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The author is a Registered Nurse who has worked in the US, UK, Canada and Australia. The US is the only industrialized country without a National Health Care plan. Pharmaceutical companies and the Medical Profession are self centered when they oppose a National Health Care System. A National Health Care System will cost less, increase life expectancy, and reduce infant mortality. It will put a dent in the income of doctors and the pharmaceutical industry but it will better for more people even though the privileged few will end up getting less.

A Nationalised Health Care Plan for all the people of the United States is long overdue. The United States is the only industrialized country which does not look after all its citizens. Citizens who are poor, citizens who are disabled, citizens who are unemployed or under employed. Canada is often referred to as the Great White North, is America’s largest trading partner. It provides universal health care to all its citizens, free. Until recently private health care was illegal. The cost of providing free care is not as high as is under the American system.

The United Kingdom and Australia have both systems of health care (private and public) running parallel to one another. The Canadian system of health care is not inferior to that of the US, UK, or Australia.

I have worked as a Registered Nurse in Scotland, England, Canada, USA, and Australia. During my employment in the Public Health Systems and in the Nationalised Systems I have come to know the advantages and disadvantages of both systems. There is no one system which suits all countries therefore each country has to find its own health care system.

 

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A shot in the arm for a National Health Care System is needed. It is a must. It is needed for the betterment of the total health of the country. Some individuals may lose some privileges. Yes, the doctors and the pharmaceutical industry will bitterly oppose such a plan.

The main reason for the absence of a national health care system in the US is the opposition by the Medical profession and the Pharmaceutical Industry. The Doctors are looking after their economic interest when they refuse to support a nationalised system under the guise of quality of care. The reality is that doctors will most likely end up seeing more patients and earn less. This is the crux of the matter. The medical profession may have its earnings capped and regulated. If the government becomes the major buyer of pharmaceutical products it will most likely be able to negotiate the price downwards. The pharmaceutical industry is opposed to a national health care system for the same reasons.  

The current system in the US is both good and bad. It is good because the quality of health care provided is very high, there are no waiting lists, each patient gets to choose his doctor, and it is technically more advanced than the health care systems of all other countries. However, this is NOT grounds complacency because all these benefits do not confer any advantage for the people who are not insured. The uninsured people are the  majority of Americans.

A 2008 report by the Commonwealth Fund ranked the United States LAST in the quality of health care among the 19 compared countries. This is because more than half of the population of the United States is uninsured. America remains the only developed country without health care system for all it’s people.

The United States is the only industrialized country in which approximately half the population is not insured and does not have access to medical services. A look at the table below shows that all countries where the per capita income is greater than $29,000 have a health care system for all its people. The United States needs a National Health Care Plan for all it’s citizens.

Table 1: National Average Per Capita Income

Rank

Country

Per Capita Income in US$

1

Luxembourg

54,430

2

Bermuda

36,000

3

United States

37,500

4

Norway

37,300

5

Liechtenstein

25,000

6

Channel Islands

N/A

7

Switzerland

32,030

8

Denmark

31,210

9

Ireland

30,450

10

Iceland

30,140

11

Canada

29,740

Despite the best technology and facilities the infant mortality in the United States is worse than that of Singapore, Cyprus, Brunei, and Cuba. The United States needs to look after its women, infants and children.

Powerful Interest groups are opposed to a national system because they will become less important and they will lose economically. As things stand the medical profession of the United States is the richest, most prestigious and most monopolistic. It is successfully keeping competition out in the guise of quality of care. What good is quality of care when only half the population can have it?  

  Table 2.  Infant mortality per 1,000 live births

163

 United States

6.3

164

 New Caledonia

6.1

165

 Cyprus

5.9

166

 Brunei

5.5

167

Channel Islands (  Jersey and  Guernsey)

5.2

168

 Cuba

5.1

Even after spending the most amount of money in the world America does not have the lowest life expectancy or the longest life expectancy. The “high quality” remains the domain of the filthy rich and famous.   

The life expectancy in the United States is less than that of many other countries despite the fact that the United States is one of the wealthiest countries. The United States needs to look after its tax payers when they retire. In 1990 and 1995 the life expectancy in the US was not ranked in the top twenty countries.

Table 3. International rankings of life expectancy.

Rank

1981

1986

1990

1995

2000

1

Japan (73.9)

Japan (75.3)

Japan (76.0)

Japan (76.5)

Iceland (77.9)

2

Iceland (73.5)

Iceland (75.1)

Iceland (75.3)

Sweden (76.2)

Japan (77.8)

3

Greece (73.3)

Greece (74.1)

Sweden (74.8)

Iceland (75.6)

Sweden (77.4)

4

Sweden (73.1)

Sweden (74.0)

Greece (74.7)

Australiab (75.5)

Australiab (77.2)

5

Netherlands (72.7)

Switzerland (73.7)

Australiab (74.0)

Switzerland (75.4)

Switzerland (77.0)

6

Norway (72.6)

Spain (73.3)

Switzerland (74.0)

Canada (75.2)

Australian-bornc (76.8)

7

Spain (72.6)

Netherlands (73.1)

Canada (73.9)

Australian-bornc (75.0)

Canada (76.7)

8

Switzerland (72.4)

Canada (73.0)

Netherlands (73.8)

Greece (74.8)

Italy (76.4)

9

Canada (71.8)

Australiab (73.0)

Australian-bornc (73.7)

Italy (74.8)

New Zealand (76.1)

10

Italy (71.5)

Norway (72.9)

Italy (73.6)

Norway (74.8)

Norway (75.9)

11

Denmark (71.4)

Australian-bornc (72.7)

Norway (73.4)

Netherlands (74.6)

Spain (75.8)

12

Australiab (71.3)

Italy (72.6)

Spain (73.3)

France (74.4)

Greece (75.7)

13

Australian-bornc (71.0)

Denmark (71.9)

France (73.3)

Spain (74.3)

Austria (75.5)

14

UK (70.9)

UK (71.8)

UK (72.9)

New Zealand (74.1)

UK (75.5)

15

France (70.9)

France (71.8)

Belgium (72.7)

UK (74.0)

Netherlands (75.5)

16

New Zealand (70.5)

Germany (71.3)

New Zealand (72.4)

Austria (73.6)

France (75.4)

17

USA (70.4)

Belgium (71.3)

Austria (72.3)

Luxembourg (73.5)

Germany (75.1)

18

Ireland (70.1)

USA (71.3)

Denmark (72.2)

Belgium (73.4)

Denmark (74.8)

19

Belgium (70.1)

New Zealand (71.0)

Luxembourg (72.0)

Germany (73.2)

Luxembourg (74.7)

20

Germany (69.9)

Austria (70.9)

Germany (72.0)

Denmark (72.9)

USA (74.2)

The United States is one of the wealthiest countries in the world. The table below shows that the income per capita is second highest in the world. Yet it is the only industrialized country without a national health care system.

The quality of life index places the United States in the 13th position. See table below. The quality of life will improve if there was a national health care system for all its citizens.

Country

Score – Quality

Rank – Quality

GDP in US $

GDP Rank

Ireland

8.333

1

36,790

4

Switzerland

8.068

2

33,580

7

Norway

8.051

3

39,590

3

Luxembourg

8.015

4

54,690

1

Sweden

7.937

5

30,590

19

Australia

7.925

6

31,010

14

Iceland

7.911

7

33,560

8

Italy

7.810

8

27960

23

Denmark

7.796

9

32,490

10

Spain

7.719

10

25,370

24

Singapore

7.719

11

32,530

9

Finland

7.618

12

29,650

20

United States

7.615

13

41,529

2

Canada

7.599

14

34,150

5

Table 5. Quality of life index. America is Ranked thirteenth.

Recently I posted the following question on the internet, “Why is the USA without a Universal Public Health Care Plan? Most countries of the industrialized world have a Public Health Care System. The USA is one of the few countries which do not. Why?

I received 18 responses. The question and responses can be read at:  http://ca.answers.yahoo.com/question/index;_ylt=AlRVT4DE95dNnQBZm0qWZULBFQx.;_ylv=3?qid=20090611145628AA1lUN4

Upon reading the responses I could not find a single reason which I considered legitimate. Of course I am not objective either.

As a Nurse I advocate a national health care system for all, the rich and the poor. Health Care is right not a privilege of the rich and gainfully employed.

I hope we as nurses will support such a plan. A plan where all the people get quality health care!