Introduction
Quality and accessible healthcare services are fundamental rights for every citizen. It is the government’s responsibility to establish a healthcare system that facilitates the efficient and effective delivery of these services. Healthcare systems adopted by nations worldwide to provide health services to their citizens are different, with varying levels of involvement between private and government sectors. This paper compares and contrasts the United States and Norway’s healthcare systems, focusing on funding, cost containment, coverage, and their positive and negative features.
Funding and Cost Containment
Health insurance in the United States is funded through government programs and private insurers. The federal government funds the national Medicare program for the older population, 65 years and above, and individuals with disabilities (Fulmer et al., 2021). The government also funds programs such as the Children’s Health Insurance Plan and Medicare for the low-income population and veterans.
According to Tikkanen et al. (2020a), the remaining funding is through private health insurance, which is mainly employer-sponsored (55%). There is also out, of-pocket spending, which only accounts for approximately 10% of the healthcare system’s total expenditure (Tikkanen et al., 2020a). Conversely, the Norwegian healthcare system has well-defined funding sources, including the general tax system and out-of-pocket payments from households. The general tax sources consist of state and payroll taxes and national as well as municipal levies.
The federal government in the United States uses different measures to contain costs in the healthcare system. According to Tikkanen et al. (2020b), the government sets rates for the Veteran and Health Administration (VHA) and Medicate. It also capitates payments to Medicare and Medicaid managed care organizations and negotiates drug prices for the VHA. Further, the government caps the annual out-of-pocket fees for beneficiaries and implements the Affordable Care Act (ACA) to control costs among private insurers.
On the contrary, Norway’s central government sets an annual healthcare budget maintained by the Regional Health Authorities (RHAs) and municipalities. The Norwegian Medicines Agency (NOMA) decides maximum drug prices and medication reimbursements for outpatients. Other approaches to contain costs in the Norwegian healthcare system include patient out-of-pocket payments and wage negotiation.
Coverage
Health insurance coverage differs significantly between the United States and Norway. According to Tikkanen et al. (2020b), the coverage in the United States is approximately 92%, leaving about 8% of the population uninsured. The coverage is primarily through private insurance (67% of Americans). The remaining percentage of the coverage is through government-sponsored plans such as Medicare, Medicaid, and the Children’s Health Insurance Program. For instance, Medicaid covers about 17.9% of citizens in the United States. Conversely, health insurance coverage in Norway is automatic and mandatory for all citizens (Mbanya et al., 2019). Unlike the United States, which does not have universal health insurance coverage, Norway has one known as National Insurance Scheme (NIS).
Positive and Negative Characteristics
The positive characteristics of the United States healthcare system are that it provides citizens autonomy to choose between private and government insurance programs and does not burden citizens through taxes. Additionally, the high level of private-public partnership ensures effectiveness in the delivery of services. However, the system is defined by health care disparities, with a significant of citizens being uninsured. On the other hand, the Norwegian healthcare system’s positive features include coverage of all citizens regardless of their economic and social status and well-defined measures to contain costs. Nevertheless, the system is negatively characterized because it burdens taxpayers since it is funded through a general tax system.
Conclusion
The healthcare system adopted and implemented by governments influences healthcare services’ affordability, accessibility, and quality. The Norwegian healthcare system has universal coverage under the NIS, while the United States does not have universal coverage. The funding in the United States is through public-private partnerships, but the general tax system funds healthcare in Norway. The United States uses ACA and other regulations to contain costs, contrary to Norway, where the government sets an annual budget and uses agencies such as RHAs and NOMA to do the same.
References
Fulmer, T., Reuben, D. B., Auerbach, J., Fick, D. M., Galambos, C., & Johnson, K. S. (2021). Actualizing better health and health care for older adults. Health Affairs, 40(2), 219–225. Web.
Mbanya, V. N., Terragni, L., Gele, A. A., Diaz, E., & Kumar, B. N. (2019). Access to Norwegian healthcare system – challenges for sub-Saharan African immigrants. International Journal for Equity in Health, 18(1), 1–13. Web.
Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton, G. A. (2020a). International health care system profiles: Norway. The Commonwealth Fund. Web.
Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton, G. A. (2020b). International health care system profiles: The United States. The Commonwealth Fund. Web.