Saturday, June 30, 2012

Here's a Map of the Countries That Provide Universal Health Care (America's Still Not on It)

The U.S. stands almost entirely alone among developed nations that lack universal health care.

By Max Fisher
Jun 28 2012, 6:09 PM ET 
mf healthcaremap p.jpg

As excited as American liberals and proponents of expanding access to health care might be about the Supreme Court's decision to largely uphold the Affordable Care Act, the U.S. still stands out from much of the developed world in state efforts to make medical care available to the public. If universal health care in the U.S. is your goal, then today was a big step forward, but maybe also a reminder of how far behind America still lags.

The above map shows, in green, countries that administer some sort of universal health care plan. Most are through compulsory but government-subsidized public insurance plans, such as the UK's National Health Service. Some countries that have socialized and ostensibly universal health care systems but do not actually apply them universally, for example in poverty- and corruption-rife states in Africa or Latin America, are not counted.

What's astonishing is how cleanly the green and grey separate the developed nations from the developing, almost categorically. Nearly the entire developed world is colored, from Europe to the Asian powerhouses to South America's southern cone to the Anglophone states of Australia, New Zealand, and Canada. The only developed outliers are a few still-troubled Balkan states, the Soviet-style autocracy of Belarus, and the U.S. of A., the richest nation in the world.

The handful of developing countries that provide universal access to health care include oil-rich Saudi Arabia and Oman, Latin success story Costa Rica, Kyrgyzstan, and, famously, Cuba, among a few others. A number of countries have attempted universal health care but failed, such as South Africa, which maintains a notoriously inefficient and troubled public plan to complement the private plans popular among middle- and upper-class citizens.

None of this is to downplay the importance of today's Supreme Court ruling for supporters of the U.S. effort to expand health care coverage, nor to argue that U.S. health care is equivalent to that in, say, Egypt or Belarus. It's precisely because the quality of U.S. health care is so high that makes this map interesting.

That brings us to another way that America is a big outlier on health care. The grey countries on this map tend to spend significantly less per capita on health care than do the green countries -- except for the U.S., where the government spends way more on health care per person than do most countries with free, universal health care. This is also true of health care costs as a share of national GDP -- in other words, how much of a country's money goes into health care.

"The overall level of health spending in the United States is so high that public (i.e. government) spending on health per capita is still greater than in all other OECD [Organization for Economic Cooperation and Development] countries, except Norway and the Netherlands," according to a recent OECD report, which covers most of the developed world.

Whether or not that will change with President Obama's health care reform now Supreme Court-approved, access to health care will remain yet another way in which the U.S. stands out from the rest of the developed world.

  • Sayyid Fulaan 2 days ago
    But the US government does pay for a lot of people's healthcare. There's a limit every government is willing to pay for healthcare and the limit in the US is just set differently. Some people are left out of the system, but medicare recipients receive world-class healthcare.
  •  So it's just the people are aren't quite poor enough for Medicare that get poor coverage? Great system we got there.
  • Diggitt McLaughlin 1 day ago in reply to Ethan
     Fat lot of good it does people on Medicare (you may mean Medicaid) to get "world-class healthcare" by the time they're sick, when they haven't received preventive care along the way.  They may have missed vaccinations and immunizations, had to let infections rage until they wore out, never had good dentistry (which can ravage the rest of your body), never had decent glasses, never been able to afford decent food, never had a doctor try to help them make wiser life choices, had to endure too many pregnancies...the list goes on. 
    Having seen acquaintances receive Medicaid for treatment of brittle diabetes means: their "world-class healthcare" was received in shabby nursing homes where people going into coma were ignored and bedsores abounded.  One friend received two bedtime shots of Lantis despite his protests, because of faulty charting.  It could have killed him, and might have--since his protests were ignored, and I had to threaten to wake up the county attorney to get ameliorative action. 
    THIS is Medicaid.  Yes, it's world class, if by "world-class" you mean it happens in the world.  Thank god it doesn't happen in MY world, and apparently it hasn't happened in YOUR world.
  • At least twice, my son had life-threatening conditions that could not be resolved at home. If not for the capable and awesome hospital care that was paid by Medicaid, my child would almost certainly not have survived. I believe that for Medicaid to work properly, for all, it must be federally mandated, and not left up to the states. This ensures uniform care, and fairness for all. Medicaid is far too important to be decided by state budgets and state whims.
  • I generally agree but the beauty of Medicaid, as compared to Medicare Advantage, is that states have the ability to design a program that fits their state. New Mexico and Rhode Island, for example, are two very, very different places that need entirely different solutions.
  •  poor women are dying without world class life saving abortions nor deadly disease preventing condoms.... there is a shortage of doctors in the USA as med schools deliberately keep classes small and tuition VERY HIGH... forcing up the cost of care... Medicaid forces women to wait weeks if not months for a life saving abortion as ectopic pregnancy is not an instant ticket to state funded removal of the parasite bound to cause internal bleeding and organ damage.... humans are not perfect medical machines to assemble & reassemble on a world class production line... WITHOUT primary care and affordable preventive well patient care, the poor are not getting what costs less and keeps people healthiest, this is in addition to curbing pollution which is causing millions of cancers on this planet each month
  • Jordan Hamel 2 days ago
    Population of the U.S. dwarfs most of those countries. Even Brazil and Russia have had to re-adjust to a private/public mix.  Even Medvedev and Putin are gradually with a 20 year window weening itself off of it's system that started their health care framework during the Bolshevik revolution.
    Better not to promise than to promise that future generations will take care of us and break that promise... this goes for healthcare, pensions, and all other things that we've over promised.
    Promising on the behalf of someone in the future that they will do something is easy when they haven't been born yet. :)
  •  scarcity is a choice not a necessity regarding human services and monetary policy is merely an agreement, certainly not a science of quantities mined or grown or manufactured ... global clean air, clean water and healthy soils are finite and measured... thus markets are baiting and switching all humanity, polluting what is scarce and overpricing what is limitless, our nurturing ability to care for one another @VoteLarrDis114 some basic facts from macro economics & political science 843-926-1750
  • Population is irrelevant. The figures are per capita.
  • Actually the map colors are by whether they have it or not,  he mentions that by color countries tend to trend based on per capita. My point still is the same.  The fact that we already spend X amount per capita on healthcare only makes it a more daunting task for a nation as large as ours.
  • The fact that we already spend X amount per capita on healthcare only makes it a more daunting task for a nation as large as ours.
    And all the more critical! It would be one thing if we were getting top notch healthcare as a nation for the astronomical sums we spend. But we're not. A modest portion of the population gets outstanding healthcare. The bulk of the population gets standard-issue rich country quality care (good, but by no means "great" -- or better than what the typical Frenchman or Norwegian receives). And then a sizable minority gets substandard care -- or (if they're uninsured) gets pretty much zero access to regularized, preventative care or treatment of chronic conditions.
  • it makes it easier actually, given the larger pool of patients
  • You know, the problem with your basic argument is that all human societies have taken care of their elderly. It's what distinguishes us from animals. That suddenly in the 21st century, at the peak of our collective wealth, we can no longer afford to is a meme spread by wealthy, selfish conservatives. Don't believe it. It literally dehumanizes you.
  • ahh, human societies never took care of anyone's elderly. Healthcare was always provided from the family..... family problem @divorce-rates @shrinking-birth-rates
  • Jordan, when you use absolute terms, such as "never," and "always," your argument is weak and easily refuted. Only one exception is needed to disprove your stand, in these cases. If "human societies never took care of anyone's elderly," how then do you explain Social Security? Poof! Now your argument is moot.
    Furthermore, the point of view that the churches or the families ought to provide all care is one that particularly rankles me. Our tax funded government programs are extremely important. Sometimes whole families, and communities can be decimated at one time by natural disasters, or unfortunate accidents. It is unreasonable to expect our families to supply our needs when they, too, are vulnerable to the vagaries of living, and to devastation or destruction due to unexpected disasters.
    Our blessings in life, our health, or our relative prosperity is not guaranteed for life. We can't predict the future, so we don't know if or when we might find ourselves in need of help. Most importantly, not all of us have friends, family, or willing church members who are eager or able to come to our aid. It is a responsible and good government that insures that its people will have safety nets for those unexpected misfortunes that can happen to almost anyone.
    A good and responsible government ensures its citizens will have a level of security, dignity, and independence in their old age. I don't know who said it first, but I agree that "the mark of a healthy and strong society is how well it cares for its most vulnerable citizens." I believe the opposite is just as true, that is, a society on the verge of or in the throes of collapse, disregards or abuses its most vulnerable citizens.
  • Actually, health care has traditionally been seen as a societal responsibility -- discharged through charity and public support. The notion of care for the ill and dying as a profit center is quite new. Until the 1980s almost all health insurers were non-profit and most hospitals were established and supported by religious orders or were community based -- supported through taxes and charity.
  • You need to read history better. To be sure, until modern medicine developed, healthcare was often as harmful as helpful and there was rather little it could do other than provide supportive care. However even in ancient Egypt there were professional physicians, and certain temples were tasked with seeing to it that the people of the community had some health care at need. The Church played that role in the Middle Ages in Europe, and in India the Buddhist emperor Asoka bragged of having provided people throughout his domains with doctors. The ancient Greeks paid public doctors to treat the poor and cities in Renaissance Italy created the first HMOs for their citizens. Universal healthcare, provided through the whole community, is a very old human tradition. Heck, the Neanderthals took care of their elderly and injured. Social Darwinism-- let the sick and the old just die-- is what is the aberation here.

  • JoshINHB 7 hours ago
    Why oh why can't the US be as civilized as Russia, Saudi Arabia and Sri Lanka?
  • sympatikos 7 hours ago
    Regardless of Obamacare, can anyone tell me why we Americans pay, not double, not triple, but 4, 5, 6 or seven times more for our health insurance?  Than any other country in the world?  Than we would pay if we moved to any other country in the world?
  • I watched a talk show from the states a while back in which the commentators were chatting about the Canadian healthcare system as though it was a total crock - deeply flawed and "socialist". Knowing how excellent the Canadian system can be - recently a relative received top notch cancer treatment and is well on the road to recovery - it is offensive to listen to these types of characterizations. Is the Canadian system perfect? What system is... but it is humane and overall a successful model.
    Those of us who have lived in the UK, Canada and other green countries on the map and been privileged to receive quality medical care - not in relation to our monetary worth - but because it's a fundamental cornerstone of a civilized society to treat the sick and the injured, struggle to understand the deep dyed resistance on the part of many Americans to universal healthcare.
  • sympatikos 7 hours ago
    Can anyone, ANYONE, tell me why we Americans must pay not double, not triple, but 4, 5, 6 or SEVEN times more for health insurance than people in any other country ?
  • yes!!
    you're paying $3 to $3.50 a gallon for gas while in europe your have
    to pay $6 to $10 or more a gallon.
    now,  the next time you fill it up and 1t costs $150,  just remember some
    of those gas taxes go to help pay for the best health care in the world.
    and if you don't believe it's the best care,  just follow some saudi prince or king
    to the hospital when he (she) needs treatment.  if you can read the sign.
  • Unfortunately, unless you too are as rich as a Saudi prince, the major benefit you're getting from the quality of his treatment is the ability to make somewhat illogical and irrelevant claims on the internet.
  • Gas taxes help pay for health care ?
  • US is on the map of paid political thinks tanks in bag of corporations that benefit from   preventing it from having a universal plan. 
    If you map the world  of political hacking you would not find as many political hacking institutions as in USA.  Be sure of that.  Citizen United is a boon to their income.  They attack universal plans in other countries too and  they work to collapse their systems through propaganda  so that they can export corporate health goons into other regions.
  • U-S-A! U-S-A! U-S-A!
  • TheGlobalizer 6 hours ago
    You can be for universal access without having the care provided by the government and while opposing PPACA.
  •  The care isn't provided by the government under PPACA. Its  nearly all private sector providers, with some Americans having their insurance through the public and others through private companies. What is your alternative?
  • abby0802 6 hours ago
    What is so bloody difficult to understand or to accept about having universal health care?
    I have been the recipient of military health care, European health care, and the typical health care provided through insurance at work in America.  I have also been without health insurance and for that reason gone without health care.
    It simply amazes me that some Americans find fault with the concept of universal health care.  Even post-war Europe as devastated as it was after WW II got its act together and provided national health care.  Even Switzerland, that bastion of conservative thinking where women did not get the right to vote until the 1970s, has a national health care system and the Swiss love their system.It seems that there is a belief among too many of us that health care is somehow a privilege.  But for all of us it is a matter of life or death.  Without appropriate, timely health care our bodies deteriorate into an early grave.
    America should be ashamed that it has taken us this long to get the law we have now.
  • DavidComments 5 hours ago
    The map is misleading.  The Russian Federation has universal healthcare in name only.  People with means get private insurance because the public care is so bad.  In Russia, doctors working for state healthcare providers make as little as $200 a month. . .
  • JohnJMac 4 hours ago
    How many of these countries share a 2,000 mile border with a 3rd world narco-state?
  •  Only one...Canada.

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