Introduction
The US healthcare system is often criticized for being inaccessible, inefficient, and lacking in a diverse and equitable approach. The New Zealand healthcare system, on the other hand, is often regarded as a more practical approach to addressing the well-being of the national population. The two systems, however, share similarities in several aspects, such as regulatory circumstances, systematic contents, and limitations linked to the provision of healthcare services. On the other hand, the systems differ in relation to funding, structural disturbances, and accessibility. In this paper, the US and New Zealand health systems will be discussed from the perspective of national structures, mechanisms of funding, legislative organs, and service provision. Moreover, the benefits of universal systems will be apparent, as well as certain concepts that are to be addressed in both frameworks.
National Structure for Health Services Provision
Both New Zealand and the US health services provision structures are similar in one regard. Namely, the US framework is based on a systematic division between public, private, and voluntary health services (Papanicolas et al., 2019). Thus, medical coverage can be funded by the state through Medicare and similar initiatives, individually through health insurance, and voluntarily through charitable organizations. A similar approach can be exemplified through an analysis of the New Zealand system (International Trade Administration, 2022). However, disparities persist concerning the demographics that adhere to each of the three frameworks. Based on recent statistics, approximately 85% of the New Zealand health provision services are covered by the government (International Trade Administration, 2022). At the same time, roughly half of the healthcare spending accounted for in the US is linked to government funding (Tikkanen et al., 2020). Thus, while the national structures share similarities linked to the system itself, they contrast in terms of the impact the systems have on individuals. On the one hand, the New Zealand framework allows individuals to access universal healthcare that is funded through taxpayers’ money and does not require additional investment for certain services. On the other hand, the framework exemplified in the US portrays a system in which, while a certain amount of the service provision is, indeed, covered by the government, individual spending is higher.
Funding Mechanism
It has been mentioned previously that the US healthcare system is less universal compared to the New Zealand one. The funding system practically applied in New Zealand is reliant on state support. As a result, the framework implies that the taxes paid by the citizens are partly covering the health services required for the maintenance of the population’s well-being. However, it is essential to mention that specific services are partially funded or not covered through the universal healthcare policy. Thus, individuals are required to invest in health insurance to achieve the said services. Namely, elective surgeries in private hospitals, private consultations with physicians, and faster access to health services are certain aspects of private insurance that cannot be offered universally, thus requiring investments. Moreover, one-third of the population benefits from private insurance, which highlights the extent of interest in said initiatives (Tikkanen et al., 2020). While hybrid characteristics can be exemplified, the system remains universal and mainly funded by the government.
The US framework, as mentioned previously, is also partially funded by the government, with more than 50% of all health services being covered through initiatives such as Medicaid and Medicare. However, it is essential to mention the health insurance strategies that are more extensive than those illustrated in the New Zealand example. Namely, most Americans are insured through their employers. Namely, employers offer healthcare coverage, allowing employees to access the aforementioned services (Shrank et al., 2021). Individual insurance is also possible to obtain. Thus, multiple individuals pay a certain amount to an insurance company to then access health services if needed. The number of people with no health insurance continues to decrease, which means that fewer individuals are incapable of accessing much-needed diagnostic, treatment, and preventative health services (Shrank et al., 2021). Nonetheless, disparities persist when it comes to the funding system in relation to the accessibility of the services. While both national systems are partly government-funded, major differences are illustrated in the way individuals are able to achieve the needed health results. Hence, in the US, private funding remains somewhat pivotal, while in New Zealand, it is optional and does not require each individual to opt for health insurance.
Regulatory Overview
In regards to regulations and entities responsible for policy implementation, both New Zealand and the US rely on state bodies of regulations. In the US, the Department of Health and Human Services and its branch, the Department of Public Health Services, is the entity addressing public health services on a federal level. Among responsibilities such as constructing agendas for systematic changes, monitoring population well-being, and reducing disparities, implementing and formulating legislative implications is one of the aims correlating with the operation of the entity (Tikkanen et al., 2020). In coordination with local and state authorities, as well as in collaboration with private organizations, the department determines regulations needed to improve the overall system of public care provision. Some of the most important policies are the Healthcare Quality Improvement Act, Children’s Health Insurance Program, and Affordable Care Act.
In regards to the New Zealand system, the main regulatory body is also a state department that ensures universal care is provided. Namely, the Ministry of Health of New Zealand is the entity responsible for regulating and maintaining the healthcare system accessible and efficient (Ministry of Health, 2022). Hence, the New Zealand Public Health and Disability Act and Health Act are among the most important legislative implications directly correlating with the involvement of the Ministry of Health.
Provision of Public Health Services
The provision of public health services correlates with negative aspects when it comes to both frameworks. It is certain that due to the fact that the New Zealand system is a universal one, it is more accessible compared to the US one. However, both countries face challenges when it comes to reducing disparities among different demographics. Thus, according to researchers, Māori children are provided with fewer health resources compared to non-Māori ones (Chin et al., 2018). The same study shows that if the US were to address disparities in public health services provision among different age groups, races, ethnicities, and nationalities, the healthcare industry costs would be reduced by 1 trillion dollars in three years. The outcome correlates with the major costs linked to health disparities.
Conclusion
The universal system illustrated within the New Zealand healthcare system appears to correlate with positive outcomes in regard to accessibility and outcomes. On the other hand, the insurance-based system exemplified in the US is linked to disparities and lower health outcomes for the population. Both frameworks are regulated by government departments and are partly based on private insurance. However, its purchase in New Zealand is optional, while in the US, it has a more significant role.
References
Chin MH, King PT, Jones RG, et al. Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States. Health Policy. 2018;122(8):837-853.
International Trade Administration. New Zealand – healthcare. International Trade Administration | Trade.gov. Web.
Ministry of Health. Legislation and regulation. Ministry of Health NZ. Web.
Papanicolas I, Woskie LR, Orlander D, Orav EJ, Jha AK. The relationship between health spending and social spending in high-income countries: How does the US compare? Health Affairs. 2019;38(9):1567-1575.
Shrank WH, DeParle N-A, Gottlieb S, et al. Health costs and financing: Challenges and strategies for a new administration. Health Affairs. 2021;40(2):235-242.
Tikkanen R, Osborn R, Mossialos E, Djordjevic A, Wharton GA. New Zealand. Home. Web.