Introduction
Nowadays, the health care environment undergoes a number of changes and challenges. Medical workers face various ethical dilemmas, delivery systems should consider the last achievements of technological progress, and each country needs to pay attention to its own cultural, economic, and political issues to offer the elderly population the best health care delivery services. The rise of health care delivery costs and population aging become a burning question for the debates. The current paper aims at analyzing literature about health care delivery systems of three highly industrialized countries like Canada, Germany, and the USA. Canadian, German, and American health care delivery systems for the elderly people have their own peculiarities, and their analysis helps to understand how the implementation of different policies may improve the current state of affairs and provide people with a kind of insurance about appropriate health care services.
Health Care Delivery System’s Peculiarities
According to Markides, a health care system may be defined as “the practice of health and medical professionals preventing and treating illness as well as maintenance of mental and physical well-being (2007:261). People are in need of professional and in time medical help, especially, the people aged 60. Health care delivery systems of the developed countries are usually better prepared for the challenges that may take place because of rapidly aging societies; still, even such huge and successful countries like Germany, Canada, or the USA should be ready to make certain improvements, consider such health indicators like life expectancy, health condition, and determinants, and follow the provisions in their health policies.
General Evaluation of the Countries
The analysis of German, Canadian and American health care systems shows that, in contrast to the USA, almost all citizens of developed countries receive health care services according to special national health insurance programs, which are run by the government and financed by means of general taxes (Shi and Singh 2009). Each chosen country has its own peculiarity that makes its health care delivery system unique and worth attention. For example, Germany has a kind of socialized medicine that obliges the government to offer a number of social benefits to its citizens (Porter and Guth 2012). Canada is famous due to its national health insurance program according to which the government offers its population a properly defined package of medical benefits (Marchildon 2006). The USA does not have any national health insurance program that makes its health care one of the most expensive in the whole world (McCarthy, Schafermeyer, and Plake 2011).
Health Indicators
Life expectancy, health status, and determinants are the main health indicators that measure various aspects of health and explain what may affect health, which programs and services are more appropriate for a certain group of people, and which implementations are necessary. Statistics show that Canadian life expectancy at birth has been considerably improved since 1970: it has risen “roughly 1 year for every 5 calendar years” and reached 82.2 years for women and 77.1 years for men (Marchildon 2006:12). It is explained by the improvements in the Canadian lifestyle, health care quality, and wealth increases. German life expectancy at birth is unique in two parts of the country, eastern and western. The rates of East Germany increase quicker in comparison to those of West Germany. In the world, the country ranks 14th place with the data 78.1 years for men and 83.1 – for women (Porter and Guth 2012). American life expectancy shows lower results: women live approximately 80.2 years, and men live 75.1 (McCarthy, Schafermeyer, and Plake 2011). Canadian general health status is good indeed, as it is influenced by the following factors: alcohol and tobacco use has been decreased considerably and immunizations help to prevent problems with diphtheria, tetanus, etc. Unfortunately, high obesity rates low the overall health status in Canada. German health status may serve as an example to be followed: appropriate immunization, attention to nutrition, and alcohol and tobacco control make more than 90% of Germans regarding themselves as healthy. The health care system of the USA cannot be called as the main contributor to its health status because of inabilities to gain control over the following health determinants: the use of tobacco and alcohol in all states and the promotion of immunization as the main disease prevention means.
Health Services Covering
The success of health care delivery systems and the preparation for the future growth of population is predetermined by the way of how the services are covered and funded. Health services offered in Canada, Germany, and America are covered in different ways. For example, Canada is known for its health services financed by means of general tax revenues. Health service delivery is decentralized because of territorial responsibilities (Canada consists of 10 provinces), physicians’ status, and the existence of different organizations (e.g. Regional Health Authority). Canadians also have a limited amount of private health insurance and an access to Medicare, the health care system that is funded by the government and provide all citizens, including the elderly, with a universal coverage. In comparison, the USA deprives the elderly of the same opportunities.
In its turn, Germany has SHI (Social Health Insurance) as the main source of health care financing. It covers about 85% of Germans and becomes one of the most successful programs in the globe. The principle of this coverage is simple: the government has to provide each citizen with a number of social benefits, including health services. There are also some private sickness funds. These independent funds presuppose direct payment to the service providers.
From this point of view, the German system is more relevant to the one of the USA due to the existence of many small private plans by means of which health services are funded. The main burden of such cost of society is the necessity to control the incomes of the elderly and explain the reasons of why governmental support can or cannot be given in a particular case, and what measurements may be discovered in a particular health care delivery system.
Provisions in Health Policies
Health service provision is the way of how such inputs like equipment, staff, drugs, and money are evaluated to provide citizens with appropriate health interventions’ delivery. For example, Canadian long-term care provision for the elderly may be offered in special facility-based institutions like nursing homes. However, long-term care is not an insured under the Canada Health Act service and varies among the territories according to the programs and regimes offered. Territorial governments pay for services, and people cover meal and accommodation costs (Marchildon 2006).
In Germany, there is a three-level statutory long-term care insurance system. Social insurance covers all the costs depending on the level of care required, still, the elderly without children should pay some percent. American long-term care is funded by several parties: family members, Medicare or Medicaid, or care insurance. There are many conditions to be considered to understand what kind of financial support is available for older patients, and not all Americans are satisfied with the offered system (McCarthy, Schafermeyer, and Plake 2011). Preventive medicine in Canada is provided by family physicians or special screening programs supported by the territorial governments. Much attention is paid to AIDS prevention and tobacco reduction. Preventive care in Germany may be facilitated by health plans and sickness funds. A wide range of services including health spa are offered to the citizens, still, the majority of preventive services are of public concern – people should pay for them independently.
Preventive medicine in the USA is replaced by the attention to social, behavioral, and environmental factors. In other words, Americans focus on prevention and healthy life promotion more than on disease treatment. Such services are usually funded by state or federal governments. Coverage of chronic illness depends on the system of a particular country. The majority of Canadians, German, and Americans admit that in spite of the existing financial support that comes from the governments, people continue spending much money on prescribed drugs and cannot allow themselves all the prescriptions. Chronically ill people may allow themselves a quick access to drugs; still, they are not always able to pay for them.
Lessons to Be Learnt through the Analysis
Each of the chosen countries has its own peculiarities, positive and negative aspects of the health care delivery system, and effects on the elderly population. Canadian experience shows that everything has its prices. Even if health services are free, the system can always find a way to allocate the resource and offer a new one for affordable prices. In spite of the fact that Canadian rates of life expectancy are higher than in the USA, there are many Canadians, who prefer to cross the border and use American treatment instead of waiting on lists for free governmentally supported treatment.
The lesson that comes from Germany is probably the most powerful as it is based on the social solidarity and the necessity to make use of law to get the required portion of treatment. Health services create a solid basis on which the society develops. Though the health care system in Germany is not perfect, it is stable and does not create any invisible barriers for the citizens. The USA may implement the policies offered by the German health care system and benefit from it a lot. The use of small and independent plans should not create many challenges for the country: the elderly can feel governmental support from different perspectives and use free services without unexpected expenditures. The Canadian policies seem to be effective as well, but not as stable and assuring as German ones. If the German social approach is implemented, the issues of race, gender, and class inequalities will hardly complicate health service delivery. Much depends on how people are can get their insurance, pay for treatment, and prove the rights to have health services. When the question of health is raised, inequalities should not matter.
Conclusion
In general, Canada, Germany, and the United States of America meet the needs of its elderly population and prepare for the future growth in its own particular way. Each country has its strong and weak sides, and the governments of these countries try to do everything possible to improve the situation, offer better services, and create the most powerful health care delivery system. It is not necessary to identify the system of which country is better or stronger, it is more important to evaluate all their peculiarities and take the best to create one powerful and helpful system around the whole globe.
Reference List
Marchildon, Gregory, P. 2006. Health Systems in Transition: Canada. Toronto: University of Toronto Press.
Markides, Kyriakos. 2007. Encyclopedia of Health and Aging. Thousand Oaks: SAGE Publications.
McCarthy, Robert, L., Schafermeyer, Kenneth, W. and Plake, Kimberly, S. 2011. Introduction to Health Care Delivery. Ontario: Jones & Bartlett Publishers.
Porter, Michael, E. and Guth, Clemens. 2012. Redefining German Health Care: Moving to a Value-Based System. New York: Springer Science & Business Media.
Shi, Leiyu and Singh, Douglas. 2009. Essentials of the U.S. Health Care System. Sudbury: Jones & Bartlett Learning.