Global Health Blogs with Professor Swahn

Health systems comprise of people, institutions, and resources to meet the health needs of populations. With a robust adjusted health system’ that seeks to meet the needs of different individuals, countries can focus on prevention, diagnosis, treatment, disease control, violence prevention, and improving individuals’ physical or mental health needs. Countries with efficient and effective access to quality healthcare systems have better health outcomes that identify care variations, reduce per capita cost, and improves patients experience and overall population health. According to the World Health Organization (WHO), access to quality health care requires governments to ensure all individuals receive universal health coverages that promote services without financial hardship. I believe the burdens of financial cost, access, and unequal systems have negatively affected developed and developing nations. How can we address such issues to improve health systems worldwide when governments do not accept their methods are failing. Therefore, collaboration and contributions from all parties are needed to strengthen health systems worldwide. Despite knowing this, I question what classifies as an excellent healthcare system? Through research, I came across WHO’s critical components to improving health care systems. Not stating it works. However, it’s a start.  

WHO’s key components of a well-functioning health system include:

• Improving the health status 
• Defending the population against what threatens the health
• Protecting people against the financial burdens of health
• Person centered-care
• Including people n decision-making

I believe these critical concepts described are essential for improving the needs of populations. However, the achievement of a well-functioning health system is proven to be challenging. Many health systems worldwide fail to meet the critical components mentioned above, and that failure leads to adverse health outcomes. In the United States, which is considered a high-income country,  describing and understanding tits healthcare system can be challenging, yet there are some advantages and disadvantages. I solely believe we have some strengths-based on the Affordable Care Act (ACA) provision. Some strengths include but are not limited to;  

U.S. System’s Strengths: 

•  If insured, high-quality service is available.
• Great clinical research
• Technological breakthroughs for disease diagnosis, prevention, and treatment
• Physicians and specialist accessibility (based on geography)

Based on these system’s strengths, if you have access to health insurance, the services received(based on race and socioeconomic status) benefit consumers. Also, the U.S. advancement in research has made them influencers in disease control and prevention. Lastly, Individuals living within a location with access to care benefit from the U.S. health system because the timeliness of care is essential to eliminating adverse health outcomes. Perhaps a pregnant woman lives miles away from the hospital and is experiencing pregnancy-related health complications; she becomes a high risk for maternal mortality and morbidity due to transportation or access to services.

With the evolution of technology, research, and medicine, access is a factor in inequalities, which causes significant weaknesses within the U.S. health systems.

 Disadvantages: 

• Lack of universal health coverage
• More spending on healthcare
• Adverse health outcomes
• Inequalities between low-income communities/cultural competency                                             In the U.S., the ACA aims to provide near-universal coverage, but without state-level expansion of healthcare, inadequate coverage to disadvantaged communities remains a concern. Universal coverage is essential; it ensures healthier people, poverty reduction, and improves health inequalities. Inequalities have been a historical factor in how individuals perceive health systems. For example, although decades ago, the U.S. Public Health Service Syphilis Study at Tuskegee still plays an integral role in the perception of research and vaccination amongst minority populations. In this study, a federally funded experiment conducted on African Americans with syphilis in rural Alabama would reveal that researchers withheld treatment and informed consent of the risk to over 400 men. Researchers’ negligence despite their knowledge of the drug penicillin used as a treatment of syphilis led to numerous African American’s deaths. According to the Centers for Disease Control and Prevention analysis, minorities are dying at a higher rate than white Americans from the COVID-19 virus. Therefore, public health officials addressing the mistrust stemmed from mistreatment related to the Tuskegee syphilis study might increase vaccination acceptance amongst minorities.

 

Despite having the most expensive health care system, the U.S.  ranks lower than other developed countries. I spoke to a friend who lives outside of London, and he stated their health system was better than the U.S. 

U.K. Healthcare System: 

• Free healthcare from National Health Service (NHS)
• Widespread accessibility
• Promotion of human rights/equality
• Improve public health.

These factors noted the encouragement of widespread accessibility, universal healthcare, and a better chance to dispel adverse health outcomes amongst communities. The NHS publicly funded healthcare system focuses on community health and well-being versus financial consequences. Because the Department of Health is responsible for the healthcare and funding in the U.K., they evaluate what works continually or not. Although inequalities exist, U.K. has made efforts to reduce health inequalities by strengthening universal primary care services through the NHS. They grew the health budget, reduced the infant mortality rate, increased life expectancy, and promoted vaccination.

These initiatives have allowed the U.K to be successful; however, there remains room for improvement. 

Disadvantages: 

•  Frequent changes
• Lack of options
• Lower wages for medical professionals
• Longer wait times/ low services

 Universal coverage has its advantages, yet as with any system, constant improvement is needed. Individuals who need to receive care find the process daunting because of long wait times. Often, the care is not the best, partly due to medical professionals’ low wages. Care usually mimic the national public health performance standards; however, it does not. For many professionals, compensation is essential to the quality of care. From previous experience working overseas, many of my colleagues stated they found it easier to purchase private health insurance coverage due to the quality and timeliness of care. 

Therefore, what equates to a sound health system? As we compare countries, health systems appear complex and challenging. There is no easy fix. However, I believe global collaboration may assist nations who health care systems have more significant disadvantage than advantages. The cost of care, medicine, technologies, and quality access to care is a significant factor for why the health system is not well functioning.