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Health care Reforms in G8 Countries and Turkey Research Paper


One of the main objectives of the governments of G8 countries is to promote and improve the health status of their citizens. In order to achieve this objective, G8 countries have focused on providing effective, accessible, as well as, affordable health care to their citizens. Consequently, health care policies in G8 countries revolve around two fundamental issues.

The first issue is the manner in which a basic package of high quality health care should be provided. The second issue is how to “finance and manage health services in away that guarantees their availability and accessibility” (Parmmolli, Riccaboni, & Magazzini, 2011). In order to address these issues, health care has been considered a public good in G8 countries. A public good is normally provided by the government and benefits everyone in the community.

The governments of G8 countries are, thus, justified to provide health care services due to the following reasons. First, majority of the citizens can not access health services due to the high costs (Parmmolli, Riccaboni, & Magazzini, 2011). Consequently, the governments provide health services in order to promote access regardless of the ability to pay. Second, health care is a basic right of all citizens, and thus, it should be provided by the government.

Additionally, there are no substitutes for health care. Hence all citizens must be able to access quality health services. Third, the governments are able to mobilize additional funds for health care by providing universal health cover to their citizens (Parmmolli, Riccaboni, & Magazzini, 2011).

The additional funds are used to improve the quality of health care services. Finally, a healthy nation tends to be more productive. This has prompted G8 governments to provide affordable health services in order to enhance their productivity (Arrieta & Guillein, 2011). This paper focuses on the health care reforms in the G8 countries.

Health care in G8 Countries in the Last 15 Years

The G8 consists of the eight largest economies in the world. Despite the fact that all G8 countries are developed, some of them have poor health care systems. The quality of health care among the G8 countries depends on the availability of resources and health policies adopted by each country.

In the last fifteen years, health services in G8 countries, except US, have been provided by the governments. The governments either provided the services directly or contracted private providers to deliver the services. However, the percentage of health care costs paid by the governments varies from country to country. For example, in UK the government pays all the fees while in Japan, the patient pays between 10% and 30% of the total cost (Claudia, 2010).

Both taxation and national health insurance covers are used to finance health services in the G8 countries. Unlike other G8 countries, health care in US is mainly financed through private insurance. The health covers are either provided by the employers or purchased directly by the citizens. The US government has minimal participation in the provision of health services. The health care programs that are supported by the US government include Medicaid and Medicare.

Generally, access to quality health services has increased in most G8 countries. The UK, German and France have had the best health care systems in terms of quality, accessibility and affordability (Claudia, 2010). In these countries, the governments pay for nearly all health care expenses. Additionally, a lot of capital is invested in the health care sectors. Russia’s health care system remained ineffective in the last fifteen years due to poor management and lack of financial resources.

The US health system has also recorded poor performance in the last fifteen years. In particular, high costs prevent majority of US citizens from accessing quality health services (Juni, 2006). Nearly all G8 countries have faced challenges in providing health services. The common challenges include rising costs, inadequate personnel and declining service quality. These challenges have promoted the G8 governments to reform their health care systems.

Health Care Reforms

In UK, health care reforms began in 1948 with the establishment of the National Health Services (NHS). The objective NHS is to “provide health care for all citizens based on need and not the ability to pay” (Juni, 2006). NHS is funded by the public through taxation. All legal residents of UK are eligible for the services offered by NHS, irrespective of their nationalities or tax history.

NHS hospitals provide all medical services including surgeries and prescriptions free of charge. Additionally, meals, care workers, ambulance services, therapies and in-clinic nursing services are provided for free (Claudia, 2010). Only general physicians are allowed to refer a patient for acute care in a NHS hospital. The general physicians are also given feedback on the treatment given to the patient and recommendations for follow up actions.

In US, earlier reforms in the health care system involved the formation of the “Veterans Health Administration, the Military Healthcare System and the Indian Health Services” (Juni, 2006). These programs provide subsidized health care services to specific groups such as the military.

Publicly funded programs such as Medicaid and Medicare provide subsidized health care to vulnerable groups such as the poor, the old (over 65 years) and the disabled. Major reforms began in 2010, with the enactment of the new health reforms bill. The new health bill aims at improving access to health services through universal health cover. Under the new legislation, all US citizens will be required by law to obtain health insurance (Arrieta & Guillein, 2011).

The government will provide tax credits to those living below the poverty line to enable them obtain health insurance. Insurance companies will be prohibited from refusing to offer covers to citizens with preconditions. The health insurance covers will cater for all medical services demanded by all US citizens.

Russia adopted a socialist approach to provide health care between 1917 and 1990. During this period, the government provided all health care services through taxation (Claudia, 2010). Thus, all citizens were able to access services such as prescriptions, surgeries, therapies and other treatments for free.

Following the collapse of the Soviet Union, Russia adopted a mixed model of healthcare provision (Claudia, 2010). In this case, the private and public sector participates in financing and provision of health services. The private sector provides health insurance and health facilities while the government subsidizes the cost of treatment and also provides health workers (Parmmolli, Riccaboni, & Magazzini, 2011).

Reforms in Turkey’s health care system began in 2003. The reform program “aims at increasing the ratio of private to state health provision and making health care available to all citizens” (Feldster, 2009). Private insurance companies partnered with private hospitals to provide quality health care. In 2006, laws that facilitate provision of universal health cover were enacted in order to enhance access to health services.

The government funds nearly 70% while the private sector funds 30% of all health expenses (Feldster, 2009). The family practitioner model was introduced in 2010 to provide low cost medical services by local doctors. The family practitioner model provides treatment to citizens of all ages. Members of a family can receive treatment from the same doctor. However, the doctors are not specialized, and thus, services such as surgery are obtained in centralized government hospitals.

Healthcare in Germany is provided by the government through a universal health cover system. The insurance cover is provided in two forms namely the sickness fund and private insurance (Agrell & Bogetoft, 2001). Membership in sickness funds is compulsory and contributions are made by employers and employees.

Overall, the government funds nearly 77% of the total health care budget. The remaining 23% is funded by the private sector (Agrell & Bogetoft, 2001). The funding from both the government and private sectors caters for treatment, medicine costs, as well as, the cost of staying in hospitals. Following a sharp increase in costs, the government introduced new health financing reforms in 2007 through an act of parliament.

The new legislation guarantees access to health insurance, and provides incentives to enhance effective coordination of health care (Arrieta & Guillein, 2011). Additionally, it introduced a unitary contribution rate, and enhanced competition among insurers, hence reducing the cost of health insurance.

The French health system is funded through pension schemes, family allowances, as well as, health insurance. Pensions and family allowances are managed as a national fund. There are also smaller funds that cater for workers in specific professions. All health “funds are private but are highly regulated by the government” (Parmmolli, Riccaboni, & Magazzini, 2011).

The funds cater for hospital care, prescriptions, cash benefits and outpatient services. The other services offered include preventive care for mothers and children which are provided through community –based health facilities. Health workers such as nurses, midwives social workers are provided to care for children and other patients.

Health care in Italy is financed and provided by both the government and the private sector. The government provides health care through the National Health Services (NHS). NHS pays the family doctors, nurses, and the costs of treatment. However, medicinal drugs can not be obtained without a doctor’s prescription (Parmmolli, Riccaboni, & Magazzini, 2011).

The drugs prescribed by a family doctor are partly paid for by the patient. Over-the-counter drugs, on the other hand, are fully paid for by the patient. The family doctor is assigned to a maximum of 1500 patients and must visit the patients at least five times in week.

Both Japan and Canada have universal health covers through which they provide health care to their citizens. In Japan, the government pays 70% of the health care costs while the patient pays the remaining 30%. The funds from the government cater for parental care, disease control, and screening examinations (Agrell & Bogetoft, 2001).

Patients can access medical services from doctors of their choice, and have a right to health insurance from any provider. In Canada, health care is provided freely at the point of treatment or use (Arrieta & Guillein, 2011). Health services are mainly provided by private organizations. However, the government regulates the private providers in order to enhance the quality of health care. The government pays for the drugs, treatment and salaries of the health workers.

Effectiveness of the G8 Health Care Systems

In general, the reforms adopted by the G8 countries have helped them to improve the effectiveness of their health systems. At least 85% of Canadians are satisfied with their health care system.

The Canadian health system is also cost-effective since 96.2% of adults spend less than five percent of their disposable income on medical expenses such as prescription drugs (Arrieta & Guillein, 2011). In UK, the reforms have enabled the government to deliver health services closer to those who need them most. Consequently, health care costs have significantly reduced, and the service quality has improved tremendously.

In Turkey, the increased participation of the private sector raised competition for patients. Consequently, the quality of health care in public and private hospitals has improved. The number of health practitioners and health facilities has increased by 30% following the introduction the family practitioner model (Claudia, 2010). Majority of the rural population can now access health care through universal health cover and government subsidies.

The life expectancy in German increased to 78 years while the infant mortality rate reduced to 4.7 for ever 1,000 live births. Currently, German is one of the countries with the highest number of physicians (Claudia, 2010). The health financing reforms introduced in 2007, has enabled majority of Germans to access better health care through health covers.

The French health system is considered the best in Europe and among the G8 member countries. This is because it provides a variety of high quality health care services for free. At least 65% of France’s citizens are satisfied with their health system. Italy’s health system is the second best after the French system. At least 95% of Italians are able to access quality medical services. In Japan and Canada, access to medical services has significantly increased in the last decade.

Unlike other G8 countries, U.S and Russia still have ineffective health care systems. Russia has the worse health system among the G8 countries. Its health system initially helped in reducing infectious diseases and increased bed capacities in hospitals (Feldster, 2009). However, the introduction of the mixed model led to inefficiency in the health system.

Consequently, the health of Russia’s population has deteriorated in nearly all measures. In United States, the main challenge is high costs of accessing health care. Additionally, the quality of health services is very low. Only 40% of US citizens are satisfied with their health care system (Arrieta & Guillein, 2011). However, the challenges facing the United States’ health care system are likely to be addressed by the new health reforms laws.

In conclusion, providing health care through universal health covers has enabled most G8 countries to achieve the objective of delivering quality and affordable health care. However, the existing health care systems are still faced with challenges such as rising costs, inefficiency and administration problems (Parmmolli, Riccaboni, & Magazzini, 2011).

Role of the Private Sector

In all G8 countries, health care services are provided by both the government and the private sector. The government and the private sector participate in financing and actual provision of health care services. The private sector plays three fundamental roles which include the following.

First, private health providers deliver health care services directly to the citizens. The private providers include private hospitals, doctors working in the private sector and private health organizations (Feldster, 2009). Second, private insurance companies provide covers that enable citizens to access medical services. Finally, employers in the private sector help in financing health care by purchasing health covers for their employees.

The extent to which the private sector participates in the provision of health care varies from country to country. United States has the highest percentage of private sector participation in the provision of health care services. Nearly 70% of US citizens access medical services through private insurance.

The insurance covers are directly purchased by citizens and employers (Feldster, 2009). In France, the private sector dominates in the provision of health covers. All insurance plans or health funds are arranged by the private sector under the regulation of the government. In Japan, the private sector funds only 30% of the health care costs. Besides, the government provides most health care services through public health facilities (Juni, 2006). There is minimal involvement of the private sector in UK, Canada, German, Turkey and Italy.

In these countries, the governments pay for at least 75% of the total health care costs. Most health care facilities are owned by the government and the health workers are directly paid by the governments. In countries such as Italy and UK, the services provided in public hospitals are better than in most private hospitals.

Private verses Public

The above analysis indicates that access to quality and affordable health care is high in G8 countries where health services are provided by the public sector (government). However, in US where the private sector dominates the provision of health care, medical services are inaccessible and of low quality.

Thus, we can conclude that the public sector can provide health care in a better way than the private sector. The effectiveness of the public sector can be explained by the following reasons. First, empirical studies reveal that 1% of the population pays for nearly 25% of health care costs. 50% of the population pays for only 3% of the health care costs (Parmmolli, Riccaboni, & Magazzini, 2011).

Since, a high percentage of health care costs are paid by the minority, pooling of resources through a compulsory universal health cover becomes apparent. It is only the government that has the capacity to implement a compulsory universal health cover (Juni, 2006).

Second, provision of health care by the public sector addresses equity issues. Since the private sector is driven by the profit motive, it restricts access to health care through the price mechanism (Feldster, 2009). The public sector, on the other hand, enables everyone to access health care regardless of their purchasing power (Arrieta & Guillein, 2011).

Second, provision of health care by the public sector improves the quality of health services. For instance, the additional resources resulting from a universal cover can be used to acquire more health facilities.

Third, provision of a public good such health care requires a high level of administration that a single enterprise can not arrange. It is only the government that can arrange for such high level of administration through its ministries (Arrieta & Guillein, 2011). Additionally, the private sector might not be able to access the large capital that is required to offer universal health covers. Fourth, providing health care through publicly owned universal covers is likely to be more acceptable than private insurance (Juni, 2006).

This is because a universal cover is relatively cheaper and is not subject to contractual obligations. Finally, the rapid economic growth in G8 countries provides a favorable environment for implementing universal health care (Claudia, 2010). The high employment rates in G8 countries means that majority of the citizens can contribute to health funds. Additionally, G8 countries have high tax revenues that can be used to meet the costs of health care services.


Health care is an important sector since it determines the productivity and welfare of the population. It is against this backdrop that G8 countries have focused on providing affordable and quality health care to their citizens. Health care is considered a public good in most of the G8 countries. Consequently, the governments are more involved than the private sector in the funding and provision of health services.

All G8 countries, except the US, provide health care through universal insurance covers and taxation (Feldster, 2009). In US, the private sector dominates in the provision of health care through private health insurance. The governments pay for the costs of treatment, prescription drugs, costs of staying in hospitals and the salaries of health workers. The private sector mainly participates in the provision of health covers (Arrieta & Guillein, 2011).

The challenges facing G8 countries in providing health care services include rising costs, mismanagement of funds and inadequate funds. In general, provision of health care through the public sector has enabled G8 countries to provide affordable and quality health care to their citizens. Thus, we can conclude that the public sector can provide better health care than the private sector.


Agrell, P., & Bogetoft, P. (2001). DEA-Based Incentive Regimes in Health Care Provison. Journal of Economics and Management, 3(2), 78-91.

Arrieta, A., & Guillein, J. (2011). The Private Health Care Sector and the Provison of Parental Crae Services in America. World Development, 39(4) , 579-587.

Claudia, C. (2010). Macrosystematic Reforms in the Health Care System for Eastern European Countries. Journal of Economics and Management, 10(2), 124-128.

Feldster, M. (2009). Balancing the Goal of Health Care Provision. Social Science and Medicine, 31(6), 45-49.

Juni, M. (2006). Public Health Care Provision: Access and Equity. Social Science and Medicine, 43(5), 759-768.

Parmmolli, F., Riccaboni, M., & Magazzini, L. (2011). The Sustainability of European Health Care System: Beyond Income and Ageing. Journal of Economic s and Management, 10(1), 199-209.

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