The United States has experimented with healthcare reform almost constantly for the past few decades with few tangible improvements. Costs for hospital visits are higher than in any other developed nation, while government spending on the sector continues to rise as a percentage of GDP. Healthcare dominates the news once again, and leaders struggle to comprehensively improve the price and quality of medicine in America. Considering this, analyzing what some other nations do to keep costs low and overall health high would prove beneficial. Japan and Cuba employ two differing health systems in efficient and affordable ways that may offer insights to make healthcare work in this country.
Japan represents a nation comparable to the United States in terms of population, government ideology, and public expectation. There is universal coverage in Japan, meaning every person—poor, sick, and elderly—has coverage from either an employer, subsidized private company, or the government. The Health Ministry also controls the prices of all drugs and procedures, keeping costs low and fixed. According to NPR, premiums are around $280 a month for the average family, a relatively low price. Even with full coverage of all people and generous subsidies, Japan spends only 8.5 percent of its GDP on health care, as opposed to over 17 percent for the U.S. budget. The system is not socialist though, as doctors and hospitals are mostly privatized. On top of cheaper healthcare overall, Japanese visit the doctor four times more than the average American, can see any specialist they chose, and can get any test done, resulting in the second-longest life-expectancy in the world (after Monaco) and extremely low infant-mortality.
Cuba, like Japan, pays less for more. On the small Caribbean island, people enjoy the same life expectancy as their American counterparts, though the government spends $813 annually on each citizen according to the Atlantic, a tenth of what is spent in America. The Cuban system relies on preventative primary care: local doctors visit neighbors at least once a year for a checkup and design individualized healthcare plans for patients. The government also invests in education on healthy living, such as exercising, eating well, getting vaccines, and not smoking. Cuba also boasts the Latin American School of Medicine (ELAM), which United Nations Secretary General Ban Ki-moon deemed “the world’s most advanced medical school.” These world-class doctors have long proven a valuable export, aiding third-world allies across the globe as a sign of Cuban medical excellence.
The structures that these nations use clearly cannot apply exactly to the United States. Moreover, they receive criticisms in their homelands, too. Japan faces backlash from underpaid doctors and an aging crisis that has caused government spending to increase greatly. Cuba enforces vaccinations in a way other democracies cannot and requires many doctors per capita. But, the facts show that we spend too much on health for meager results. Examining and borrowing ideas from these nations could benefit our search for productive, competent healthcare for American citizens. Socialized health may not be the answer, but alternatives exist that could truly improve life for the average American.