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http://edition.cnn.com/2012/06/28/health/countries-health-care/index.html?hpt=hp_c2


Where in the world can you get universal health care?
By Madison Park, CNN
June 28, 2012 -- Updated 1506 GMT (2306 HKT)
America doesn't have universal health care coverage -- but Thailand, Chile and 
Brazil do.
America doesn't have universal health care coverage -- but Thailand, Chile and 
Brazil do.
STORY HIGHLIGHTS

    Universal health coverage prevalent in Europe and several non-Western 
nations
    World Health Organization calls universal coverage "a widely shared 
political aim of most countries"
    U.S. Supreme Court is expected to rule shortly on Obama's sweeping health 
care reform

(CNN) -- The U.S. Supreme Court upheld President Barack Obama's sweeping health 
care legislation Thursday in a narrow 5-4 ruling that Obama says will provide 
up to 30 million additional Americans with health care.

America doesn't have universal health care coverage -- what the World Health 
Organization (WHO) calls "a widely shared political aim of most countries" -- 
but neither do most other countries.

Nearly 50 countries have attained universal or near-universal health coverage 
by 2008, according to the International Labor Organization. Several well-known 
examples exist like the UK, which has the National Health Service, and the 
Canadian public health care system.

Here are more examples of countries have implemented near-universal health care.

Brazil
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Free health care coverage is recognized as a citizen's right in Brazil.

Brazilians have both a private and public health care system, which was 
overhauled in 1988. The Sistema Único de Saúde, a nationalized program, 
provides primary health care, while a network of public and contracted 
hospitals delivers specialist care.

About 80 percent of Brazil's population relies on public care, while the 
wealthiest 20% can afford private health care, according to a Center for 
Strategic and International Studies report.

Since the 1990s, Brazil has also provided universal access to HIV/AIDS drugs.

During the three decades since the nation's major health care changes, infant 
mortality decreased and life expectancy increased by 10.6 years, according to a 
2011 article in medical journal The Lancet.

But the system hasn't been without problems, according to the Center for 
Strategic and International Studies report, which alluded to gaps in the 
quality of care between various Brazilian regions.

Rwanda

Since establishing a national health plan in 1999, Rwanda has insured about 91% 
of its population with health care -- a greater percentage than the United 
States.

Rwanda has been dubbed "Africa's Singapore" by The Economist for its 
transformation since a devastating genocide in 1994.

Watch Fareed Zakaria talk with Rwanda's president

The country has three health insurance plans, one for government employees, 
another for the military, and the third for the remaining population. The 
country commits about 20% of its annual spending to health, which is funded by 
tax revenues, insurance premiums and financial support from international 
donations, according to a WHO report.

Since introducing health insurance, Rwanda has seen lower childhood mortality 
rates; more people are also receiving medical attention. But the country faces 
challenges from an increase in health services and making contributions more 
affordable for its poorest citizens, according to a WHO report.

Thailand

By law, Thailand requires all patients to be covered by health insurance, 
regardless of their ability to pay.

The WHO uses Thailand as an example of a low- or middle-income country that has 
been able to extend health coverage to all citizens.

Introduced in 2002 as the "30-bhat scheme," (which is less than $1), the plan 
added about 14 million previously uninsured people to the Thai system.

Prescription drugs, hospitalizations and services like chemotherapy, surgery 
and emergency care are free to patients, according to a WHO report.

But the addition of millions of people to a health care system strained the 
existing structures, prompting criticisms of long waits, poor quality of 
service and shortage of service.

South Korea

South Korea passed a law in 1977, mandating health insurance for industrial 
workers. During its rapid economic growth, health care became a priority for 
the government, which created the National Health Insurance. The system 
extended to universal coverage by 1989.

The government merged more than 300 individual insurers into a single national 
fund, according to a WHO report.

Korea's single-payer program has "been successful in mobilizing resources for 
health care, rapidly extending population coverage, effectively pooling public 
and private resources to purchase health care for the entire population, and 
containing health care expenditure," according to a report published in Health 
Policy Plan.

But another report published in Health Affairs said that the public funding is 
limited, leaving "beneficiaries with relatively high payments." South Korea's 
expenditure on health care is 6.3% of the country's gross domestic product, 
compared with 18% in the United States.

Moldova

The Eastern European country became independent with the fall of the Soviet 
Union in 1991. By 2004, it began a mandatory health insurance program with the 
aim of providing the entire population with basic health care.

Employed Moldovans chip in a portion of their income through a payroll tax or a 
flat-rate contribution. Others who are unemployed or not working are insured by 
the government.

Its National Health Insurance Company is the sole buyer of health care services 
and organizes emergency, primary and secondary care locally, according to a 
report by the European Observatory on Health Systems and Policies, a joint 
partnership between European governments and the World Health Organization.

Kuwait

Kuwait's level of health care is comparable to average European standards, 
according to the WHO's profile of the Middle Eastern country.

The country began building up its health care system as it gained wealth from 
oil revenues. By the 1950s, the government implemented free comprehensive 
health care. This resulted in declines in general mortality and infant deaths, 
the report said. "Free health care was so extensive that it even included 
veterinary medicine," according to a local WHO report.

Kuwait faces an aging population as well as an epidemic of diabetes, heart 
disease and obesity-related complications that place great demands on its 
health care system.

Chile

The Chilean constitution guarantees rights to health protection.

Chileans can opt for public care or get coverage from private health insurance 
companies. Wealthier citizens can buy insurance from the Instituciones de Salud 
Previsional or obtain coverage through their employer. A 7% income tax funds 
the public health care system, the Fondo Nacional de Salud, according to an 
analysis of health care reform in Chile.

Public care includes free medical, dental and midwifery services, which are run 
locally. Private insurance tends to focus on specialist treatment.

The existence of both public-private insurance has created inequities of care, 
prompting reform efforts in 2000 to increase equality across the country.

Chile has guaranteed universal access to quality treatment for some conditions 
including certain cancers, HIV/AIDS, pneumonia, depression and dental care, 
which has improved care for the poor, according to the WHO.

China

China announced an overhaul of its health system in 2009 to bring safe, 
affordable basic health services to all residents -- a tall order for a country 
containing 1.3 billion people.

The government committed about $126 billion to reform the quality and 
efficiency of its health care, and ensure affordable and quality medication.

But the issue of equity in health care persists. "There are still significant 
disparities in health status between regions, urban and rural areas, and among 
population groups," according to the WHO.

China has seen increased life expectancy and reductions in infant deaths, but 
health observers stated in the WHO report the need to improve delivery of care.






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