International comparisons of health and health expenditures Module 3 International comparisons of health and health expenditures

Correctly understand how to read numbers Oftentimes, you will see something that says in (millions) 16,244,600 What about 6.8 (in billions) What about 0.6 (in trillions)

Understand the global and US trends regarding Population (US/Georgia/Atlanta) Global GDP Area Population Richest/Poorest

Trends continued US Richest/poorest = states Richest/poorest = cities Healthiest/unhealthiest = states

Understand the stroke belt Unusual high incidences of stroke and other CV diseases Possible reasons

Identify examples of countries fall under each category Low-income = underdeveloped Middle-income = developing High-income = developed

Understand terminology Micro/macro allocation of goods Micro = individual spending Macro = national spending People/nations spend Luxury goods = See PowerPoint

Differentiate between causality and correlation Correlation = relationship between two = one is more likely to result in the other, but doesn’t mean it causes

Understand common types of international trade in health care See PowerPoint Medical tourism

The state of health in the world Global health conditions have improved Still significant issues that plague the world

Global health issues Poverty Disability

Epidemiological transition ET = change in the type of diseases and illnesses experienced within a society 1st Development of urban centers 2nd rise of chronic and degenerative diseases 3rd reemergence of infectious diseases

Diseases of poverty Infant child mortality Malnutrition Food safety Acute respiratory infections Diarrheal disease

Diseases of the affluence Arthritis Cancer CVD Diabetes Hypertension

Addition of new diseases in less-wealthy Tobacco use Alcohol use Intentional violence: Suicide, homicide, and warfare Dietary imbalance Changes in physical activity Automobiles Environment Workplace injuries

Models of financing Entrepreneurial model Mandated insurance model National health services model

Models of financing and organization of health systems Type of country Entrepreneurial model Mandated insurance model National health service model High income US South Korea Argentina Germany Italy France UK Japan Canada Middle income China Mexico Botswana Brazil Jamaica South Africa Costa Rica Cuba Poland Russia Turkey Low income Congo India Nigeria

Financing health services General tax revenue Social insurance Voluntary insurance Charitable donations Individual payment

High-income countries characteristics Government funding All of the countries, except the US, guarantee health coverage for all citizens All are struggling to control costs

Middle-income country characteristics Government funding Typically devote a smaller portion of the GDP to health care

Low-income country characteristics Little government funding for health care Private payments account for more than 50% Little private insurance is available

Rank Country LE Payroll tax Sales tax % Gov’t funding HE per capita 1 Monaco 89.52 38-54% 5-19% 18.8 8,148.81 2 Japan 84.74 25.63% 8% 20.3 3,702.95 3 Singapore 84.68 11-36% 7% 14.2 2,752.32 8 Andorra 82.72 0% 1 or 4% 27.9 3,746.33 9 Switzerland 82.50 N/A 2, 3, or 8% 22.7 9,673.52 18 Canada 81.76 9% 5% 5,291.75 19 France 81.75 25-30% 2, 5, 7, 20% 15.7 4,958.99 32 Germany 80.57 41% 7, 19% 19.7 5,410.63 33 UK 80.54 0-25% 20% 16.5 3,934.82 43 United States 79.68 0-11% 21.3 9,402.52 222 Afghanistan 50.87 2 – 5% 12 56.57 223 Guinea-Bissau 50.23 ? 7.8 37.28 224 Chad 49.81 37.10

LE in the US Gender Racial/ethnicity

What causes high LE?

What causes low LE?

Medical tourism Why is medical tourism so popular?