing to the economic burden of the system.
Improvement Prospects for the United States
Without doubts, New Zealand is a country that deserves recognition for its efforts to reform and improve its healthcare system. Though, the question arises as to whether the same model applies to the US. Some of the advantages of NZ health care include public funding, universal coverage, and a highly trained and educated workforce. The Ministry of Health (2018) calls its public health and no-fault accident compensation system one of the kind as it serves eligible residents throughout their lives – something that the US strives to achieve. New Zealand focuses on state-of-art research and seeks to introduce evidence-based practices in clinical settings. The US has some of the best medical schools in the world, so it should prioritize translating scientific knowledge into practice.
What is also positively unique about New Zealand is its attention to its indigenous people. The Ministry of Health (2018) states that the system enjoys a sufficient number of Māori and Pacific health providers that stay connected to their communities and develop integrated approaches to care. In the US, first nations are some of the most underprivileged demographics in terms of access to healthcare. Willging et al. (2018) explain that historically, these populations have been at a greater risk of being uninsured, suffering from more serious morbidities, and having an overall poor quality of life. Therefore, one of the prospects of improvement for the US is paying greater attention to its indigenous people. Lastly, the healthcare system in the US should be strengthened by education, especially about sexual health to prevent unwanted pregnancies and sexually-transmitted diseases.
Conclusion
The United States healthcare system has long been criticized for its convolution, unnecessary complexity, and dubious efficiency. Today, what raises the most concerns is its high costs, the great share of uninsured American residents, and poor healthcare outcomes, especially when compared to other developed Western nations. New Zealand outperforms the US by criteria such as life expectancy, infant mortality, obesity, HIV rates, abortions, and many more. The small island nation enjoys universal health care where emergency and preventive medicine are not only accessible but also low-cost or free. The US could learn valuable lessons from NZ experience, especially regarding administrative efficiency, healthcare coverage, and attention to underprivileged communities. Patient education should also become an integral part of the US healthcare system to address preventable diseases and life events.
References
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Smith, T. E., Panisch, L. S., Malespin, T., & Pereira, M. G. (2017). Evaluating effectiveness of abstinence education. Journal of Evidence-Informed Social Work, 14(5), 360-367.
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