University of California
Type of paper: Thesis/Dissertation Chapter
Role of the Government vs. Private Sector in Paying for the Healthcare
Writing Prompt 1
Table 1: Clinical
United States (High Income Country)
Somalia (Low Income Country)
High life expectancy.
Low life expectancy.
Low mortality rate.
High mortality rate.
Low infant mortality rate.
High infant mortality rate.
Low adult mortality rate.
High adult mortality rate.
Cause-specific morbidity and mortality (low mortality rate due to communicable, non-communicable, and injury). Cause-specific morbidity and mortality (high mortality rate due to communicable, non-communicable, and injury). Low rate of infectious diseases (Cholera, Malaria, TB).
High rate of infectious diseases (Cholera, Malaria, TB).
High health service coverage.
Low health coverage.
Low risk factors.
High risk factors.
High availability of health systems as regards to physicians, nurses, and hospital beds per 10,000 people. Low availability of health systems as regards to physicians, nurses, and hospital beds per 10,000 people. Median availability of generic medicines in public and private sectors. Median availability of generic medicines in public and private sectors. Median consumer price ration of generic medicines in public and private sectors. Median consumer price ration of generic medicines in public and private sectors. Median age of population = 40 years.
Median age of population = 17.5 years.
Median age among adults = 55 years.
Median age among adults = 30 years.
Low literacy level.
High literacy level.
High gross national income per capita of $50, 120.
Low gross national income per capita of $150.
Little part of population living on $1 and below a day.
Large part of population living on $1 and below a day.
Table 2: Sources
Expected years of life at birth.
Categories of national health expenditure.
80 years in the United States and 51.19 years in Somalia.
$2.7 trillion or $9,000 per person in the United States and $2 per person in Somalia.
Role of the Government vs. Private Sector in Paying for the Healthcare
From the data available in the table, it is evident that the role of the Government apropos the provision of healthcare to the citizens of the United States is a high compared to the same services in Somalia. That is, the public sector has a high responsibility to ensure payment and subsidizing of hospital bills for its citizens. National health systems of these two countries differ significantly because of public and private sectors involved in the health docket. The Government of the United States plays greater role in healthcare services starting from the provision of healthcare facilities to making relatively cheaper and available healthcare services and providing health insurance cover to all public employees. Andersen, Rice, & Kominski (2011) assert that the Government also provides healthcare payments through Medicare and Medicaid to its citizens without favors. The Emergency Medical Treatment and Active Labor Act of the US enables treatment of patients, who need emergency treatment by availing funds that cover the costs incurred in such instances.
Public sector is the backbone of the United States as an independent country whose values and principles are well established to ensure maximum social advantage. Private sector also plays a greater role in paying for healthcare compared to the public sector in the United States. On the other hand, both private and public sectors play minor roles in paying for healthcare services and facilities. This is mainly because of the fact that Somali’s government is not politically stable, and this also hampers private investors, which translates to government’s and private sector’s minor role in paying for the healthcare of its citizens. Unlike in Somalia, there is quality service assurance in many healthcare centers in the US, which ensures that proper healthcare procedures provided for the welfare of United States’ citizens. Besides, Capobianco & Naidu (2008) opine that Somalia is a poorly developed country, whose healthcare development heavily depends on international aids to support the country. The World Health Organization reports that Somalia has high mortality rate with low life expectancy compared to the United States, which is a much more developed nation in the globe.
Data also unveils that health system physicians allocated per ten thousand people is reasonably good due to higher literacy level in the United States compared to Somalia. Here, both private and public sectors play a bigger role, whereby the public sector provides enough support to a private sector in various ways. This also explains why there are enough hospital beds available to accommodate a bigger number of patients. The Government of the United States through its intervention ventures into necessary expenses ensures that enough healthcare facilities, such as clinics, are set up in various communities and centers in a bid to reduce the risk of running into shortages. In addition, the Government of the United States in collaboration with the private sector has inexorably endeavored to support one another to pay for the healthcare and improve services in all states.
Burden of Illness and Other Health Indices
The United States is one of the most developed countries in the world, which means that the country has the potency to provide healthcare facilities and highly competitive healthcare services to its citizens without feeling the pinch. The country has well-developed heath care units that range from clinics that are set up in almost every corner to large hospitals with relevant and enough healthcare equipment and tools to meet the demand when it arises. In addition, unlike in Somalia, the United States has various research centers that are involved in everyday research in a bid to find medical solutions to everyday problems as far as diseases are concerned. These very research institutes have enough facilities and expertise to undertake numerous studies and develop solutions to various problems. Barton (2010) reiterates that the burden of illness in the United States is not evident due to the high investment in country’s healthcare sector. Various health indices depict the United States as a nation that can comfortably and without strain provide some free healthcare services and other subsidized services to its citizens. This is however not the case in Somalia due to lack of such institutions and disparity in healthcare service delivery.
There are incredibly few healthcare centers in the country, and those few that are available cannot fully serve the whole population. Low mortality rate both among children and among adults, which translates into high life expectancy in the United States, clearly depicts that the burden of illness is insignificant. This is unlike in Somalia where the opposite is true. That is, life expectancy in the United States is 80 years, while it is only 51 years in Somalia. Besides, there is high health coverage in terms of provision of healthcare services that covers almost all diseases that cannot be easily treated in Somalia due to lack of expertise and facilities at the few available healthcare centers in the country. There are more risk factors leading to high mortality rate in Somalia compared with the United States due to poor implementation of policies regarding stepping up health facilities and prevention measures to reduce the number of deaths among the Somali populace. Relationship between Payment System and Health Burden
There exists a nexus between the payment system and the health burden evident in each of the two countries. That is, the health burden directly related to the payment system of these two nations in the sense that there is a bigger health burden in Somalia due to poor payment system implemented. This significantly contributes to a heavy health burden experience in this country. High mortality rate both among adults and among children as well as low life expectancy coupled with low income per capita and low illiteracy levels in Somalia are indicators of a huge health burden among country’s populace. According to Capobianco & Naidu (2008), poor development in infrastructure and in relevant sectors have utterly crippled country’s potency to provide proper medical care to its citizens despite the availability of resources. Insecurity has also been among the top reasons hampering private investors from setting up for-profit healthcare facilities both in urban and rural areas due to physicians’ fear of loss of their dear lives.
Most healthcare practitioners fear for their lives and do not want to work in an insecure environment despite the escalating health issues that are rampant in the nation. On the other hand, developed US also shows pure connection between the existing payment system and the negligible health burden. That is, country is well established healthcare sector has a momentous impact on the insignificant health burden. The Government’s role in the healthcare sector in collaboration with the largely operated private healthcare centers in the country contributed to the reduced health burden due to the efficient payment system. There are also many private healthcare centers, which create stiff competition among themselves, which leads to reduced healthcare prices paid by individuals in a bid to access the services.
Andersen, R. M., Rice, T. H., & Kominski, G. F. (2011). Changing the U.S. health care system: Key issues in health services policy and management. New York: John Wiley & Sons. Barton, P. L. (2010). Understanding the U.S. health services system. New York: Health Administration Press.
Capobianco, E., & Naidu, V. (2008). A review of health sector aid financing to Somalia. Washington D.C: World Bank Publications.