University of Bridgeport Canada Healthcare System Presentation

choose any country that you want and do the presentation, I will attach some examples but you can’t choose the same country.

Penina Agyeman,
India is a union of 28 states and 7 union territories
States are largely independent in matters relating
to the delivery of health care to the people
Each state has developed its own system of health
All citizens who pay tax have the ability to receive
public health services
India has a mixed health-care system, inclusive of public and
private health-care service providers.
However, most of the private health-care providers are
concentrated in urban India, providing secondary and tertiary
care health-care services
Levels of Care
Primary: Consists of public
health centers and subcenters (free/inexpensive)
Secondary: patients from
primary health care are
referred to specialists in
higher hospitals for treatment
(typically paid out of pocket)
Tertiary: If the patient hasn’t
recovered in secondary level
then they are referred to
private hospitals with
better/high quality care
● Achieve universal health coverage
● Ensure Healthy lives and promote wellbeing for all at
all ages
● Provide effective healthcare to rural people with a
focus on the states with poor public health indicators
Low-Middle Income
Public, Private, NGO
Health System expenditure and finance
In india, there is a big gap between the
rural and urban populations. Majority of the
population resides in rural places.
So the only treatment they can afford to
receive is public government health clinics.
To get better treatment, most Indians have
to pay out of pocket just for a doctors
According to the World Health Organization
(WHO), most of the healthcare expenditure
in India – which averages $75 per capita comes from the private spending of
India’s two key achievements
According to the CDC, India implemented a surveillance system in 35 hospitals
and 22 states for healthcare associated infections. Evaluated 346 laboratory
facilities across the country to identify needs and trained more than 1,700
laboratorians on quality diagnostic testing/reporting of priority diseases
India was able to identify monsoon seasonality of influenza in India, leading to
revision of recommendation to vaccinate during pre-monsoon period (AprilMay)
India Main Challenges
The existing healthcare infrastructure is just
not enough to meet the needs of the
population. The central and state
governments do offer universal healthcare
services and free treatment and essential
drugs at government hospitals. However,
the hospitals are, as we said, understaffed
and under-financed, forcing patients to visit
private medical practitioners and hospitals
India has one of the lowest per capita
healthcare expenditures in the world.
Government contribution to insurance
stands at roughly 32 percent, as opposed
to 83.5 percent in the UK. The high outof-pocket expenses in India stem from the
fact that 76 percent of Indians do not have
health insurance.
Two suggestions for improvement
One suggestion would be building more hospital, have more physicians
available to meet the criteria. In rural areas public hospital only have one 1
doctor for every 10 people. The infrastructure is really poor to meet
everyone’s needs.
The second suggestion would be to provide universal health coverage to those
who reside in rural and urban populations .
1) How do you think your health would
be if you grew up in India?
1) For better health, is there anything
you would suggest on India improving
their health care system?

Chokshi, M., Patil, B., Khanna, R., Neogi, S. B., Sharma, J., Paul, V. K., & Zodpey, S. (2016). Health systems in India. Journal of
perinatology : official journal of the California Perinatal Association, 36(s3), S9–S12.

CDC Global Health – India. (n.d.).

India’s healthcare: Private vs public sector. (2020). Retrieved 18 February 2020, from

Kumar, P., & Kumar, R. (2018). Rural Health Scenario – Role of family medicine: Academy of Family Physicians of India Position Paper.
Journal of family medicine and primary care, 7(6), 1157–1162.

World Health Day 2019: Challenges, opportunities in India’s $81b healthcare industry – Firstpost. (2019, April 7). Retrieved December 16, 2019, from
Firstpost website:
This Photo by Unknown Author is licensed under CC BY-SA
 Health care in the United States is provided by many distinct organizations. The
facilities are largely owned and operated by private sectors businesses. 58% of
community hospitals in the United states are non-profit, 21% are government owned,
and 21% are for profit. According to WHO, the United States spent $9,403 on health
care per capita, and 17.1% on health care as percentage of its GPD in 2014. Health
care coverage is provided through a combination of private health insurance and
public health coverage (Medicare, Medicaid).The United States does not have a
universal health care program unlike some countries.
 US health care spending increased 5.3 percent to $3.0 trillion in 2014. On a per capita basis, health
spending was $9,523 in 2014, an increase of 4.5 percent from 2013. The share of gross domestic
product devoted to health care spending was 17.5 percent, up from 17.3 percent in 2013. The faster
growth in 2014 that followed five consecutive years of historically low growth was primarily due to the
major coverage expansions under the affordable care act, particularly for medic aid and private health
insurance, which contributed to an increase in the insured share of the population. Additionally, the
introduction of new hepatitis C drugs contributed to rapid growth in retail prescription drug
expenditures, which increased by 12.2 percent in 2014. Spending by the federal government grew at a
faster rate in 2014 than spending by other sponsors of health care, leading to a 2-percentage-point
increase in its share of total health care spending between 2013 and 2014.

Personal health care expenditures are outlays for goods and services related
directly to patient care. These expenditures are total national health
expenditures minus expenditures for investment, health insurance program
administration and the net cost of insurance, and public health activities.

In 2014, private insurance accounted for 35% of personal health care
expenditures, followed by Medicare, Medicaid, and out of pocket (Figure 6).

Sources of funds varied by type of expenditure (data not shown):

Private insurance accounted for 37% of hospital, 42% of physician, 10%
of home health, 8% of nursing home, and 43% of prescription drug

Medicare accounted for 26% of hospital, 23% of physician, 42% of home
health, 23% of nursing home, and 29% of prescription drug expenditures.

Medicaid accounted for 17% of hospital, 11% of physician, 36% of home
health, 32% of nursing home, and 9% of prescription drug expenditures.

Out-of-pocket payments accounted for 3% of hospital, 9% of physician,
9% of home health, 27% of nursing home, and 15% of prescription drug
Personal health expenditures illustrate the economic burden of disease and
barriers to access to health care. Findings from the Access and Disparities in
Access to Health Care section of this report show the progress and
opportunities for improvement in overcoming these barriers.
This Photo by Unknown Author is licensed under CC BY-SA
 Making Care Affordable requires smarter spending
of limited health care dollars. Health care is costly.
In 2015, U.S. health care spending increased 5.8
percent to reach $3.2 trillion, or $9,990 per person.
In addition, the overall share of the U.S. economy
devoted to health care spending was 17.8 percent in
2015, up from 17.4 percent in 2014 (CMS, 2015).
 Multiple sources of fragmented expenditures
channeled to both the public and private sectors of
care make it challenging to control growth in health
care costs. New delivery system models such as the
patient-centered medical home (PCMH) have been
developed that coordinate care across sectors and
may help ensure that money is spent efficiently.
STATE, 2014-2015
 The life expectancy ahs been declining
 Here is a video about Life expectancy in the U.S
Reducing health inequities an
disparities. Increase stakeholder
participation and include the
community in decision making.
Health in all sectors. Culturally
competency is a major factor in the
healthcare as well. Access to
healthcare and primary care and
access to health literacy.
Making sure the care we are
receiving is safe, avoid errors
preventing infection, and be more
mindful of the medication
distribution. According to CDC,
people get affected by nosocomial
infection which is something we can
prevent by applying proper hygiene.

Medicare is a national health insurance program in the United States, begun in
1966 under the Social Security Administration and now administered by the
Centers for Medicare and Medicaid Services. It primarily provides health insurance
for Americans aged 65 and older, but also for some younger people with disability
status as determined by the Social Security Administration, as well as people with
end stage renal disease and amyotrophic lateral sclerosis.

Medicaid in the United States is a federal and state program that helps with
medical costs for some people with limited income and resources. Medicaid also
offers benefits not normally covered by Medicare, including nursing home care and
personal care services. The Health Insurance Association of America describes
Medicaid as “a government insurance program for persons of all ages whose
income and resources are insufficient to pay for health care.” Medicaid is the
largest source of funding for medical and health-related services for people with
low income in the United States, providing free health insurance to 74 million lowincome and disabled people as of 2017. It is a means-tested program that is jointly
funded by the state and federal governments and managed by the states, with
each state currently having broad leeway to determine who is eligible for its
implementation of the program. States are not required to participate in the
program, although all have since 1982. Medicaid recipients must be U.S. citizens or
qualified non-citizens, and may include low-income adults, their children, and
people with certain disabilities. Poverty alone does not necessarily qualify
someone for Medicaid.
 Two-tier healthcare is a situation in which a basic
government-provided healthcare system provides basic
care, and a secondary tier of care exists for those who can
pay for additional, better quality or faster access. Most
countries have both publicly and privately funded
healthcare, but the degree to which it creates a quality
differential depends on the way the two systems are
managed, funded, and regulated. By two tier I mean a
healthcare system where there is both a private sector and a
public sector both providing a full range of healthcare
services. The private sector is for profit and charges what
the market will bear while the public sector is free and paid
through the general taxes.”
With Medicaid, millions of people have gotten
gotten help with healthcare, assistance in other
domain such free health screening, free dental
services, health coverage assistance to those
with a lower income. Those who socio
economic , gender, race and level of education
play a role.
Failure to assist those who are REALLY in need.
Be selective, obtain full assessment including
backgrounds check in order to make sure
people are not manipulating the system.
 Sometimes the foods we love and count on for good health are contaminated with germs that cause sickness and
can even be deadly. More progress is needed to protect people and reduce foodborne illness in America.
 New challenges to food safety will continue to emerge, largely because of:
 Changes in our food production and supply, including more imported foods.
 Changes in the environment leading to food contamination.
 Better detection of multistate outbreaks.
 New and emerging bacteria, toxins, and antibiotic resistance.
 Changes in consumer preferences and habits.
 Changes in the tests that diagnose foodborne illness.
The U.S should take consideration of a universal healthcare and
healthcare expenditure. We have the components attributing
to the healthcare such as the physicians, nurses, healthcare
team and personals . The country can also reinforce the law
and requirements to Medicare and Medicaid to avoid
fraudulent activities. The healthcare provided now has its pros
and cons but can always get altered to something better that
benefit all.
 Center for disease Control and Prevention, National Center for Emerging and Zoonotic Infectious
Diseases(NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases(DFWED).
Costa Rica
Health Systems and Care
Organization of the Health System

A system of healthcare management in Costa Rica celebrates its 80th year in

Began as a social security to public sector workers but it eventually turned into the
most effective and universalized healthcare systems in Latin America.

The infant mortality rates and life expectancy in Costa Rica is comparable to that of
European developed countries.
Health as a Human Right
“Article 21 of our constitution, thus recognizing life as the most important good that can and
should be guaranteed by the Legal System, even giving it the status of principal value within the
scale of personal rights. This is justified in the fact that without its enjoyment, all the other
rights prove to be useless. Therefore, the Political Constitution, in its 21st article, recognizes
that human life in inviolable, and from there, the Court has derived the right to health as a
fundamental one which, from all standpoints, must be guaranteed by this Jurisdiction. As a
result, there is no questioning whatsoever about the constitutional protection of this
fundamental right, inasmuch as it is inherent to the dignity of the human being, regarding this
matter (SC, Sentence N. 2002-06166)”.
Human Rights Cont.

1973 General Law of Health

Beneficiary of Healthcare Provisions

Compromisos de gestions (management compromise)

Lista Oficial de Medicamentos (official list of medicaments

Pillars of “Right to Health”




Goals of the Health System
● To guarantee the rights and obligations of the users of all
the healthcare services, both public and private, established
on national territory
● Detailed and timely information
● Consideration and respect
● Details about expenses
National Income and GDP
● Middle Income Country
● National Income- 79 Billion PPP dollars
● GDP- $61 Billion
● PPP- Purchasing Power Parity
Financing of the National Health System

Healthcare services is a tripartite contribution from the state, your employer,
and your own.

At the moment the current contribution percent is 22.91% of each of the
insured salaries.

Out of which the employer provides 14.16% the worker provides 8.25% and the
State contributes 0.50%.
Obligations of the Users
● Law of Rights and Obligations
● Provide the most accurate information about their medical
● Follow any instructions and maintain responsibility
● Contribute Timely
Key Achievements

Maintained annual growth GDP rates of 1.2% between 1975 and 2001 and
2.8% between 1995 and 2001.

Having comparable rates of economic growth to Columbia, Costa Rica had
twice the reduction in infant mortality.

Costa Rica also achieved twice the reduction in infant mortality rates as Mexico
with similar economic growth rates and health care expenditures.
Failures and Challenges
● Limitations between health governance with regard to social
● A strong epidemiological transition
● The universalization of the system
● Demographic dynamics of population growth
● Increase in the offer of private and international healthcare and
insurance services
● Does an ideal system of healthcare exist and what does it
look like?
● Are there any noticeable similarities and differences
between this health care system and the United States?

RICA.” World Health Report (2010) Background Paper, No, no. 11,

Unger, Jean-Pierre, et al. “Costa Rica: Achievements of a Heterodox Health Policy.” American Journal of
Public Health, American Public Health Association, Apr. 2008

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