Abstract

Background: A long-term debate persists in global health concerns about the proper balance in the delivery of healthcare services between the private and public sector to the people of the low and middle income countries. The private sector allies claim that private companies may be more efficient and receptive in fulfilling patient needs, while the public sector allies have stressed the incapacity of the poor people to pay that causes imbalances in access to health care. Aim: This study aims to compare the health-care privatization models of the United Kingdom, Germany, and Canada through health expenditure statistics. The findings will serve as a source of benefits from the privatization of health sectors in Kingdom of Saudi Arabia to strengthen its implementation. Method: This is a descriptive-comparative research where the healthcare privatization model among the chosen first-world countries will be compared through the available health expenditure statistics. Results: The United States of America (USA) has the highest Total Health Expenditure as a percentage of the Gross Domestic Product with 15-17% since 2006, and lasted until 2014. Saudi Arabia has only 3-5% as compared to the selected first-world countries. The United Kingdom (UK), Germany, Canada, and Saudi Arabia have significantly higher General Government Health Expenditure as a percentage of Total Health Expenditure. On the contrary, the Private Health Expenditure (PvtHE) of USA is higher with 52-55% than the GGHE with only 45-48%. Also, the private insurance as a percentage of PvTHE of the USA is the highest with 63-65% as compared to UK, Germany, Canada and Saudi Arabia. Conclusion: The healthcare system of Saudi Arabia is a mainly public-funded and public-owned similar to the UK, Germany, and Canada. Despite of the effectiveness of the public-contract model, the private insurance or provider model and the privatization of hospitals could notably change the healthcare system in Saudi Arabia. Thus, the resources and the quality of healthcare services in Saudi Arabia must be enhanced through these mechanisms.

Keywords: Healthcare · Healthcare services · Hospital · Private insurance · Privatization

References

  1. 1.Berendes S, Heywood P, Oliver S, Garner P(2011) Quality of private and public ambulatory health care in low and middle incomecountries:systematicreviewofcomparative studies. PLoS Med 8: e1000433. doi:10.1371/ journal.pmed.1000433.
  2. 2.Stuckler D, Basu S, Wang SW, McKee M (2011) Does recession reduce global health aid? evidence from 15 high-income countries, 1975–2007. Bull World Health Organ 89: 252–257.
  3. 3.World Bank (2009) World Bank responds to new Oxfam health report. Washington SaadAlflayyeh:ThePrivatizationofHealthcareinselectedFirst-worldCountriesanditsImplicationsintheKingdomofSaudiArabia:ADescriptive-Comparative Majmaah Journal of Health Sciences ,Vol.5, issue 2, Nov. 2017 - RabiulAwwal - 1439 125 125 (District of Columbia): World Bank.
  4. 4.Rachlis, M. (2007) “Privatized Healthcare Won’t Deliver”, Commissioned Policy Research, Toronto: Wellesley Institute.
  5. 5.5 Øvretveit J. 1996. Beyond the publicprivate debate: the mixed economy of health. Health Policy 35: 75–93.
  6. 6.Øvretveit, John. “Nordic privatization and private healthcare.” The International journal of health planning and management 18.3 (2003): 233-246.
  7. 7.European Observatory on Health Systems and Policies. (2008). Glossary. Geneva: WHO European Centre for Health Policy.
  8. 8.Rosenthal G, Newbrander W (1996) Public policy and private sector provision of health services. Int J Health Plann Manage 11: 203–216.
  9. 9.World Health Organization (2005) Saudi Arabia: national expenditure on health. Available at: http://www.emro.who.int/ emrinfo (accessed 09 September 2017).
  10. 10.Aldossary A, While A, Barriball L. Health care and nursing in Saudi Arabia. International nursing review. 2008 Mar 1;55(1):125-8.
  11. 11.Al-Yousuf, M., Akerele, T.M. & Al-Mazrou, Y.Y. (2002) Organization of the Saudi health system. Eastern Mediterranean Health Journal, 8, 4–5.
  12. 12.Ministry of Health, (2008). Health Statistical Year Book. Riyadh: Ministry of Health Press.
  13. 13.Schieber, G., (2001). “Vision 2020 Health Sector Report”, in Ministry of Economy and Planning’s Future Vision for the Saudi Economy. Riyadh: Ministry of Economy and Planning Press.
  14. 14.Albejaidi FM. Healthcare system in Saudi Arabia: An analysis of structure, total quality management and future challenges. Journal of Alternative Perspectives in the Social Sciences. 2010;2(2):794-818.
  15. 15.Wolfe I, Sigfrid L, Chanchlani N, Lenton S. Child Health Systems in the United Kingdom (England). The Journal of pediatrics. 2016 Oct 31;177:S217-42.
  16. 16.Doyle Y, Bull A. Role of private sector in United Kingdom healthcare system. BMJ: British Medical Journal. 2000 Sep 2;321(7260):563.
  17. 17.GKVSpitzenverband,Statutoryhealthinsurance, http://www.gkv-spitzenverband. de/ Statutory_health_insurance.gkvnet.
  18. 18.PKVVerband,ZahlenberichtderPrivaten Krankenversicherung 2010/2011, 2011, http:// pkv.de/w/ les/shop_zahlenberichte/ zahlenbericht20102011.pdf.
  19. 19.OECD, Health at a Glance 2011, 2011, p.
  20. 20.Economist Intelligence Unit, Germany: Healthcare and Pharmaceuticals Report, December 2011.
  21. 21.Cathy Schoen, Robin Osborn, David Squires,MichelleM.Doty,RozPierson,and SaadAlflayyeh:ThePrivatizationofHealthcareinselectedFirst-worldCountriesanditsImplicationsintheKingdomofSaudiArabia:ADescriptive-Comparative Majmaah Journal of Health Sciences ,Vol.5, issue 2, Nov. 2017 - RabiulAwwal - 1439 126 126 Sandra Applebaum, “How Health Insurance Design Affects Access To Care And Costs, By Income, In Eleven Countries,” HealthAffairs, Vol. 29 (2010), No. 12, pp. 2323-2334; Karen Davis, Cathy Schoen, and Kristof Stremikis, Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally, Commonwealth Fund, June 2010, p. v.
  22. 22.Oliver Tiemann and Jonas Schreyögg, Changes in Hospital Ef ciency after Privatization, Hamburg Center for Health Economics, 2011, p. 2.
  23. 23.“Germany’s local nances: Hundreds of mini-Greeces,” The Economist, April 20, 2011.
  24. 24.Statistisches Bundesamt, Grunddaten der Krankenhäuser, Fachserie 12 Reihe 6.1.1, 2011, p. 13.
  25. 25.Angell M. Privatizing health care is not the answer: lessons from the United States. Canadian Medical Association Journal. 2008 Oct 21;179(9):916-9.
  26. 26.Geyman J. Do not resuscitate: Why the health insurance industry is dying and how we must replace it. Monroe (ME): Common Courage Press; 2008.
  27. 27.Potetz L. Financing Medicare: an issue brief. Washington (DC): Kaiser Family Foundation; 2008. Available: www.medicareadvocacy.org/Reform_08_01.Kaiser BriefReMAFinancing.pdf (accessed 2008 Aug 27).
  28. 28.Relman AS. A second opinion: rescuing America’s health care. New York (NY): PublicAffairs; 2007.
  29. 29.Marchildon GP. Health systems in transition: Canada. Toronto (ON): University of Toronto Press; 2005.
  30. 30.Chaoulli v. Quebec (Attorney General), no 29272, Sup Ct of Canada 130 CRR (2d) 99; 2005 CRR LEXIS 76.
  31. 31.Steinbrook R. Private health care in Canada. N Engl J Med 2006;354:1661-4.
  32. 32.World Health Organization (WHO). Health expenditure database 2004-2016. Available: http://apps.who.int/nha/database (accessed September 11, 2017)
  33. 33.World Bank (WB). World bank data. Available: https://data.worldbank.org (accessed September 11, 2017)
  34. 34.Ministry of Health, (2014). Health Statistical Year Book. Riyadh: Ministry of Health Press.
  35. 35.Lorenzoni L, Belloni A, Sassi F. Healthcare expenditure and health policy in the USA versus other high-spending OECD countries. The Lancet. 2014 Jul 11;384(9937):83-92.
  36. 36.Squires DA. Explaining high health care spending in the United States: an international comparison of supply, utilisation, prices, and quality. New York, NY: Commonwealth Fund, 2012. SaadAlflayyeh:ThePrivatizationofHealthcareinselectedFirst-worldCountriesanditsImplicationsintheKingdomofSaudiArabia:ADescriptive-Comparative Majmaah Journal of Health Sciences ,Vol.5, issue 2, Nov. 2017 - RabiulAwwal - 1439 127 127
  37. 37.ChandraA, Skinner J. Technology growth and expenditure growth in health care. Cambridge: National Bureau of Economic Research, 2011.
  38. 38.Moriya AS, Vogt WB, Gaynor M. Hospital prices and market structure in the hospital and insurance industries. Health Econ Policy Law 2010; 5: 459–79.
  39. 39.White C. Health care spending growth: how different is the United States from the rest of the OECD? Health Aff (Millwood) 2007; 26: 154–61.
  40. 40.Walston S, Al-Harbi Y, Al-Omar B. The changing face of healthcare in Saudi Arabia. Annals of Saudi medicine. 2008 Jul 1;28(4):243.
  41. 41.Al-Shaikh, S. August 7, 2006, “Saudi health care Sector: need for More investment”Arab news.
  42. 42.Docteur E, Oxley H. Health-system reform: lessons from experience. In: Organization for Economic Co-operation and Development. The OECD health project: towards high-performing health systems. Paris: OECD Publishing, 2004.
  43. 43.OliverTiemannandJonasSchreyögg,“Effects of Ownership on Hospital Effciency in Germany,” Business Research, Vol. 2 (2009), No. 2, pp. 115-145.
  44. 44.Björn A. Kuchinke, Dirk Sauerland, and AnsgarWübker, Determinanten der Wartezeit auf einen Behandlungstermin in deutschen Krankenhäusern: Ergebnisse einer Auswertung neuer Daten, Technische Universität Ilmenau, 2008.
  45. 45.Roeder FC, Labrie Y. The private sector within a public health care system: The German example. Health Care. 2012 Feb.
  46. 46.Saudi Arabian Ministry of health. 2005, health statistic book for the year of 2005. retrieved January 2007 from http://www. moh.gov.sa/statistics/1425/index.html
  47. 47.Mufti, M. 2004, healthcare development Strategies in the Kingdom of Saudi Arabia. Springer.
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