Should I Stay or Should I Go?
The definitive guide to moving abroad and whether it's right for you

Health and Healthcare

This is a preview to the chapter Health and Healthcare from the book Should I Stay or Should I Go? by Paul Allen.
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“Health is worth more than learning.” – Thomas Jefferson, 3rd US President (1743-1826), letter to his cousin John Garland Jefferson, June 11, 1790

Every year the World Health Organization (WHO) produces a World Health Report, in which it gives an assessment of various health indicators among all its member states. In addition, the report zeroes in on a particular subject. In 2008 the theme was primary healthcare1; in 2007 it was promoting international health security.

In 2000, the focus was on comparing aspects of health systems around the world2. The main findings, which brought together all the data to give an overall performance ranking, came in Annex Table 10: Health system performance in all Member States, WHO indexes, estimates for 1997.

France came top of the pile, which won’t be a big surprise to anyone who has had cause to use their health service. Italy was close behind. Spain fared well too, coming in seventh.

The UK, however, trailed in 18th, one place ahead of Ireland. Canada was down at 30th (one place below Morocco), with Australia at 32nd. The United States, the world’s richest nation, was 37th. New Zealand languished at 41st.

WHO World Health System Rankings 1997
[THIS TABLE IS ONLY INCLUDED IN THE FULL VERSION OF THE BOOK]

The statistics may be over a decade old, but they paint an interesting – and still relevant – picture of the state of the respective health services.

Interestingly, the UK’s total expenditure on health has been growing though, from 7.2 percent of GDP in 1999 to 7.8 percent by 2003, according to Annex Table 2 of the WHO’s 2006 Health Report3. Over the same period, government spending on health rose from 14.5 percent to 15.8 percent of its total expenditure, indicating a greater share of available resources are being thrown at the issue.

Of course, it’s also a question of the effectiveness of the spending. Spain spent 7.5 percent of its GDP on health in 1999 and 7.7 percent in 2003, comparable figures to the UK, but it seems with much better results. In France the figure is higher, rising from 9.3 percent to 10.1 percent of GDP by 2003.

The US, by comparison, spent 13.1 percent of its GDP on health in 1999 and 15.2 percent four years later. By 2007 health expenditure reached 16.2 percent of GDP, nearly twice the average of other OECD countries. The US is also the world’s largest market for pharmaceutical sales, accounting for around 48 percent of the world total, with a per capita expenditure on drugs in 2005 of US$1141, twice the amount of Canada, Germany or the UK, noted the World Health Organization’s 2008 health report4. But despite this level of spending, the country continues to lag many of its peers in key health indicators such as life expectancy, cancer rates and the incidence of heart disease and strokes.

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What else is in the chapter 'Health and Healthcare'?

Healthcare – an American Example

  A subscriber to my Moving Abroad-opedia newsletter, a native of New York City, gave the following account of some of her experiences of the health system in the United States. ...

Birthing

Having been blessed with two daughters since moving to Spain in 2003 we have had a chance to compare the relative pros and cons of the Spanish and British health ...

Allergies

Allergy care is another case in point. ...

On The Upside …

Still, despite criticism of the UK’s National Health Service, it’s worth remembering that it is not all doom and gloom. Yes, improvements undoubtedly can and should be made in waiting ...

Healthy Living

Of course, health is not solely about hospitals and doctors, health systems and budgets. ...

Questions:

1) How satisfied are you with your current primary care facilities (local doctor, nurses, dentists, etc)? Are the standards good? Are they deteriorating? Is it a cause for concern? ...

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