Health Care Across the Globe: Comparing Argentina and the United States

Buenos Aires Travel Blog

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Public Children's Hospital in Buenos Aires

Health care is something that consumes everyone’s life because at one point or another everyone has had to see a doctor or visited a loved one in the hospital.  Health care is not the same across the globe and every health care system has its problems.  It is not about which country has the most efficient health care system according to the statistics, it is about which health care system works best for the people.  Argentina and the United States have very different health care systems as a result of each countries own unique national character, history, demographics, economy, and democracy.  The purpose of this blog is to discuss the health care systems of Argentina and the United States, give my comparison of the two systems, and explain why the same system cannot work for two culturally very different nations.

 

Overview:  Universal Health Care

One of the main differences between the health care models of the United States and Argentina is that Argentina utilizes some form of universal health care and the United States does not.

Backside of the hospital in Buenos Aires
  It is important to mention universal health care because it has been a big topic of debate in the U.S. as the state of Massachusetts has plans to implement a universal health care system.  There are several different types of universal care implemented across the globe but the common denominator is that every resident of a country is mandated to have health insurance.  Today in the United States 16 percent of the population is uninsured (Health Insurance Coverage).  Universal health care calls for more centralization and government-mandated procedures.  Economically universal care is beneficial because it requires all citizens to purchase insurance thus limiting the opportunity of insurance companies to deny insurance to individuals or vary price between people.  Those opposed to universal health care argue that it causes poorer quality of care and it reduces competition causing a decrease in efficiency (Universal Health Care).
Grady Hospital
  

 

Overview:  Health Care in Argentina

The Argentine health system is divided into three main sectors:  the public sector (a representation of universal health care) which is provided by the government through taxes and covers about 50 percent of the people but coverage increased after the 2001 economic collapse because of increased unemployment, the social plans sector (known as Obras Sociales) which is administered by trade unions and covers about 45 percent of the population, and the private sector which covers about 5 percent of the people (Paganni).  Both public and private hospitals are found in Argentina but the number of public hospitals is far greater than the number of private ones.  There is no health care system without problems and Argentina has its problems.

  For example, hospitals lack the technology to determine insurance qualifications of an arriving patient and the government is always delayed on providing an updated list of social security beneficiaries.  On top of that patients usually deny social security coverage to avoid paperwork (Runde).  Also, it does not come as a surprise that corruption exists in the Argentine health care system.  Due to the lack of enforced rules corruption is evident through the overpayment of supplies in public hospitals (Lewis). 

 

Overview:  Health Care in the United States

Of all developed nations, the health care system of the United States has the highest degree of privatization and the United States spends more on health care than any other nation.

  In the United States 84 percent of the people have health insurance through their employer, bought individually, or through a government program (Health Insurance Coverage).  The government does not guarantee universal health care but has certain publicly funded programs for the elderly, disabled, children, and poor.  Both public and private hospitals are found in the United States but the number of private hospitals out numbers the public hospitals.  In the United States access to advanced medical treatments and technologies is far above other developed nations and waiting times for specialist are usually shorter (Health Care in the United States).  Just like Argentina the U.S. has its share of problems with its health care system.  For example, the United States wastes a large portion of health expenditures on administrative costs because there are a vast number of players including thousands of insurance companies.  Also 16 percent of the population is uninsured (Health Insurance Coverage).         

 

My Comparison of Public Health Care in Argentina Versus the United States

 

During my eight weeks in Argentina I went to volunteer at a public children’s hospital.  After working at Grady, a public hospital in the United States, I had some not so good preconceived notions of what a public hospital in Argentina would be like.  I, therefore, made the assumption that a public hospital in Argentina would be several times worse since it would be a hospital in a developing country.  However, when I first walked into the hospital my initial thought was this must be a private hospital because it is so much nicer than Grady.  The waiting room was not in chaos with lines of people filling out stacks of paperwork, I didn’t see employees franticly running to find beds because there was a shortage of them in the emergency area, people were not lying in the hallways from lack of space, there were more doctors than nurses, and one doctor did not have to attend to ten patients at one time.  Some doctors said that working at the public hospital was not their full time job because they also worked in other private practices where they could earn more money.  Working at a public hospital in the United States is a full time job for most doctors.  While I noticed that technology in the Argentine hospitals is behind that of the United States, Argentine hospitals seem to more efficiently administer primary care needs.  My observations led me to ask myself, “why does public health care in Argentina seem several times more adequate in terms of patient care compared to a public hospital in the United States?”  Well first of all there is a larger public to private ratio of hospitals in Argentina.  This indicates to me that public hospitals are of greater concern to the government of Argentina since the majority of the population utilizes public hospitals.  In the United States the majority of the people use private hospitals and therefore, the government in the U.S. has less interest in public hospitals.  Also, the doctors in the Argentine hospital seemed more invested in the patient.  I remember one doctor stopping me from going into a patient’s room because she thought the little boy was asleep.  The doctors at Grady have too many patients at one time to really care about the needs of one person.  There are several reasons why an Argentine doctor is more invested in the patient.  It may be the fact that they simply have fewer patients to tend to or maybe they relate better to people coming into the public hospitals.  In the United States the doctors at public hospitals are more detached from patients because the patients are usually homeless people just looking for a place to sleep while the doctors represent the upper middle class.  In Argentina there is a larger lower class and the majority of people go to public hospitals and many of these people most likely come from the families and communities of these doctors.     

 

The Factors that Create Different Health Care Systems in the Two Countries

 

A perfect health care system cannot be achieved by looking at simple statistics based on factors such as performance, responsiveness, fairness of financial contribution, and health expenditure.  If this were the case every country would adopt the universal health system that France uses.  The World Health Organization currently ranks France number one in health care (World Health Organization).  For those that argue that universal health care is the best system why is it that all countries with universal health care are not all ranked at the top of the World Health Organizations list.  For example, the United States is ranked 37th while Argentina, with universal health care, is ranked at 75th (World Health Organization).  The best health care system is dependent on what country a health system is operating in.  National character, history, economics, demographics, and politics of a country shape the health care system.  In terms of national character the United States has a fear of the government impinging on personal choice.  A system of universal health care would increase the role of the U.S. government through health care centralization and higher taxes and ultimately not appeal to the national character of the United States.  As for history and the economy the United States has been a country of capitalism for over 150 years.  The United States today revolves around a market economy with private owned enterprises and this is why private health services dominate.  Most of Argentine history and economics revolves around corruption.  When you live under a corrupt government you develop a lifestyle that work well within a corrupt system.  For example, an under paid police officer will begin taking bribes.  Once you learn how to survive in a corrupt system you do not want change.  If the people figure out how to benefit from a corrupt health care system they do not care to change it.  Some Argentines have learned to benefit by denying social security benefits.  Also, instead of paying out of their own pocket the Argentine people are more likely to continue relying on the government to provide health care as a way of paying its dues to the people.  Also, when President Menem was in power he implemented decentralization and privatization to combat growing inflation and later in 2001 the economy collapsed.  Even if privatization was not a factor contributing to the economic collapse it may have been conceived by the Argentine people as a cause for the turmoil and would create a country view against privatization.  In terms of demographics the unemployment rate and poverty rate of Argentina far exceed that of the United States.  The unemployment rate in the United States is at 4.5 percent while in Argentina it is nearly double that at 8.7 percent.  The United States poverty rate is at roughly 13 percent but is over double that amount in Argentina at 26.9 percent (2006 World Population Data Sheet).  A population with a large portion of unemployed and poor is more likely to rely on government assistance for things such as health care.  The United States having one of the lowest unemployment rates is less likely to rely on the government.  Earlier this summer I found myself in the center of a protest at Plaza de Mayo where people from northern provinces far removed from Buenos Aires marched into the city to protests hunger and creating a better life for their children.  The protest demonstrated that while several have recovered since the 2001 economic crisis a large part of the population, mostly outside Buenos Aires, is still plagued by poverty.  Under current U.S. policy President Bush is working to make private health insurance more affordable for low-income Americans (Strengthening Health Care).  This shows that the United States has interest in decreasing the percentage of people without private health care insurance but does not want to work towards centralizing the health care system.  President Kirchner has made budget cuts in the public sector of health care causing a decrease in emergency transportation to the hospitals and pharmaceuticals in stock (Iriart).  The people of Argentina that rely on the government to provide healthcare are not happy about the budget cuts.  Every cab driver I talked to expressed discontent with Kirchner and they all listed health care reforms as one of the reasons for their discontent.   

 

Which Health Care System is Better:  Argentina or the United States

 

If my goal were to determine which health care system was better in terms of the World Health Organizations standards the United States would be the clear winner according to the statistics.  I believe the statistics may tell me which countries boost the best health records but what works for one country might not always work for another country.  For example, if Argentina privatized a larger portion of it’s health care system and did away with universal health care I am sure there would be more than 16 percent of the population without health insurance.  Then Argentina’s ranking according to the World Health Organization would only worsen.  My point being neither health care system is better than the other.  Both systems have their strengths and weaknesses and fit their country based on the country’s national character, economy, history, demographics, and policy.  

 

Bibliography

 

“Health Care in the United States.”  Wikipedia Online. 20 Jul. 2007 <http://en.wikipedia.org/wiki/Health_care_in_the_united_states>

 

“Health Insurance Coverage.” CDC Online. 21 Jul. 2007 <http://www.cdc.gov/nchs/fastats/hinsure.htm>

 

Iriart, Celia. “Managed Care and Globalization:  The Argentinean Case.” 3 Nov. 2004. 20 Jul. 2007 <http://www.bioethics.nih.gov/globalslides/iriart.pdf>

 

Lewis, Maureen. “Governance and Corruption in Public Health Care Systems.” Center for Global Development. Jan 2006. 20 Jul. 2007 <http://www1.worldbank.org/publicsector/anticorrupt/Corruption%20WP_78.pdf>

 

Paganni, Jose M. “Argentina:  Current activities in the field of quality in health care.” International Journal for Quality in Health Care. 1999. 21 Jul. 2007 <http://intqhc.oxfordjournals.org/cgi/reprint/11/5/435.pdf>

 

Runde, Sonia C. “The Crisis in Argentina’s Health Care System.” Harvard Health Policy Review Archives. 2002. 20 Jul. 2007 <http://www.hcs.harvard.edu/~epihc/currentissue/fall2002/runde.php>

 

United States. The White House. Strengthening Health Care. 23 Feb. 2007. 22 Jul. 2007. <http://www.whitehouse.gov/infocus/healthcare/>

 

“Universal Health Care.” Wikipedia Online. 20 Jul. 2007 <http://en.wikipedia.org/wiki/Universal_health_care>

 

“World Health Organization Assesses the World’s Health Systems.” World Health Organization Online. 21 Jun. 2002. 21 Jul. 2007 <http://www.who.int/inf-pr-2000/en/pr2000-44.html>

 

“2006 World Population Data Sheet.” Population Reference Bureau. 21 Jul. 2007 <http://www.prb.org/Publications/Datasheets/2006/2006WorldPopulationDataSheet.aspx>

 

 

            

 

    

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Public Childrens Hospital in Buen…
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Backside of the hospital in Buenos…
Backside of the hospital in Bueno…
Grady Hospital
Grady Hospital
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