Medical Care in Latin America and the Caribbean
Medical care is the treatment of illness, injury, and disease. It includes medical, dental, and veterinary services as well as medications and devices. Learn more
The goal of medical care should be to improve outcomes and patient satisfaction, not to increase profits. To achieve this, providers must move from an organization by specialty department and discrete service to a medical condition-based structure.
The United States
The United States spends far more on medical care than other high-income nations, yet it ranks below them in key health outcomes measures, including life expectancy. More Americans die from chronic disease and suicide than residents of peer countries, and more report that they or a family member have not filled prescriptions or cut pills due to cost.
A fundamental change in health care is needed to address these challenges and bring costs under control. Payers must shift to a system that covers all individuals and emphasizes comprehensive primary care. Patients must be able to voluntarily enter into direct contracts with physicians for a negotiated set of visits and services (e.g., direct primary care) without cost-sharing. Many of these changes will require new resources. Fortunately, there are encouraging signs that health systems and payers are starting to move in this direction.
Germany has one of the world’s best and oldest healthcare systems. The public-private system is based on statutory contributions, which guarantee free health coverage. In addition, private insurance is available for those who prefer it.
The monthly fee varies by the insurer and is about 2% of a yearly salaried income. However, even patients who have a subsidized public health insurance plan are often required to pay a flat fee for first consultations.
At a hospital, patients will be asked for their health insurance ID card and to fill out a medical questionnaire. In some cases, doctors may also ask patients to undress for physical examinations. Many hospitals in Germany have very structured visiting hours, and visitors must follow strict rules regarding mobile phone usage, smoking, and meals in the hospital room. However, some specialist fields do not require a referral from a family doctor, including emergency treatment, dentistry, gynecology and ophthalmology.
The Brazilian health system is based on a decentralized universal healthcare model called SUS. This consists of a network of public medical facilities with the ability to offer free GP consultations, hospitalisation and surgery as well as prescription medicines.
However, the centralized nature of the system can create difficulties for patients seeking specialist care. The study found that many SUS users also sought private healthcare. Dual users were mainly female, non-white and lived in the southeastern region of Brazil.
The study analysed data from the National Health Survey. It used descriptive statistics to describe dual use, adjusting for personal characteristics. The results indicated that higher SES, region and private health insurance ownership was associated with increased use of the private healthcare system, although other factors such as gender and age were not significant in bivariate analyses. However, this result must be interpreted with caution, as the study did not measure the quality of the care received in each healthcare system.
Mexico’s national healthcare system is based on a three-tier model: care provided by the state – Instituto Mexicano del Seguro Social (IMSS), funded partly by employers and open to expats; care available via a universally accessible, basic scheme called Seguro Popular, which is free for those without formal employment; and private sector medical centres and hospitals.
The quality of healthcare varies widely across the country. In remote areas such as the coffee-growing state of Chiapas, access to healthcare is a challenge: clinics may be miles from homes and hospitals lack equipment and supplies.
In the private sector, there are a number of world-class hospitals with English-speaking staff and specialist doctors. However, these facilities can be costly for travellers not backed by private medical insurance. Most foreign residents in Mexico take out a private health policy to ensure they have direct access to private doctors and hospitals. A good global medical insurance provider can help arrange this.