Health Care Delivery Systems Analysis
The United States is a world leader in sophisticated health care technology, medical training and is home to world renowned research institutions like the Harvard Medical School, and the Mayo Clinic. The huge investment in health care has not translated into superior quality health care delivery for the American citizens. Approximately 50 million American citizens are uninsured, and consequently have no access to routine primary health care. Americans may find the Swiss health care system of special interest. Switzerland is a capitalist country just like the U.S and has a highly developed pharmaceutical industry and yet it guarantees its citizen universal coverage with superior outcomes and great satisfaction. As the U.S. policy makers are debating an appropriate health care model for its future, they may find the Swiss health care system of special interest.
Underpinning of Healthcare Delivery Systems
Data from the Central Intelligence Agency (CIA-The World Fact book, 2011), reveal that “the United States has the most technologically powerful economy in the world” and that the U.S is “market-oriented, private individuals and business firms make most of the decisions in the economy”. The U.S. health care delivery system reflects the ideology of free enterprise espoused by American citizens. Health care is viewed and regarded “as an economic good and not as a public resource” (Shi & Singh, 2008). The passing of the landmark Health Care Reform Bill into law by President Obama in March 2010 was a watershed in American health care history. The bill will ensure that 32 million more American citizens will have insurance coverage by the year 2016 Congressional Budget Office (CBO, 2010).
The Swiss system is based upon “liberalism, private initiative, and is heavily regulated by the state” (Okma, et al., 2010). The system draws inspiration from European model of “managed competition” based on the premise that “the rules of the free market do not work adequately in the health care sector”. (Okma, et al., 2010, p.144). In 1996 the Federal Health Insurance Law (FHIL) was passed which outlined an alternative approach to approaching competition by “shifting the competition mechanism away from the direct relationship between patients and their physician to the relationship between health insurer and insured as well as the relationship between health insurer and health care provider” (Okma, et al., 2010, p.144). The Swiss health care system is also characterized by three important factors, “a strong decentralized political system based on federalism and the institutions of direct democracy, and a liberal economic culture, and a well-developed tradition of social security” (Okma, et al., 2010),. This tradition of social security led to the rise to universal social insurances in the form of pensions, annuities for widows and orphans, disability insurance, unemployment insurance, family allowances, and medical care. The Swiss system consists of 26 subsystems, connected to each other by the 1996 (FHIL). According to Okma, et al., (2010), two other fundamental concepts worth mentioning are: “voice”- which is a federal means of direct democracy; and “exit”- which gives the regions “cantons” “recourse to “voice” when citizens feel that political decisions do not adequately reflect their regional preferences. The Cantons are responsible for health care regulation, supply and implementation (Okma, et al., 2010).
Access and Utilization
In the U.S there are significant barriers to entry at “both the individual and the system level” (Shi & Singh, 2008). According to...