Increasing the quantity and quality of life for each individual is arguably the most important undertaking for any society. In fact, it’s probably a large part of why humans group together and cooperate in the first place. Health, whether it is physical, mental or psychological, is a crucial factor in a life of longevity. Thus, a good healthcare system is at the forefront of societal agendas, and that’s what we’re looking at here.
Over the years there has been much debate over what kind of system can most effectively produce health care for a country…
However, the term “effective” is ambiguous. For the purposes of this list, and according to the previous Director General of the World Health Organization or WHO, “The difference between a well-performing health system and one that is failing can be measured in death, disability, impoverishment, humiliation and despair.” So with this in mind the WHO clarified and quantified the distinguishing features between good and bad health care systems, and spearheaded the largest research campaign into countries’ healthcare systems.
In WHO’S millennial report, the organisation analysed over 190 countries. The overall health system score for each country was the combined results of 5 key categories. The 5 components were weighted with different levels of importance. The ideal system, as per these components, is an equitable healthcare system – both equitable in its remit and in its financial burden on the country’s citizens – and one that is, of course, effective in keeping the country healthy and, well, alive. The different aspects were weighed with varying degrees of significance: 25% for level of health measured by the DALE (or disability-adjusted life expectancy) scale, 25% for the distribution of health, 12.5% for the level of responsiveness, 12.5% for the distribution of responsiveness and 25% for the fairness of financial contribution. As per these specifications, collated with reports from a survey of each country’s citizens, each country was ranked by their ‘overall health system performance’ index, on a scale of 0-1. Some of the lowest performing countries included the Central African Republic, which had an index of 0.156, and Nigeria, which stood at 0.176.
At the top of the scale, however, WHO listed these 5 countries as, rather definitively, the best health care systems in the world as of the turn of the century. What makes them so successful? Read on to find out.
5. Malta: 0.978
Malta is an Island in the Mediterranean Sea, south of Sicily, and is part of the European Union. Perhaps the combination of mild temperatures, spiced with sea breezes and a healthy diet contributes to the high average life expectancy of 80.4 years. Of course, the combination of private and public health care, that’s free at the point of delivery – for a total population of 411, 277 – probably helps the situation. Malta spends around 8.7% of it’s GDP on health care, which translates to 2443 US$ per person annually. Malta’s primary hospital, the Mater Dei Hospital, opened in 2007 and is home to one of the largest and most innovative medical buildings in Europe. Regardless of high smoking rates this country was ranked number 5 overall scoring highly in each of the five categories. If you get sunburnt on the beach here while sipping on some of their fine wine don’t worry – Malta’s got you covered.
4. Andorra 0.982
Andorra is one of the smallest states in Europe tucked in between France and Spain next to the Pyrenees Mountains. They have a staggering population of 85, 293, and the lucky citizens of this health haven have an average life expectancy of 82.58 years. The central government does shape health care policy, but the financial responsibility and the main implementing structure to cover health care costs come from the work force. Employed citizens join the Caixa Andorrana de Seguretat Social or CASS through their employer and this program covers their health expenses. Andorra spends about 7.2% of it’s GDP on health, which is the equivalent of 3073.3 US$ per capita. People who are not employed pay around 300 euro’s per month if they want to opt into the insurance system. Andorra also has one of the world’s lowest unemployment rates at 2.9, which translate to about 2,500 people. With all this, Andorran citizens can enjoy skiing down some slopes in the Pyrenees Mountains without worrying about the cost of a tumble.
3. San Marino 0.988
It seems smaller countries have it sussed when it comes to health care. Another tiny country makes the top five list for healthcare here: San Marino is geographically the third smallest state in Europe, but proudly claims to be the oldest republic in the world. It is an enclaved microstate located in the northeastern side of Italy and is host to 32, 448 citizens. The standards of health equality are scrupulously followed in the country. Laws are enforced that make equal access to any health care facilities obligatory no matter what your situation is. The unemployed, old age pensioners, people with chronic illness, and those on maternity leave do not have to pay for healthcare here. The list goes on to generally cover any particularly susceptible or in-need group. San Marino spends about 7.2% of its GDP on health care, which translates to 3279.4US$ per capita. There is a combined public and private health care system that eases up waiting times for the one state hospital, the San Marino Hospital. This area of Europe is a particularly safe place to fall ill, especially given that San Marino’s neighbour takes the next spot on our list…
2. Italy 0.991
Italy, home of the Colosseum, the works of Da Vinci, countless beautiful cities, fantastic food, magnificent beaches, fashion, architecture, the list could go on for a very long time, just like Italy’s history. This nucleus of Western civilisation is also the country with the second best health care system in the world. Italy is host to a large population of about 62 million, which means that the implemented health care system could be used as a model for other countries looking to improve their own system. Life expectancy at birth is on average 81.95 years for these Mediterranean men and women. Italy spends 9.5% of GDP on health care, which translate into 3129.5 US$. Italy’s designation as the number 2 spot by the World Health Organization was not free from controversy. Numerous response articles and academic papers were written about the miss interpretation of many problems that the Italian health care system faces. Citizens of Italy complain that an urban favoritism clearly exists, and that people in the south do not have access to public hospitals. They claim that rural citizens have to either go to large cities or pricey private hospitals to receive adequate medical attention. Taking these factors into account Italy still has an overall low-cost health care and a good standard of medical assistance in both private and public sectors. So if you are out enjoying the many sites of Italy, but trip over a rock and hurt yourself, don’t worry Italy has got you covered.
1. France 0.994
The number one spot goes out to none other than the featured star of Michael Moore’s Sicko, France. Oddly enough considering it’s number one spot France spent 11.6% of GDP on health care, which is approximately 4,086 US$ per capita. Such spending is higher than the average in Europe, but is still less than half the amount of money the average U.S citizen pays for health care, which in terms of GDP is 17.7% or 8,608$ per person. France’s slightly larger cost is mostly covered by government public funds, which cover 76.8% of overall health expenditures. Parliament has a direct influence on health care policy thus there is a great responsiveness and sensitivity to public concerns about the health care. The Ministry of Health controls a large part of the regulation of health care expenditure and tries hard to keep costs low while maintaining or raising the quality standards. It’s responsible for an array of the health systems mechanics’ from dividing the budget expenditure for that 76.8% stated earlier, to deciding on the number of medical students to be admitted to medical school each year.
From providing welfare and work programs responsible for the financial support of low-income elderly and disabled people to sending a nanny as a state sponsored helpful hand of maternal and child health care France covers countless of health matter scrupulously and proudly. So if you are enjoying French coffee with a croissant on a Sunday afternoon, but you realize the waiter accidentally added milk to your treat, and you are seriously lactose intolerant so you panic, don’t worry France has got you covered.
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