Evaluation of United States and Mexico

The world over, countries are grappling with the need to offer universal medical healthcare to their respective citizens regardless of economic development or form of political orientation. As such, all countries are striving towards coming up with new means with which to address emerging health care challenges which are basically as a result of lifestyle diseases and new disease causing strains such as the H1N1 virus.

In the United States of America, healthcare services are mainly offered various legalized private entities. The private sector own and run most of the health institutions and related facilities within the US borders (Sultz & Young, 2010). However, health insurance cover is mainly provided by the US government through both the private and the public sectors. There are numerous health insurance programs offered by the US government’s public sector (Sultz & Young, 2010).

According to data from the United States Census Bureau in 2009 reported that nearly 17% of persons living in the country were uninsured (Sultz & Young, 2010). The United States has the highest expenditure per individual with relation to healthcare in the world. Thus healthcare in the United States uses a greater percentage of the country’s total income than any other country in the world. The underlying fact to these statistics is the high cost of medical care in the country (Sultz & Young, 2010).

In Mexico, just south of the United States border, healthcare is provided through public institutions, private establishments and qualified private medical practitioners (Homedes & Ugalde, 2006). Healthcare provided through the public institutions is realized through an effective and elaborate system formulated by the federal government of Mexico to provide and deliver healthcare services to the general public. Healthcare services provided by private healthcare establishments and private medical practitioners are available to those who can afford the services in accordance with the free market policy. Public health care establishments under the supervision of the Health Secretariat Agency offers to all Mexican citizens subsidized health care services regardless of their employment status (Homedes & Ugalde, 2006).

The Mexican Constitution guarantees the provision of public healthcare to all citizens of the country as stipulated in article 4 (Homedes & Ugalde, 2006). In public healthcare institutions, the cost of healthcare is free or subsidized by the Federal Government relative to an individual’s employment class. The structure of the Mexican Federal Government’s healthcare system has a system structured to accommodate the various classes of society in the country (Homedes & Ugalde, 2006).

There is also a health care scheme operated under the administration of the Mexican Social Security Institute (Instituto Mexicano del Seguro Social) IMSS (Homedes & Ugalde, 2006). Under this scheme employed persons and their respective dependant share the cost of healthcare with the IMSS and the employee’s employer. The health care cost is shared equally among the three. However, it should be noted that the IMSS does not cater for the health care services of state workers (Homedes & Ugalde, 2006).

State workers such as local authority workers, state employees and employees with the federal government have their healthcare needs covered by the Institute for Social Security and Services for State Workers (Instituto de Seguridad Servicicios Sociales de los Trabajadores del Estado) ISSSTE (Homedes & Ugalde, 2006). This agency caters for employees in the public sector providing health care services as well as social services (Homedes & Ugalde, 2006).

The provision of basic healthcare in Mexico dates back to the late 18^th century with the establishment of Hospicio Cabanas in the Mexican city of Guadalajara. This famous hospital is now recognized by UNESCO as a world heritage site (Homedes & Ugalde, 2006). The IMSS healthcare scheme was initiated in 1943 and by the beginning of the 1990’s the healthcare systems in Mexico was reaping the benefits attributed to this scheme. This was supported by the mortality rates which were ranked approximately at par with those recorded in developed countries (Homedes & Ugalde, 2006).

From the 1970’s, overall health statistics progressed positively for Mexican citizens. Overall healthcare expenditure for this nation stood at just below 6.5% of Mexico’s GDP in the year 2005 Homedes & Ugalde, 2006). Public sources accounted for about 45.6% of health spending. This was way below the average recorded in Organization for Economic Co-operation and Development (OECD) member countries. In Mexico, government provisions for healthcare services are universal and also affordable to most of the population (Homedes & Ugalde, 2006).

Thus the private healthcare insurance covers are only used in privately run hospital facilities. In 2005, Mexico had 1.8 medical doctors and about 2.2 nurses for every 1000 Mexican citizens (Homedes & Ugalde, 2006).

In Mexico, all large and medium sized cities have at least one well equipped hospital. Healthcare costs in Mexico are up to 40% less compared with those charged in California in the United States (Black, 2008). Healthcare in Mexico is so much affordable as compared to the US that Americans cross the US-Mexico border to access the affordable healthcare services in healthcare facilities in Mexico (Black, 2008). In Mexico, specialized medical practices such as dent surgery cost a quarter of the costs in the US. (Black, 2008) In 2005, an estimated 60,000 elderly American nationals opted to spend their retirement years in Mexico with an all inclusive nursing home policy, weather and healthcare services that are both professional and affordable (Black, 2008).

The quality of healthcare services in Mexico is considered to be of very high quality. The rich history of the Mexican healthcare sector has seen reforms formulated as way back as the 1940’s improving considerably in the 1970’s to be an accredited healthcare policy recognized as successful by other countries in 2005 (Homedes & Ugalde, 2006). Most of the Mexican doctors receive at least some part of their medical training in the US. There are many medical doctors from the United States who receive medical training in Mexico (Homedes & Ugalde, 2006). Thus it can be argued that the medical expertise in the two countries is at par with each other. However, most American citizens and the developed countries regard the quality of the Mexican health care system as of low quality since the medical services offered there in are considerably cheap (Homedes & Ugalde, 2006). Quite the contrary, the Mexican healthcare system is in a class of its own. The quality of Mexico’s healthcare services, healthcare system, and medical personnel professionalism, response to disease outbreaks, hygiene standards and accessibility is of very high standards with the most modern medical equipment installed in Mexican health institutions (Homedes & Ugalde, 2006).

The outbreak of the Swine Flu fever tested Mexico’s intricate healthcare systemv. Millions of the country’s population flocked into healthcare facilities for both healthcare services and professional diagnosis (Whyte, 2009). In 2009, Mexico was estimated to be home to about 105,000,000 citizens. Other diseases common in developing countries such as malarial fever and TB still plague the country (Whyte, 2009). Statistics from the World Health Organization (WHO) indicate that Diabetes, liver and heart disease as emerging concerns for the country’s healthcare experts. The universal health care insurance schemes, private healthcare insurance schemes both big and small dictate the level of healthcare and quality relative to the level of payments for medical services and care (Whyte, 2009). A dilemma that Mexico is grappling with is the rising expenditure on health care as much as Mexico still has the lowest expenditure on healthcare per capita among the OECD member nations (Whyte, 2009). More than 3 million upper and middle class Mexican citizens pay for insurance schemes that guarantee top class, state of the art healthcare services (Whyte, 2009). More and more Mexicans insured through public insurance schemes are opting for private care for better healthcare services. Therefore, the private health care provision sector is booming business (Whyte, 2009).

There have been numerous incidences in which the poorest Mexican households have been rendered bankrupt by disease. (Whyte, 2009) The Mexican Government in 2003, embarked on ensuring that the estimated 40 million Mexicans living under the poverty line received universal access to healthcare to mitigate such occurrences (Homedes & Ugalde, 2006). This scheme is referred to as Seguro Popular translated to mean the Popular Health Insurance. This scheme is projected to reduce the level of inequality in the provision of health care services (Whyte, 2009). This scheme has been attributed to special programs which have drastically reduced malaria prevalence by a commendable 60% (Homedes & Ugalde, 2006). However, in rural areas, medical training is inadequately monitored and as such some professional posted to such areas opt to train the nurses on how to screen disease other than offer healthcare services (Homedes & Ugalde, 2006).

Health care in the US constitutes up to 15 the country’s gross domestic product making it the single largest expense in the super power’s economy (Sultz & Young, 2010). However, this does not reflect in the average state of health of the general US population, this is attributed to a lower quality healthcare system than expected given the huge budget allocation (Sultz & Young, 2010). Life expectancy in the US is also considerably lower as compared to other developed nations. An estimated 45 million US citizens are not covered by medical insurance. Nearly 18 percent of these uninsured individuals are below the age of 65 (Sultz & Young, 2010). The worrying trend suggests that adult Americans do not receive 50% of the advocated healthcare provision and services (Sultz & Young, 2010). Statistics indicate that individuals above the age 65 spend a lot more of their money on health care services approximately more than four times the cost spent on healthcare services by individuals under the same age.  22% of the elderly demographic spend a large fraction of their health care money on nursing homes (Sultz & Young, 2010). Medical providers and hospital care services however account for a large percentage of monies spent on healthcare with statistics indicating that American citizens under the age of 65 spend 64% while citizens aged above 65 spend up to 65% of healthcare money on the same services (Sultz & Young, 2010).

In the US, statistical data indicates that the cost on healthcare tends to increase exponentially relative to age. It can therefore be said that the elderly dictate the US health care spending. A decade ago, the mean annual health care expenditure per capita for the general US population stood at more than 2,250 (Sultz & Young, 2010). Age as an effective measure of healthcare spending and as such demographic numbers indicated that the mean per-capita costs for persons aged between 65 and 74 years were higher than those for persons aged between 18 and 64 years by 250% (Sultz & Young, 2010). Health care expenditures for persons aged 85 years and over were 300% more than the general average. This has been a cause for concern for the US health care policy makers as containing these costs poses a huge problem creating budget deficits (Sultz & Young, 2010).

The dilemma faced by the US healthcare system is that uninsured Americans have no access to basic healthcare (Walt, 2010). This presents healthcare policy makers with more costly eventualities in curative healthcare other than preventive healthcare (Walt, 2010). Diseases such as cancer are on the increase in the US and as such uninsured individuals are in the high probability zone of being diagnosed with such diseases at the final stages. Any form of treatment to alleviate suffering at this stage is very costly (Walt, 2010).

There are more than 100 insurance plan providers in the US. Administrative overhead expenses require a larger proportion of the healthcare budget (Sultz & Young, 2010). In March 2010, the American president approved health care reforms and signed the patient protection and Affordable Care Act (Walt, 2010). Provisions provided in the Act offer businesses incentives to give employees healthcare benefits, curtailing denial of such benefits on the basis of preexisting conditions. Annual caps set by insurance providers have been eliminated among other many such provisions in the Act (Walt, 2010).

Other members of the OECD member states have ridiculed the United States for not having instituted the health care reforms enacted into law in 2010 (Walt, 2010). In Europe failure by elected heads of government to institute healthcare reforms as advocated by citizens amounts to these leaders being voted out of office. Taxes in countries within the European Union are lower than those taxed in America, but the health care services are for the wealthy (Walt, 2010). In Europe, healthcare and other public services are heavily subsidized by governments and services offered are of very high professional standards and much more affordable as compared to those experienced in the US (Walt, 2010).

The United State is a free market economy and the government has delegated healthcare services to the private healthcare sector (Sultz & Young, 2010). This has made the access and affordability of healthcare services beyond reach for more than 45,000,000 American people who cannot afford healthcare services offered at theses private institutions. With the health care reforms under President Obama’s administration have laid the ground work for improvements in this sectors future (Sultz & Young, 2010).

References

Whyte, S. (2009). How Mexico’s health system works. CBC News. Retrieved 15 July 2011, from http://www.cbc.ca/news/health/story/2009/05/04/f-health-mexico-health-system.html

Black, T. (2008). Mexico Builds Hospitals to Lure Medical Tourists From America. Bloomberg L.P. retrieved 15 July 2011, from http://www.bloomberg.com/apps/news?pid=newsarchive&sid=audTNhIlsFSg

Walt, V. (2010). E.U. Gloats over belated U.S. Health Care Reform. Time. Retrieved 15 July 2011, from http://www.time.com/time/world/article/0,8599,1974424,00.html

Homedes, N. & Ugalde, A. (2006). Volume 25 of U.S.-Mexico contemporary perspectives series. Berkeley: Center for U.S.-Mexican Studies, UCSD.

Sultz, H. A. & Young, K. M. (2010). Health Care USA: understanding its organization and delivery. Sudbury: Jones & Bartlett Learning.