Medical Services

Developed countries use part of their wealth to provide publicly funded medical care to all citizens. The high expenditure on health care in developed countries is reflected in medical facilities.

Medical Facilities

Many countries in Europe have more than 50 hospital beds per 10,000 people, compared to fewer than 30 in sub-Saharan Africa and South and Southwest Asia (Figure 2-28). Europe has more than 30 physicians per 10,000 people, compared to fewer than 5 in sub-Saharan Africa.

Physicians PER 10,000 People

In most developed countries, health care is a public service that is available at little or no cost. Government programs pay more than 70 percent of health-care costs in most European countries, and private individuals pay less than 30 percent. In developing countries, private individuals must pay more than half the cost of health care. An exception to this pattern is the United States, a developed country where private individuals are required to pay an average of 55 percent of health care, more closely resembling the pattern in developing countries.

Developed countries are hard-pressed to maintain their current levels of public assistance. In the past, rapid economic growth permitted these states to finance generous programs with little difficulty. But in recent years, economic growth has slowed while the percentage of people needing public assistance has increased. Governments have faced a choice between reducing benefits and increasing taxes to pay for them. In some of the poor countries, threats to health and sustainability are not so much financial as environmental.

Pause & Reflect 2.3.1

Why might levels of hospital beds and physicians in developed countries of Europe be higher than in North America?

Health Care

Annual per capita expenditure on health care exceeds $1,000 in developed countries, compared to less than $100 in sub-Saharan Africa and South Asia (Figure 2-30). Expenditure on health care exceeds 15 percent of all government spending in Europe and North America, compared to less than 5 percent in sub-Saharan Africa and South Asia. So not only do developed countries spend more on health care, they also spend a higher percentage of their wealth on health care.

Health-Care Expenditure

Debate It!

Should the United States adopt universal health care?

• The United States is the only populous developed country that does not have universal health care.

The current system has strengths

• The United States has the world’s seven best hospitals and 17 of the top 20, according to the Spanish National Research Council (CSIC) (Figure 2-31).

• U.S. health care can be extended to more people without overhauling the entire system.

• Countries with universal health care may not have enough doctors, leaving patients with long wait times for appointments and operations.

Universal access would cut costs

• Access to health care should be a right of all citizens, but millions of Americans do not have health care (Figure 2-32).

• Per capita spending on health care exceeds $5,000 in the United States, compared with only $1,000 in other developed countries.

• The United States spends around 17 percent of its GDP on health care, compared with around 11 percent in Canada and wealthy countries of Europe.

Questions For Research & Analysis

1. Use your browser to go to Pew Research Center Health Care or enter

2. Select a research paper that relates to U.S health-care issues.

3. What is the paper’s overall assessment of the strengths and weaknesses of the current health-care system?

4. Summarize the main points the paper makes about how problems with the current system could be remedied.