Health care

What is the second richest country in the world that does not have universal health care?

ANSWER PERSON RESPONDS: This isn’t straightforward. The exact coverage of “universal” health care does vary by country, although it’s agreed upon that the USA doesn’t have it. Usually it’s equated with some sort of single-payer system managed by the government.

Probably because of the definitional issues, “universal coverage” isn’t listed as an “indicator” by the World Health Organisation (WHO) or World Bank. They have indicators relating to expenditures on healthcare: total, public, private, and “out-of-pocket” (which may be the difference between total private health spending and that paid with private insurance, but don’t quote me).

An interesting ratio that gets at the idea as to whether healthcare is paid by the government (i.e., from taxes and other govt. revenue) is the “Private expenditure on health as % of total expenditure on health” as reported in “Annex Table 2” of the WHO’s 2006 World Health Report. The USA is 55.4% in 2003. Most other wealthy countries are in the teens and 20s.

This gets tedious, but if you then rank each country by Gross Domestic Product per capita in 2003 (you can get this from the World Bank database World Development Indicators, through the library’s database list), you can scan down the list under the United States. The next richest country with >55.4% private funding is Singapore (63.9%), then Trinidad and Tobago (62.2%). Most of the coutries with a higher percentage private health expenditures are poor or dysfunctional countries. The highest is Guinea, at 83.4%.