Currently, millions of persons all over the world lack health insurance and are left to either bear the burden of expensive healthcare costs or slowly perish remaining disabled without medication or adequate treatment. Global healthcare systems encompassed in all of their financial struggles have been perpetuating a vicious cycle causing the sickest of the sick to remain in poor health and hurdled into financial catastrophe. Many health systems are financed by out of pocket payment for services rendered during which far too often a sick person will seek care –> care is too expensive –> person remains ill and cannot work –> person becomes impoverished or on the other hand a sick person will seek care –> spend all of his/her life savings on treatment –> person find themselves penniless.1 As healthcare is a human right, is it not the job of our governments to protect us all from this type of financial catastrophe? After all, the health of no human being is guaranteed.
Inadequate healthcare financing is a major problem in many under developed countries. Poor countries are suffering the worst from the aforementioned viscous cycle and consequently, they are still facing immense burden from preventable disease. So do we (America and developed nations) go into developing nations and show them how things should be done? Do we give them the money to institute social health insurance, which has been proven to be both cost effective and fair?2
Research shows that the persons of lower income regardless of whether their country is developed or not have a higher incidence of catastrophic healthcare spending than persons with higher income.1 In New York City, NYU Tisch (rich country/high income persons) is a private hospital located just one block away from Bellevue (poor country/low income persons) which a large public hospital. At Tisch, most of the patients are covered by private insurance and receive a high caliber of care along with a plethora of amenities during their hospital stay. Bellevue patients on the other hand are often poor, lack adequate health insurance and are subject to long wait times and care limited by lack of resources. These two hospital systems and their methods of health financing are a microcosm for the world at large. The poor patients at Bellevue who are often very sick, bear many of the financial risks and burden of paying out of pocket for health care that is often no match for the quality of care received by the rich at private hospitals such as Tisch. Thus, the short answer to whether or not we should meddle in the affairs of health financing in other countries is no. We do not have authority to do so when we ourselves cannot get a grasp on our own health system’s spending and health outcomes. The United States has no business attempting to influence health financing anywhere other than at home where persons of lower income suffer everyday from health care imposed poverty just down the street from those who are protected from financial catastrophe.
- Xu K, et al. “Protecting households from catastrophic health spending.” Health Affairs, 26(4):972-83.
- Birn A-E, et al. (2009) Textbook of International Health, 3rd Edition: Chapter 11: Health Economics and the Economics of Health.