The USA can learn from these foreign health care systems

health
Credit: Petr Kratochvil/public domain

The U.S. has lots to learn when it comes to health care coverage.

And studying what other countries have done is even more useful now that President Trump and the Republican-controlled Congress have failed to produce a to replace the Affordable Care Act, or Obamacare.

USA TODAY picked five countries ranked in the top 10 for care, according to a 2016 prosperity index by the Legatum Institute, a think tank based here. The index measured performance in basic physical and mental health, health infrastructure and preventative care.

There are a number of similarities—and differences—in the way the top-rated countries provide health care:

—All are dealing with aging populations. The World Health Organization said the average at birth worldwide was 71.4 years in 2015. In the U.S. it was 78.74.

—Most of the systems have universal health care, meaning all citizens have access to health services without finding themselves in financial hardship.

—Spending as a share of the economy does not equate with quality of care. Some of the top-rated countries spend less than the world average of 10% of GDP. The U.S. spends the most—17%, according to the World Bank.

—Alcohol and tobacco use are key to health.

—Most patients are satisfied with their treatment.

Here is a closer look at five of those top-rated systems:

Singapore

William Haseltine, the co-founder of the think tank ACCESS Health International, believes the city-state's promotion of "social harmony" is a key factor in its health care achievements. "They believe that nobody in their country, even a foreigner, will go without health care," he said at a talk at Harvard University in 2014. The government regulates both public and private health .

TYPE OF SYSTEM: Government-funded

LEGATUM HEALTH RANKING: 2

POPULATION: 5.6 million

LIFE EXPECTANCY AT BIRTH: Male 80; female 86

TOTAL HEALTH EXPENDITURE AS PERCENTAGE OF GDP (2014): 4.9

RISK FACTORS; Alcohol, tobacco

Switzerland

People living in Switzerland pay for health care themselves through insurance contributions. Health care for people with low incomes is subsidized by the government. Undocumented immigrants are in a difficult position, however, because people can only take out insurance if they have papers proving valid residence for more than three months.

TYPE OF SYSTEM: Paid for by residents

LEGATUM HEALTH RANKING: 3

POPULATION: 8 million

LIFE EXPECTANCY AT BIRTH: Male 81; female 85

TOTAL HEALTH EXPENDITURE AS PERCENTAGE OF GDP (2014): 11.7

RISK FACTORS: Alcohol, tobacco

Japan

A trend of patients attending hospitals for minor complaints like colds has led some hospitals to charge about $30 to people without referrals from doctors, according to The Japan Times. Residents, who are required to have , pay up to 30% of the cost of treatment and prescriptions. People with low incomes get government support.

TYPE OF SYSTEM: Hybrid, funded by taxes and public health insurance

LEGATUM HEALTH RANKING: 4

POPULATION: 127 million

LIFE EXPECTANCY AT BIRTH: Male 80; female 87

TOTAL HEALTH EXPENDITURE AS PERCENTAGE OF GDP (2014): 10.2

RISK FACTORS: Alcohol, tobacco

Australia

Although the population's overall health is generally good, some groups have poor health status —notably Aboriginal people and Torres Strait Islanders, the Australian government says. The private health sector is complemented by Medicare, the universal public health system. The government gives a subsidy of about 30% to people who buy .

TYPE OF SYSTEM: Mainly government-funded

LEGATUM HEALTH RANKING: 8

POPULATION: 24 million

LIFE EXPECTANCY AT BIRTH: Male 81, female 85

TOTAL HEALTH EXPENDITURE AS PERCENTAGE OF GDP (2014): 9.4

RISK FACTORS: Alcohol, road traffic accidents, tobacco

Israel

Israel began providing insurance to all of its citizens in 1995. Foreign workers must be enrolled in private insurance plans by their employers. Israel has the longest life span in the Middle East and Africa.

TYPE OF SYSTEM: Government-funded

LEGATUM HEALTH RANKING: 9

POPULATION (2015): 8 million

LIFE EXPECTANCY AT BIRTH (2015): Male 81, female 84

TOTAL HEALTH EXPENDITURE AS PERCENTAGE OF GDP (2014): 7.8

RISK FACTORS: Alcohol, tobacco


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