Almost each developed country has some form of general health coverage that assists in reducing the care disparity. However, the systems are usually affected by their issues, including high costs and long waiting times for care. There are many advantages and disadvantages of healthcare systems which are visible mostly compared to other world healthcare systems. An analysis of the two healthcare systems between the US and Norway provides a deeper understanding of the similarities and differences between the systems. The healthcare services of Norway are high on different rankings in healthcare performances worldwide. This paper discusses the comparisons between healthcare quality and the equity of care distribution between Norway and the United States.
Access and Barriers to Healthcare
The affordability and timeliness of healthcare describe access to care. The factor is different between the two countries. First, the US healthcare system usually comprises private insurance coverage, which is employment-based primarily, along with public insurance meant for the elderly (Medicare), the military, and the poor and disabled individuals (Medicaid) in society (Tikkanen et al., 2020). The US is the only country in the developed world apart from South Africa that does not offer free healthcare services to all its citizens. The US federal government continuously contributes greatly to funding healthcare because Medicare caters for 56% of the elderly individuals’ bills PSchneider et al., 20121). the healthcare system in the US is the most expensive worldwide, considering health expenditure per individual which is $4,178 per person, and the total expenditure on healthcare as a percentage of the GDP, which is 13.6%. National healthcare spending has steadily increased over the past 40 years (Schneider et al., 2022). Healthcare spending accounted for 5% of the GDP in 1960 and 15% by 2002. The high cost of the US healthcare system makes it challenging for several individuals in the United States to access quality care since they cannot afford it.
In contrast, Norway has better access to healthcare. The country has a universal, tax-funded, single-payer National Insurance Scheme (NIS) meant to fund the healthcare system. All the citizens in Norway, including anyone living or working there, have coverage provided by the NIS. Tikkanen et al. (2020) state that the hospitals are owned and governed by the Norwegian government, though there is a small private sector of the health system which mainly focuses on substance abuse treatment and dental care. Under the Norwegian healthcare system provides extensive and inclusive inpatient and outpatient care, specialist care, preventive medicine, diagnostic services, maternity services, prescription drugs, and palliative care (Aas et al., 2021). Public hospitals have no charges for treatment or hospital stays, including administering drugs and programs that offer “sick pay” and disability benefits. The government sets the global budget of Norway to limit the general expenditure and capital investment in healthcare which needs limiting and rationing services. It can make the citizens opt out of the government system and finance their own treatment in other countries, which most choose to do due to long waiting lists. Although Norway has effective access to healthcare, there are still long waiting lists, which somehow make access challenging. However, the healthcare system in Norway generally has better access to care than that of the United States.
Equity
Equity is mainly focused on the income-related disparities in accessing healthcare. The United States consistently shows large disparities in income apart from the measures related to preventive services and safety of care. The country mainly shows disparities when analyzing financial barriers experienced to access medical care, challenges in getting after-hours care, medical bill burdens, and web portals application to ease patient engagement (Papanicolas et al., 2018). The US has higher income-related inequalities in patient recorded experiences as they struggle to access quality care compared to other countries (Tikkanen et al., 2020). Several regulations have been implemented to assist in promoting health care equity in the US. For example, there is a legal requirement for non-profit hospitals by ACA to exempt them from paying specific taxes due to their charitable status, and they provide community health needs assessments with the stakeholders to identify and provide the unmet health needs.
Norway has ensured provision of equity in access to quality care provided by the Patient and User Rights Act. Equality and Equity in Health Care, was a strategy in 2013-2017, which guaranteed quality health for all and targets health social determinants. There has been an emphasis on personal health-related behaviors rather than healthcare social determinants. There are still some disparities in healthcare access, but the Norwegian government struggles to eliminate all. Studies of demographics today of mortality variances between the Norwegian population and immigrants show no disadvantage for the immigrants. It means that there are little to no disparities in access to care. The Norwegian government has equity in care provision compared to the United States.
Care Process
Measure in preventive care, quality care, engagement, and patient preferences refers to the patient care process. The US happens to come number 2 in the care process performance domain. The US has achieved higher performance when it comes to preventive care issue that includes influenza vaccination and mammography screening rates, as well as the adults who discuss smoking, alcohol use, and nutrition with their provider (Papanicolas et al., 2018). Then we best perform the self-care subdomain with highly reported computerized alerts and medication reviews. However, over 10% of adults report medication mistakes in their care.
Norway provides the best measures for communication in the care process between primary care doctors and specialists. There was a 2012 care coordination reform meant to emphasize the municipality’s responsibility for 24-hour care and post-discharge care (Aas et al., 2021). Additionally, the strategy provided individual treatment plans for chronic disease patients. There must be a form of agreement between hospitals and municipalities to asset patients with complex needs. Hence the Norwegian care process is better than that of the United States. However, both Norway and US have a highly web-based portal for communicating medical issues and refilling medications in adults.
Conclusion
The Norway healthcare system is high on different rankings in terms of performance compared to that of the United States. First, with access to healthcare, Norway provides fees healthcare services to all individuals, including the unemployed, funded by the NIS, while the US care services are available o only to individuals who pay the insurance and are employed. Hence lack of insurance is a barrier to healthcare in the US, making its healthcare system one of the most expensive in the world among developed countries. Secondly, Norway also has equity in healthcare provision to all its citizens, including the immigrants, compared to the United States, which still struggles with inequities from different health care disparities. Lastly, the care process is the only factor in which the United States performs better than Norway since its system is more advanced technologically. Norwegians suffer from long waiting times, making it challenging to access care. Generally, the healthcare system of Norway is way better than that of the US in providing quality healthcare services regarding quality, access, and equity.
References
Aas, E., Iversen, T., & Kaarboe, O. (2021). The Economic Sustainability of the Norwegian Healthcare System. In The Sustainability of Health Care Systems in Europe. Emerald Publishing Limited. https://doi.org/10.1108/S0573-855520210000295010
Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039. doi:10.1001/jama.2018.1150
Schneider, E. C., Shah, A., Doty, M. M., Tikkanen, R., Fields, K., & Williams II, R. D. (2021). Reflecting Poorly: Health Care in the US Compared to Other High-Income Countries. https://doi.org/10.26099/01dv-h208
Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton, G. (2020). International profiles of health care systems. The Commonwealth Fund.
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