Free Health Status and Health Care Services Essay Sample
Ireland is a country that is divided into two political entities. The first one is The Republic of Ireland, which was ratified in the year 1919 and officially formed in the year as a sovereign republic. The second political entity is The Northern Ireland which was established in the year 1921 as a part of the United Kingdom. Ireland is the third largest island in Europe and despite there being a political partition between the two parts of the islands still its maintains its political union and even fields single candidates in sports and other social events. Ireland has a population of approximately 6.2 million as per the 2008 census with the bigger fraction of the people residing in the republic of Ireland while only about a sixth of the population is from Northern Ireland. The population of Ireland had relatively been in a constant decline since the mid 19th century the time of a devastating famine that led to a death toll of over a million people. This is in the backdrop massive increase in the population of other European countries in the same period. Between 1840 and 1850, the decade of the famine, more than half of the immigrants in the USA was from Ireland. Other nations including England Canada and Australia have also been beneficiaries of this emigration. It was until the year 2006 that Ireland recorded its population growth since. However thanks to the economic growth in the 20th century and its joining the European Union Ireland is presently experiencing immigration.
On the other hand The United States of America (USA) is a much bigger both in terms of geographical area as well as the population. USA occupies the third largest land area in the world and also has the third largest population in the world. It has a population of more than 300 million including the more than 10 million illegal immigrants. It has a population growth rate of about 0.98% which is much higher than that in Western Europe thus making it the only developed country with projected economic growth. It is the most cultural diverse nation in the world of course owing to the massive immigration from other countries and also its open door policy to foreigner for example the use of the green card lottery. The USA has the highest economic rate which it owes to ample presence of natural resources, well developed infrastructure and sufficient supply of human resource which eventually leads to high productivity. The country has the largest national GDP in the world and is also the largest importer and the third largest exporter of world goods. Given this economic growth and the consequential military might the United States is said to be the superpower of the world.
In Ireland the health care system is roughly organized into the public healthcare system and the private health that is mainly offered individuals and private companies but has to be licensed by the government. The public healthcare system is managed and run by the Health Service Executive, a body that was established by the health act of the year 2004. Every person resident in Ireland is entitles to proper health care through the public health care system which is funded by the country taxation system. Depending on many factors people could be required to pay a substantially subsidized amount of money for the health services. These factors could include the age, the income bracket of the person, disability status of the person and other factors. However it is noteworthy that all maternal healthcare needs are catered for by the public health care system free of charge.
In contrast healthcare in the united is not controlled or managed by a particular specific organ but instead by various legally effected bodies and organizations. It is also significantly owned by the private sector as compared to the situation in Ireland. Just as is the case in Ireland much of the public health care expenditure in the USA is paid for by the government through the taxation and other methods. USA however spends about double of what Ireland spends on healthcare. According to Frenkel Ireland spends an average of 8.2 percent of its GDP on healthcare with the biggest bulk being paid by the government. On the other hand the current expenditure of the USA on health stands at 16% of the total GDP making the North American nation the highest spender in the world as far as health care is concerned.
Despite dedicating a much smaller fraction of the total expenditure to health care Ireland as compared to USA has shown significant success in ensuring that there is equity in accessing the required services. Depending on the earning of the person the Health Service Executive in Ireland has various packages that differ not in quality but in the price that a person is required to pay for the services. Frenkel says that all the citizen of Ireland are entitled to free health care as well as the visitors who have European health insurance cards. In case of inpatient services the patients are offered services and bed for free in the voluntary hospitals and those that are run by the health service executive.
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In the USA there are complaints from various quarters that the services are not a reflection of the money that is spent on them. This is also reflected in the fact that using the universal determinants of health status The USA has a higher child mortality rate and low life expectancy than other developed countries even though it spend more than them. The united State was ranked by the common wealth fund as the poorest in terms of the quality of health services when compare with other countries with the same status. USA is noted as the only industrialized nation without much focus on ensuring that most all of its citizens have medical cover. About 15% of the entire population of the United States does not have insurance cover at all while about 35 % percent and not adequately covered. This disparity causes differences in the amount of money different people need to pay for the health services the system being accused of discrimination. It is even worse because those that are not insure are mostly from the poor parts of the population who are hardly able to pay for the medical services required this in turn leads to many deaths that could otherwise be avoided.
As far as health cover concerned Ireland does much better than the United States in trying to make sure that all or at least the majority of its citizenry is covered. This is done through the use of payment schemes which are organized in such a way that they include as many people as possible. These schemes include The Medical Card, GP visit cards, Drugs Payment Scheme, Long Term Illness Scheme and The Accident & Emergency scheme. With a medical card a person is able to visit a family or personal doctor or GP service, to access dental services, to get hospital care and to also be given prescription medicine without paying any money. Before being issued with a medical plan the Health Service Executive (HSE) or the applicant's Local Health Office carry out an assessment of their viability. To get a medical card one's income should be below a certain level that the health service executive or any other relevant authority deems appropriate. The factors that are considered in this appraisal include a person's expenses on child care, mortgage, travel, and any other significant financial burden. The HSE may also issue a medical card to a person that proves that he has other social predicaments that are a burden to his finances. For example if a person has a long term illness that is costly to treat probably due to lifestyle adjustment or in terms of purchasing medication then he or she may be considered for a medical card. The medical card can be given to cover the whole family or it can cover one individual in the family who has more financial hardships. Up until the year 2009 the persons aged over 70 years were automatic recipients of the medical card but things changed since then and now those senior citizens are charge a price albeit lesser than the other people.
Another form of the medical scheme in Ireland is the GP Visit Card which has more strict income guidelines and requirements than the medical card. Those who do not qualify for the medical card can be eligible for the GP visit Card. With one a patient is able to visit a doctor free of charge but has to pay for any medicine that is required.
The other scheme is the Drug Payment Scheme under which a person or family is required to a certain amount of money per month, about 120 Euros, for prescription drugs and other medical needs that the person or family require in the month. The persons eligible for this scheme are those with The GP Visit card or those without a medical card. Foreigners who have been residents in Ireland for a year or intend to be resident of the country for a year are also for applying to this scheme. The maximum amount payable by people in this scheme is reviewed from time to time by the Local Health office or the HSE.
Another scheme that offers medical cover for the Irish people is the Long Term Illness Scheme. This one sources its membership from the people with certain illnesses and disabilities. These include Acute Leukemia, Mental handicap, Cerebral Palsy, Mental Illness in persons under 16 years of age, Diabetes, Epilepsy, Muscular Dystrophies, Parkinson's disease and others that the relevant authorities specify. A successful applicant is issued with Long Term Illness book with which the persons are allowed to collect drugs and other medical appliances that require for the treatment of their illnesses or conditions without having to pay for them. If one has the medical card then they do not have to apply to join this scheme.
In the cases of accidents or other forms of emergency, for one not to pay for the health services required they should have a GP visit card or a referral letter from the family of personal doctor, otherwise they have to pay for the service.
Health care in the United States is not such a success story like it is in Ireland. The American population relies heavily on private insurance companies for their health cover which of course charge higher premiums than what is paid by the Irish population. More than half of Americans are insured with private companies. According to Mitchell Public health covers in United States mostly cater for the senior citizens which are a contrast with Ireland which does not have much of a preference a far as the elderly are concerned. The covers also cater for the children from very low income families and other families that meet some specific requirements. The main coverage program is The Medicare which offers social insurance to the persons aged over 65s of age and who have permanent residents of the United States for at least 5 years. However it is also require that the applicant for this program or their spouse should have been paying Medicare taxes for at least 10 years or they may have to pay a monthly price.
The other program is the Medicaid which I funded by the Federal as well as the State Government but is affected at the state level. Those eligible for this program are those families with low incomes, foreigners who reside in the country as well as people with disabilities. The children Health insurance program (CHIP) is designed such that it gives uniform funds for health insurance for families with children. It was created to mainly cater for those families whose incomes were too high to be eligible for Medicaid but not sufficient enough for their other needs and thus cannot afford to procure private insurance coverage.
Other program includes TRICARE which covers the military personnel's health benefits, and the veteran health administration which covers the needs of America's war veterans. Some also have their own program that caters for the health requirements of their low income earning populations. However on March 23rd 2010, the United States President signed into law The Patient Protection and Affordable Care Act (PPACA) which was a result of healthcare reform lobbied by the new administration. The reforms are to be effected over four year duration and they include improving Medicaid eligibility, reducing the price charged on insurance premiums, giving incentives for private businesses to give health care benefits as well and incentives for scholars to engage in more medical and public health research among other provisions.
Fraenkel states that in Ireland the hospitals, health centers and other medical facilities are significantly owned by the public and run by the Health Service Executive. There are also those that are owned on voluntary bases as well as privately owned ones. The same is not the case in the United States as most of the health facilities are ran by private companies and individuals. There are no facilities managed by the central government but there some that are owned and ran by the federal and the state governments. However most of the hospitals despite being privately owned are not for profit and they account for the most patient intake.
Despite massive expenditure by the two nations on healthcare it has not saved their health systems from problems and criticism with Ireland being on the receiving end on the issue of waiting lists where patients have to wait for so long for up to four hours in the outpatient and as much as six months for those inpatient client seeking long term treatment like serious surgeries. On the other hand the United States main undoing is the financial burden as compared to the quality of the healthcare. As Mitchell says that some business owners can't compete favorably due to the high health benefits they have to pay to their employees.
However much of the complaining about the status of health care comes from the united states as compared to Ireland where a 2007 survey by the HSE showed that 90 percent of the patients were satisfied with the services.