World Health Organization Ranking; The World’s Health Systems
| 1 France 2 Italy 3 San Marino 4 Andorra 5 Malta 6 Singapore 7 Spain 8 Oman 9 Austria 10 Japan 11 Norway 12 Portugal 13 Monaco 14 Greece 15 Iceland 16 Luxembourg 17 Netherlands 18 United Kingdom 19 Ireland 20 Switzerland 21 Belgium 22 Colombia 23 Sweden 24 Cyprus 25 Germany 26 Saudi Arabia 27 United Arab Emirates 28 Israel 29 Morocco 30 Canada 31 Finland 32 Australia 33 Chile 34 Denmark 35 Dominica 36 Costa Rica 37 USA 38 Slovenia 39 Cuba 40 Brunei 41 New Zealand 42 Bahrain 43 Croatia 44 Qatar 45 Kuwait 46 Barbados 47 Thailand 48 Czech Republic 49 Malaysia 50 Poland 51 Dominican Republic 52 Tunisia 53 Jamaica 54 Venezuela 55 Albania 56 Seychelles 57 Paraguay 58 South Korea 59 Senegal 60 Philippines 61 Mexico 62 Slovakia 63 Egypt 64 Kazakhstan |
65 Uruguay 66 Hungary 67 Trinidad and Tobago 68 Saint Lucia 69 Belize 70 Turkey 71 Nicaragua 72 Belarus 73 Lithuania 74 Saint Vincent and the Grenadines 75 Argentina 76 Sri Lanka 77 Estonia 78 Guatemala 79 Ukraine 80 Solomon Islands 81 Algeria 82 Palau 83 Jordan 84 Mauritius 85 Grenada 86 Antigua and Barbuda 87 Libya 88 Bangladesh 89 Macedonia 90 Bosnia-Herzegovina 91 Lebanon 92 Indonesia 93 Iran 94 Bahamas 95 Panama 96 Fiji 97 Benin 98 Nauru 99 Romania 100 Saint Kitts and Nevis 101 Moldova 102 Bulgaria 103 Iraq 104 Armenia 105 Latvia 106 Yugoslavia 107 Cook Islands 108 Syria 109 Azerbaijan 110 Suriname 111 Ecuador 112 India 113 Cape Verde 114 Georgia 115 El Salvador 116 Tonga 117 Uzbekistan 118 Comoros 119 Samoa 120 Yemen 121 Niue 122 Pakistan 123 Micronesia 124 Bhutan 125 Brazil 126 Bolivia 127 Vanuatu |
128 Guyana 129 Peru 130 Russia 131 Honduras 132 Burkina Faso 133 Sao Tome and Principe 134 Sudan 135 Ghana 136 Tuvalu 137 Ivory Coast 138 Haiti 139 Gabon 140 Kenya 141 Marshall Islands 142 Kiribati 143 Burundi 144 China 145 Mongolia 146 Gambia 147 Maldives 148 Papua New Guinea 149 Uganda 150 Nepal 151 Kyrgystan 152 Togo 153 Turkmenistan 154 Tajikistan 155 Zimbabwe 156 Tanzania 157 Djibouti 158 Eritrea 159 Madagascar 160 Vietnam 161 Guinea 162 Mauritania 163 Mali 164 Cameroon 165 Laos 166 Congo 167 North Korea 168 Namibia 169 Botswana 170 Niger 171 Equatorial Guinea 172 Rwanda 173 Afghanistan 174 Cambodia 175 South Africa 176 Guinea-Bissau 177 Swaziland 178 Chad 179 Somalia 180 Ethiopia 181 Angola 182 Zambia 183 Lesotho 184 Mozambique 185 Malawi 186 Liberia 187 Nigeria 188 Democratic Republic of the Congo 189 Central African Republic 190 Myanmar |
As a country, we have been arguing over healthcare for several years now. There have been some outright whoppers being told on both sides. For instance, if you want to keep your insurance you can keep your insurance. It was not a lie, however, it was an inappropriate misdirection in that there was no mention that your insurance could very well disappear under the new regulations. In fact, that is what happened to various people. It was a lie by omission. On the other side was the whopper about death panels. There were never any death panels, and by now the Affordable Care Act has run long enough that is has proven the absolutely despicable lie that was told during the anti-Affordable Care Act campaign.
But, much of the argument about the Affordable Care Act, and now about single-payer healthcare, misses a very important point. You see, much of the argument against either some modification of the Affordable Care Act or against single-payer healthcare is based on a set of assumptions that are inaccurate. Most of the arguments against either healthcare proposal are based on pointing out issues with other systems. But, there is a major point that is missed. Every one of those arguments assume that the issues that we find in other systems will make our system worse. But, that is not actually true. That argument would be true if, and only if, we fully adopted the system of a nation that had worse healthcare than we do right now.
At the beginning of this post, I included a chart that comes from the World Health Organization that ranks national healthcare systems using various criteria. I should mention that there is at least one USA ranking system that places us even lower than what the World Health Organization ranks us. Now, let me go back several years to the original healthcare argument. At that time, many people argued that the WHO was lying because they were biased against the USA. While there are still a few that will argue that, the vast majority of people are now admitting that we have a troubled healthcare system that is NOT the number one healthcare system in the world. (In passing, that was the argument that was being used by several years ago.) And this brings us to an interesting logical point, if we use the various rankings of world healthcare systems.
I have a friend that consistently brings up that people from Canada drive to the USA to have an MRI performed. The reason is the waiting times to get an MRI in Canada. What that person says is absolutely and totally true. Canada is also a troubled system. However, whether on the WHO scale or the USA ranking system, Canada ranks 30th in the world. Here is the worst part. The USA ranks even lower than that. So, let’s look at this logically. If we were to fully adopt the deficient Canadian system, then overall we would still be better off than we are now. Our expenses would go down, and there is a good chance that life expectancy would increase over time. Mind you, increase only slightly, but, nevertheless, increase.
And there you see the logical problem with many of the arguments against changing our current healthcare system. We rank so low that we could adopt the system of up to 30 other countries and still save money and get better healthcare. Were we to adopt the healthcare system of either France, Italy, or Spain, we would have a highly efficient healthcare system that would save us a massive amount of money, plus probably help increase our life expectancy. Now, some of you will immediately try to look for death panels or some such other item against which to rail. But, there are two problems with that type of argumentation. First, we can tailor our regulations to be somewhat different than theirs. Second, in effect we have death panels, they are called insurance companies that will cheerfully disapprove and/or delay any and all treatment in order to not have to pay out, even if the patient dies (oh, so sorry). Third, in order to have to refuse to adopt any other system, you have to argue that it is better that people suffer or die than to have ordinary folk pay more taxes. But, even here there is a problem, if healthcare costs go down to the levels of any of the three nations I mentioned, then overall the savings to individuals would be far greater than any increase in taxes. You see, taxes may go up, but individual payments would almost disappear.
All three systems (France, Italy, Spain) allow individuals to freely go to personal physicians. You simply pay some extra. Thus, those who have money still get to have extra care, yet it would still cost less than what they are paying now. And now we are back to what I said back a couple of paragraphs ago. There are many healthcare systems that we could adopt that have problems, and yet would STILL be an improvement over the system we have going right now. And that is the problem with the argument that various people use against either the Affordable Care Act or some type of better-crafted replacement.
I’m a Canadian but spent five years in the US during my 37-year Air Force career. The Canadian health care system is more egalitarian than the American system; meaning the rich get a lower quality of care than their American counterparts, but the poor get better care. We all know which group has power over politicians and I can’t envisage a scenario where the American elite allows a change that would be to their detriment.
Padre, I’ve been on medical missions to the Dominican Republic and to Ecuador. Placing Ecuador at #111 might be about right, but the DR at #51 is highly optimistic.
I think a lot of countries officially and legally “provide” health care to all, but when we see the quality of it we should ask, “What’s the point?”
As in Ecuador, the Dominican hospitals are broken-down, poorly equipped and poorly staffed. The equipment—if they even have it—is 1970s era, possibly castoff from the US. Some of our older anesthesia providers get nostalgic in the operating rooms, using old equipment that they trained on, while the younger ones get a culture shock. The beds are broken and often propped up by concrete blocks and, if you want to raise the head of the bed, have someone go and find a stick on the junk pile out by the ambulance (you’ll recognize the ambulance by the red cross on the side, and the flat tire). Bend the nail over on the stick.
The power goes off every afternoon in the Dominican Republic and maybe someone will start the generator. If not, our OR team will use headlamps and light from iPhones. The water doesn’t work. The toilets clog up with no water.
Giving the Dominican nurses instructions to care for overnight patients is unreliable. Regardless of their understanding, too often we return the next morning to find empty I.V. bags and medications not given—even if we have communicated it to the Dominican doctor who was supposed to be on duty. For anything urgent, we need one of our docs or nurses to come in during the middle of the night.
So, 51 is optimistic. For Ecuador, as I said, 111 is about right, but change everything “Dominican” in the preceding paragraphs to “Ecuadorian” and you’ll be accurate, except the electricity stays on pretty well in Ecuador.
As in any country, the rich have their private hospitals. The poor get free care, for what it’s worth, but you won’t find any of the rich in the public hospitals—unless we gringos are there, then the rich will get in line first if they can. And raise a stink if they can’t.
You know the drill. You’ve seen it in Peru and other places.
But don’t get me started on the US system, either. Ours is not a matter of quality, it’s a matter of funding it. Our insurance system is double-paying, first by financing it and paying the bankers, also-known-as insurance companies, then letting the insurance pay, at their discretion, the hospitals. We need to get rid of the insurance companies from the health care system.
I’m on Obamacare. It works, but needs an overhaul. As a self-employed person, I never know how much I’ll make each year and have been on the edge of having to pay back, with my April 15th 1040 form, $20,000 in subsidies (we prefer to call it “tax credit”) each year for the past two years. Keeping my old insurance, as it turns out, was never an option after all, as I had a deductible of $15,000 to make the premiums affordable, and high deductibles are no longer permitted.
Repeal and replace? Yes, but only if it’s an improvement. Otherwise, let’s fix Obamacare and call it something else if we have to, so the Republicans can keep blaming Obama.