Overview: Health System

High-Income Countries

In these countries (Fig. 20.1), there is primarily an NCD burden of disease (left hand

Y axis: 80-90% of reported conditions are noncommunicable). There is a three- to fourfold gradient of increasing infant/neonatal/under-five mortality (right hand Y axis) from Poland to Trinidad and Tobago.

All three countries shown in Fig. 20.2 (below) are ranked according to their per capita Gross National Income (all called Gross Domestic Product or GDP) (left hand

Y axis). These countries have per capita health government expenditures ranging between $1100, about $1500 annually (left hand Y axis) and about 5-6% total health expenditure as a percentage of Gross Domestic Product (GNI: right hand Y axis)

Figure 20.3 ranks these countries by their per capita health spending (left hand Y axis). The majority of total annual health spending in these countries is in the public sector (right hand Y axis), with the largest fraction (74.5%) being in Saudi Arabia. In Trinidad and Tobago, the percent health spending in the private sector is nearly

Burden of disease estimates in high-income countries

Fig. 20.1 Burden of disease estimates in high-income countries

Selected health expenditures in high-income countries

Fig. 20.2 Selected health expenditures in high-income countries

Selected health expenditures in high-income countries equal to that of the public sector

Fig. 20.3 Selected health expenditures in high-income countries equal to that of the public sector (46.5%). There is an increasing gradient in out-ofpocket expenditures as a percent of total health expenditure and private health expenditure from Saudi Arabia to Trinidad and Tobago, the latter with over 80% of private health expenditure being out-of-pocket, the former with about 56%.

Healthcare in all three countries is primarily centralized healthcare, in which public healthcare is supported through government funded public health insurance. Saudi Arabia, in particular, has a large network of modern healthcare facilities, including hundreds of hospitals and thousands of primary care centers are currently established in the country to provide healthcare to all citizens and residents in the country.

Nonetheless, there is always an active private sector in which services provided are usually financed by cooperative health insurance schemes and out-of-pocket payments. All three countries face similar structural issues within their healthcare systems. Primary among these are escalating costs in providing healthcare services, plus local healthcare professionals. This is especially true in Saudi Arabia as the majority of healthcare professionals are expatriates. To more or less degrees, all three face a rapid population growth, the aging of the population, the high burden of chronic diseases, and a growing demand for healthcare services.

 
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