//definitions var headerArray = new Array ("Country Name","Who is covered","What is covered","Funding","Delivery system","Cost-control mechanisms","Expert's take on pros and cons","Overall health ranking*","Life expectancy**","Infant mortality per 1,000 births**","Health expenditure per capita**","Health expenditure of GDP**");//name + 11. var countryInfoArray = new Array(); countryInfoArray[0] = new Array("U.S.","Public and private insurance covers 84.7 percent of the population. In 2005, 44.8 million people were uninsured.","Benefits vary according to type of insurance, but often include inpatient and outpatient hospital care and physician visits. Many plans also include preventive services, dental care and prescription drugs. Cost-sharing provisions vary by type of insurance. ","Medicare, a federal program that covers 14 percent of the population -- mostly the elderly and disabled -- is financed through a combination of compulsory payroll taxes, general federal revenues, and premiums. It accounts for 17 percent of the country's health expenditures.

Medicaid, a federal- and state-funded program that covers 13 percent of the population with limited incomes, accounts for 16 percent of total health expenditures.

Private insurance is offered by nonprofit and for-profit health insurance companies regulated by state insurance commissioners. Individuals may purchase private insurance, or employers or other groups may purchase insurance, with covered individuals contributing to the cost of premiums. Private insurance covers 68 percent of the population and accounts for 36 percent of total health expenditures.

Out-of-pocket payments account for 14 percent of health expenditures.","Most physicians work in hospitals, health centers and private practices. They are paid through a combination of methods, such as fee-for-service, annual fees if they are members of HMOs, and salaries.

For-profit, nonprofit and public hospitals are paid through a variety of ways, including per admission and negotiated daily charges. The federal government is the single largest health care insurer and purchaser.","Private and government insurers have attempted to control cost growth through a combination of methods, including: selective provider contracting, which allows states to contract with selected hospitals to provide services to Medicaid patients at negotiated rates of reimbursement; discount price negotiations; risk-sharing payment methods; and managed care.","\"The strengths of the U.S. health care system are that it provides a tremendous amount of choice for those who have good coverage. It provides access, for those who have good coverage, to very high quality care as long as they have good advice on where to get it. But it's the only system among wealthy nations that has such a large share of its population uninsured. Those who are uninsured have mortality rates 25 percent higher than those who are insured, so this is a problem,\" said Victor Rodwin of the School of Public Service at New York University.","24 out of 191 countries","Males: 75
Females: 80","Males: 8
Females: 7","$5,711 (U.S.)","15.2 percent"); countryInfoArray[1] = new Array("CANADA","Canada provides a national health insurance program for all eligible residents of Canada.","The federal government requires that provincial and territorial health insurance plans cover all medically necessary physician and hospital services. The federal government also directly provides health care services for specific groups. Provincial and territorial governments also may provide supplementary benefits -- such as prescription drugs, dental care, home care and ambulance services -- for certain groups such as senior citizens and social assistance recipients.

There is no cost-sharing for insured physician and hospital services. However, there are often additional charges for non-insured items such as prescription drugs.","Public health insurance plans are administered by the provinces/territories and generally funded through taxes. Three provinces charge additional health care premiums. Public funding accounts for approximately 70 percent of total health care expenditures.

Many Canadians have supplemental private insurance coverage through group plans, which cover things such as vision and dental care, prescription drugs, rehabilitation services, private care nursing, and private rooms in hospitals. Private expenditures represent approximately 30 percent of total health expenditures. Individuals can only get private insurance coverage for services that are not covered under the government plan. ","Most physicians are in private fee-for-service practices. However, many Canadian physicians receive some payment for clinical care through alternative public payment plans. Provincial/territorial medical associations generally negotiate the fee schedule. Physicians must opt out of public payment to have the right to determine their own charges.

Nurses are primarily employed either by hospitals or community care organizations, including home care and public health services. Dentists, optometrists, therapists, psychologists and pharmacists may be employed or self-employed, and are generally paid salaries negotiated between their unions and their employers. Hospitals are mainly public or nonprofit private and must operate under annual budgets negotiated with the provincial/territorial ministries of health or regional health authority, with some fee-for-service payment. Provincial/territorial governments have the authority to regulate health providers. However, they typically delegate control over physicians and other providers to professional \"colleges,\" which license providers and set standards for practice.","Canada has mandatory annual global budgets for hospitals/health regions, negotiated fee schedules for health care providers, pre-approved public drug plans that can be distributed without prior authorization and limits on the diffusion of technology.","\"The entire population is covered under national health insurance. There are problems of waiting times in hospitals and there are differences across the provinces. It's a model of what single-payer health insurance or Medicare for all would be in the United States. Because Canadian health insurance is characterized by national health insurance and private fee-for-service payment, there are fewer opportunities to integrate services between outpatient and inpatient care. The innovations which we have in certain group practices are very hard to do in Canada, such as HMOs, disease management,\" said Victor Rodwin with the School of Public Service at New York University.","12 out of 191 countries","Males: 78
Females: 83","Males: 6
Females: 5","$2,989 (U.S.)","9.9 percent"); countryInfoArray[2] = new Array("CHINA","Insurance coverage is linked primarily to employment status. State enterprise employees or civil servants generally have wide insurance coverage, whereas farmers or employees of small private firms have little or no coverage.

By the end of 2006, the government's Co-operative Medical Scheme covered more than 45 percent of the rural population in nearly 50 percent of Chinese counties. The government hopes to extend CMS coverage to 80 percent of China's counties by the end of 2007. About 55 percent of the urban population is covered by a variety of different health insurance schemes, the majority through the government-sponsored urban employee Basic Health Insurance Scheme. A limited number of people in both rural and urban areas have private insurance coverage, although overseas insurers are attempting to take advantage of the market. (In 2003, 5.6 percent of urban residents had private coverage, while 8.3 percent of rural residents had private coverage.)","Benefits available under the Basic Health Insurance Scheme include general practitioner care (community health services), home visits, specialist care at hospitals for inpatients and outpatients, and essential pharmaceutical supplies prescribed by doctors. Benefits are subject to the reimbursement ceiling of four times the average regional annual salary.

Co-operative Medical Scheme benefits vary county by county. Service benefit package tends to focus on inpatient care and, in most counties, exclude outpatient/preventive care. The emphasis is on inpatient care in township health centers and hospitals. Recent reports suggest that co-payment levels reach 70 percent on average. Some counties also cover more specialized care in regional hospitals, however, generally only the better-off can afford to pay the 70 percent co-payment for specialist inpatient care. Ceilings exist but also differ widely county by county.","As part of its move toward privatization of the health-care industry, the central government has dramatically decreased its share of national health care spending in recent years and transferred many of its responsibilities for funding health care services to provincial and local authorities and required them to provide that support through local taxation.

In the BHIS system, employees contribute 2 percent of their annual wages and employers contribute up to 10 percent of an employee's wages. Under CMS, the government and rural residents both contribute to a collective insurance pool, which is accessible to cover health care services. The plan requires a 10 Yuan (U.S.$1.25) annual contribution from rural residents, which is matched by a 20 Yuan (U.S.$2.50) contribution from the government (10 Yuan each from the central and local governments), and deposited in a special, county-level account. CMS is voluntary and focuses on county-level risk pooling. Co-payments remain high, even for catastrophic costs. Government subsidies to CMS are relatively low, in particular relative to urban health spending.

Out-of-pocket expenses accounted for 58 percent of Chinese health care spending in 2002.","The vast majority of hospitals are government-owned -- different levels of hospitals are owned by the different levels of government, from the central government down to the township government. They are public in name but tend to be driven by profit maximization as their primary objective because government funding is extremely limited and most care is paid on the basis of out-of-pocket fees at the time of delivery.

Family planning institutions, township health centers and maternal and child health facilities have overlapping functions.

Patients now choose whichever level of provider they can afford, so the provincial and county hospitals are overloaded with higher-income patients and the township hospitals are underutilized and patronized mainly by low-income patients.

BHIS is managed by insurance management agencies located within local governments. Within the BHIS national policy framework, local governments have the autonomy for setting up rules of collecting and allocating funds, and operating the scheme. Payment mechanisms for outpatient and inpatient care may vary between different cities.

There are fewer health care facilities and personnel in rural areas, and existing services are inferior in quality to urban counterparts. ","Under the BHIS, health facilities are designated for use by the members. At the same time the insurance agency has also indicated the types of services and drugs that can be reimbursed/covered by the BHIS. Any services and drugs that are not listed are paid for by individuals. A fixed fee-for-service also has been introduced. The government has enacted a price control system that limits what publicly owned hospitals and clinics can charge for routine visits and services such as surgeries, standard diagnostic tests and routine pharmaceuticals. The price controls do not apply to new pharmaceuticals and modern imaging tests, which are uncontrolled. Physicians bonuses are often tied to the use of these new drugs and tests. The government also modified its salary system for hospital physicians, adding a bonus system determined by the amount of revenues doctors generated for their hospitals. Costs are skyrocketing despite largely ineffective controls. The central government is increasing its role in the health care system as a result that market reforms and decentralization have failed.","\"Previously China had public facilities and they put doctors on salary and emphasized prevention, immunizing children, clean water and so forth. They made tremendous progress improving the health of their people, but then China relieved health care to the free market. Hospitals became profit seeking. The good part of the Chinese system is that it had established a very strong immunization and maternal health program, so that part is still functioning reasonably well. That is why the Chinese health status is considered very good but its not as good as it can be because China has privatized and moved toward the market, so these staff who are doing prevention are moving away from doing prevention. There is more money in health care services such as acute health care, treating patients with illnesses rather than preventing illnesses,\" said William Hsiao of the Department of Health Policy and Management at Harvard University.","81 out of 191 countries","Males: 70
Females: 74","Males: 27
Females: 36","$278 (U.S.)","5.6 percent"); countryInfoArray[3] = new Array("JAPAN","Japan has a national health insurance program that covers the entire population. Membership is required in either the National Health Insurance or Employees' Health Insurance program. Individuals rarely purchase private complementary health insurance.","The national health insurance program covers inpatient and outpatient care, prescription drugs, long-term care, and home-nursing expenses for the elderly. There are occasional additional fees for things such as private hospital rooms, some dental treatments and some prosthetics, including eyeglasses.","Employee Health Insurance covers those who work for companies, the government or schools. The cost of premiums is shared by the employer and the employee, and the average contribution is around 4 percent of a person's salary. Those covered under EHI pay 20 percent of in-patient care costs and 30 percent of out-patient care costs up to a certain ceiling, after which they receive full coverage.

National Health Insurance covers workers in agriculture, forestry or fisheries, the self-employed and the unemployed. Participants pay co-payments for in-patient and out-patient care, co-payments for prescription drugs and a premium determined by salary. Again, participants share costs up until a certain point, after which they receive full coverage.

National and local public funds account for 31.7 percent of national health care spending, out-of-pocket payments account for 12.2 percent. The largest share of health care financing in Japan is raised through payroll taxes (34.6 percent from employees and 21.7 percent from employers).","The Ministry of Health and Welfare negotiates fees with health care providers. For any particular service, the same fee is paid by all insurers to all providers. Neither physicians nor hospitals may bill their patients more than the authorized fee. All covered medical procedures are ranked by complexity of the procedure and cost to deliver. Geographic location, institutional setting (e.g., type of hospital), qualifications of the provider and the cost of the service are not considered in this rating system.","The Central Social Medical Care Council has 20 members who represent a cross section of health care interests: eight providers (five physicians, two dentists and one pharmacist), eight payers (four insurers, including government representatives, two employers and two labor representatives), and four public interest representatives (three economists and one lawyer).

Every other year, this council renegotiates the fee schedule with the medical profession, but these negotiations are constrained by a rate cap set by the health ministry to limit the overall increase in costs. This rate cap results in a global budget for all health care expenditures.","\"Japan provides universal coverage and that's a good thing. It represents an important model of national health insurance. The Japanese population has some of the best health indicators on the planet, but they cannot really be attributed any more than any other country to the organization and financing of the health care system. They reflect nutrition, income distribution, the extent of concentrated poverty and a whole range of other social factors,\" said Victor Rodwin of the School of Public Service at New York University. \"The weakness in the Japanese health care system is the lack of functional integration, the lack of any management across different levels of care and widespread complaints about quality. Other strengths are a great deal of screening and prevention.\"","1 out of 191 countries","Males: 79
Females: 86","Males: 4
Females: 3","$2,244 (U.S.)","7.9 percent"); countryInfoArray[4] = new Array("MEXICO","Fifty-one percent of public and private employees have insurance through social security funds; 2 percent to 3 percent purchase private insurance in addition to this coverage. The rest of the population, technically uninsured, has access to health care via the State Health Services, which is funded by the Ministry of Health. The government has recently sought to improve quality of health care to those without insurance offering a subsidized insurance plan called Seguro Popular, part of the government's new System of Social Protection in Health. At the end of 2006, 42.9 percent of the previously uninsured were enrolled in Seguro. The Mexican government aims to have 100 percent enrollment by 2010.","The insured receive free care from providers belonging to their social security institutions, including inpatient and outpatient care, care for pregnancy and childbirth, physician and specialist services, and many pharmaceuticals. The uninsured can access health care services, from primary care to more complex procedures, at significantly less than full-cost prices in state health facilities. However, available resources sometimes limit some services, such as access to prescription drugs. Seguro provides progressive coverage for a package of essential interventions and selected catastrophic treatments as well as coverage for prescription drugs. ","Compulsory contributions from employees and employers combined with tax revenue from the federal government fund the social security insurance. Private health insurance is funded by premiums. Seguro is funded by state and federal governments and a small income-dependent premium from the individual. The private sector is an unregulated market where patients mainly pay providers directly out of pocket at market prices, although private insurance covers some private spending for those who have it. Out-of-pocket payments by patients represent 51 percent of total health-care expenditures, while tax revenues and social security contributions by employers and employees and private insurance premiums account for the rest.","The Mexican social security system consists of various funds covering different salaried employment categories, such as military, public and private sector employees and the self-employed. These institutions employ their own doctors and own their own hospitals and clinics. Doctors and nurses are salaried workers in all institutions, and a large number of doctors also have private practices on a fee-for-service basis. The State Health Services operates its own hospitals and clinics for those without insurance.","Administrative costs are relatively high and amount to 23 percent of total spending for the Ministry of Health and State Health Services combined and 17 percent for the social security system. The social security system has reduced management personnel in an effort to reduce overhead, but labor contracts have made it difficult to make similar cuts among lower-level employees.

There is growing interest in local agreements between providers that would allow people from different social security funds to use the same hospitals, and thus would reduce the number of needed facilities, but these are not yet widespread and are limited in scope. Also, 70 percent of them concern agreements with the social security sector about arranging care for the insured using the SHS facilities. Only 20 percent concern the reciprocal supply of services. ","\"The best thing that Mexico has done is tried to establish infrastructure to deliver health care down to each local community. But they are not adequately funded and managed. The weakness of the Mexican system is that the infrastructure is not very effective because it's poorly managed and under-funded, that's why so many Mexicans are not immunized. The good part: In Mexico City and in the north, they have modern hospitals and well-trained doctors. The downside is that these well-equipped hospitals and doctors are serving the rich people, so health care is very unequal,\" said William Hsiao of the Department of Health Policy and Management at Harvard University.","55 out of 191 countries","Males: 72
Females: 77","Males: 31
Females: 25","$582 (U.S.)","6.2 percent"); countryInfoArray[5] = new Array("UNITED KINGDOM","Coverage is universal.","The National Health Service, which is publicly funded, provides preventive care, inpatient and outpatient hospital care, physician services, inpatient and outpatient prescription drugs, dental care, mental health care and rehabilitation. Participants can choose their general practitioner.

There are relatively few cost-sharing arrangements for covered services: a prescription charge applies to drugs prescribed by family doctors, but many patients are exempt.","The National Health Service is funded by a mixture of general taxation and national insurance contributions and accounts for 88 percent of health care expenditures. A mix of for-profit and nonprofit insurers covers private medical care, which plays a complementary role to the NHS.

Private insurance offers a choice of specialists, allows participants to jump queues for elective surgery, and offers higher standards of comfort and privacy. Private insurance covers 12 percent of the population and accounts for 4 percent of health care expenditures.

Out-of-pocket payments account for 8 percent of health expenditures. ","General practitioners are independent contractors, act as gatekeepers by referring patients to specialists, and are organized in primary care trusts, local organizations that oversee primary care access. Most are paid directly by the government through a combination of methods, including annual fees and fee-for-service payments.

Hospitals are mainly semi-autonomous, self-governing public trusts that contract with physicians' primary care trusts.  ","The government sets the budget for the NHS on a three-year cycle. The UK has controlled physician training, capital expenditure and primary care trust's revenue budgets in an attempt to control costs. There are waiting lists for some elective procedures. A centralized administrative system results in lower costs.","\"The UK is a prototype of a national health service. The British generally like their system. They complain about waiting times for elective surgery, but the Blair government has taken this problem on and waiting times have reduced over the past year. There are far less choice of specialist physicians than one would have in the United States, assuming one has coverage,\" said Victor Rodwin of the School of Public Service at New York University.","14 out of 191 countries","Males: 76
Females: 81","Males: 6
Females: 5","$2,381 (U.S.)","8.0 percent"); function showtable (country1, country2){ var show = -1; if (country1 == -1){show = 0;} else {if (country2 == -1){show = 1;}else {show = 2;}} if (show == 0 ){ document.getElementById("tablediv").innerHTML = ""; return true; } var tablehtml = ''; tablehtml += ''; tablehtml += ''; tablehtml += ''; if (show ==1){ tablehtml += ''; tablehtml += ''; } if (show ==2){ tablehtml += ''; tablehtml += ''; } tablehtml += ''; for (var i = 1; i < 12; i++){ tablehtml += ''; tablehtml += ''; tablehtml+= ''; if (show ==1){ tablehtml += ''; } if (show ==2){ tablehtml += ''; } tablehtml += ''; tablehtml += ''; tablehtml += ''; tablehtml+= ''; if (show ==1){ tablehtml += ''; } if (show ==2){ tablehtml += ''; } tablehtml += ''; tablehtml += ''; tablehtml += ''; if (show ==1){ tablehtml+= ''; tablehtml += ''; } if (show ==2){ tablehtml+= ''; tablehtml += ''; } tablehtml += ''; } tablehtml += '
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