Course:DHYG404/Group 6 Block 4

This Page has been created for DHYG 404 Block 4 Group 6 Discussion Questions

1. How do the values embedded in international health care systems compare to the values expressed in our Canadian health care system. (i.e. what are the similarities and differences that you found?)

• In CANADA, SWEDEN and UK, they provide universal healthcare(HC) that’s single-payer.

• In U.S., HC system is privatized. There’s a single-payer Medicare system and does not align with the HC values of Canadians.

• JAPAN provides a universal healthcare system; it’s multi-payer.

• In DENMARK, healthcare is accessible to low-income groups with illness, while maintaining a co-payment program.

• FRANCE has good medical coverage in Statutory Health Insurance plans which are contributed by the employer; statutory sickness funds available. Voluntary Health Insurance can be purchased.

• In GERMANY, HC is shared among the federal government, the Lander and corporate bodies, and funded by the contributions of social health insurance. Benefits include prevention, screening, treatment and transportation. HC is more comprehensive including dental procedures, nursing care at home with a wide range of diagnostic and therapeutic procedures. Is not entirely publically administered; some facilities such as hospitals operate a small proportion of beds for profit. In CANADA, it is administered on a non-profit basis. It is also not offered on uniform terms and conditions as in CANADA; individuals may choose to have private insurance.

• In NETHERLANDS, hospitals are private and non-profit. It’s public universal for exceptional medical expenses. Care that is deemed less necessary is covered by private insurers and sickness funds, but private for high income earners. The system is portable.

• In NEW ZEALAND, it is public and private. Government is responsible for provision of HC through taxes and HC reform is by the people to make it more universal. HC is comprehensive for low and middle income users. Not entirely universal as high income earners can opt for private insurance. Primary care is charged on a fee for service basis (subsidies are available for low income users, children, and frequent users) and out of pocket expenditures account for 16% of total health expenditures.

2. How is oral health integrated into the health care system of different international countries and how does this compare to our Canadian approach?

• CANADA: dental care is privatized; however few provinces offer subsidized dental programs for children, the elderly, disabled and welfare recipients.

• U.S.: dental care is privatized.

• DENMARK: dental expenses are included, in which the co-payment model is in effect.

• FRANCE: dental coverage is provided in insurance plans. Some coverage plans reimburse the cost of dental prosthesis’s at as much as 235% their cost.

• SWEDEN: dental care is free until the age of 19.

• UK: pay 80% cost of dental care to a ceiling of GBP354. Free dental to children <18 years old or <19 and in full-time education; pregnant women and who have had a child in the past year; recipients of Income Support, Working Families' Tax Credit, income-based Job-Seekers Allowance or Disabled Person's Tax Credit; NHS in- or out-patient.

• JAPAN: dental care is available through multi-payer national health insurance system.

• GERMANY: dental care is included as a benefit of the publicly administered health care system.

• NETHERLANDS: dental care under the sickness funds act (ZFW) is limited to dental care for children and preventative/specialist surgery for adults.

• New Zealand: Dental care is free for children but the government pays only for urgent dental services on a means-tested basis for adults so that most adults pay for their own dental care.

References http://www.euro.who.int/document/OBS/hcs8countries.pdf http://www.amsa.org/uhc/IHSprimer.pdf