Connect with us


The Best and Worst of National Health Systems



Using data collected in 2000, the World Health Organization (WHO) used a system to rank countries around the world based on the state of their national health systems. Although the ranking process was abandoned due to academic criticism regarding the methodology and validity of the results, it’s interesting to consider how certain countries ranked in relation to others. Here we’ll take a look at either end of the spectrum, examining the top three and bottom three countries on the list.

The Top

1 – France

In 2005, France spent a whopping 11.2% of the national GDP on healthcare. This works out to around $3,926 per capita. France has an average life expectancy of 81 years. Jean de Kervasdoue, a healthcare economist, has described French medicine as being of great quality, and as the “only credible alternative to the Americanization of world medicine.”

The entire population of France pays compulsory health insurance. In 2001, the national health insurance premium was set at 5.25% of an individual’s earned income. With this huge citizen contribution, doctors don’t pay anything to attend medical school. This reduces the expectation that doctors must be highly paid once they’ve qualified and helps de-sensationalize their role.

2 – Italy

Accounting for approximately 9.0% of national GDP, which equals around $2,600 per capita, healthcare is clearly considered a priority in Italy.  According to the CIA World Factbook, Italy has the world’s 10th highest life expectancy. Thanks to its extensive healthcare services, life expectancy in Italy is at about 80.9 years, which is two years above the average.

Like in France, Italy’s healthcare system operates in a mixed public-private system known as the Servizio Sanitario Nazionale, or SSN. Under this system, each family is assigned a doctor, and each doctor is assigned a maximum of 1,500 patients. If any medication is prescribed through a family doctor, it’s given to the patient at a heavily subsidized price – sometimes requiring a small co-payment, depending on the type of medication needed.

3 – San Marino

A microstate completely surrounded by Italy, San Marino is also known as the Most Serene Republic of San Marino. With its small population, it’s one of the wealthiest countries in terms of GDP. Its healthcare system is similar to that of Italy’s. In addition, it has one of the lowest unemployment rates in Europe, no national debt whatsoever, and a budget surplus.

Technically San Marino is an associated state of Italy, rather than a country. However, its high-quality healthcare, subsidized by Italy, is undeniable.

The Bottom

188 – The Democratic Republic of Congo

The Democratic Republic of Congo, or DRC, was one of Africa’s first countries to officially recognize HIV, registering cases as early as 1983. This is unsurprising, given that HIV prevalence among adults in the country is at 4.9% or around 1.3 million people. This is 0.1% from the 5% mark, at which the epidemic would be considered “high level”. Along with other factors, poor healthcare in the nation contributes to an extremely high infant mortality rate of up to 200 per 1,000.

189 – Central African Republic

In 2007, female life expectancy in the Central African Republic was low, at only 48.2 years old. Male life expectancy was even lower, at 45.1 years old. Like the DRC, the Central African Republic has a very HIV prevalence rate, with an estimated 4.7% of the adult population suffering from the disease. This makes it all the direr that there is only an average of 8 physicians per 100,000 people.

190 – Burma

The military government ruling Burma appears to care little for national health, in that it spends only between 0.5% and 3% of the national GDP on healthcare. Public hospitals lack many of the basic facilities and equipment needed, and although there are public hospitals and clinics, patients are expected to pay for their services.