Page 44 - GHES-2-3

Global Health Economics and
Sustainability
Jamaican specialized health-care history

such as the chikungunya and Zika epidemics in the past performs poorly. The limited number of specialists on the
decade and the COVID-19 pandemic, good public health island results in very long waiting lists. In this regard, the
has mostly eradicated the scourge of infectious diseases in US ranks 1 , with significant redundancy in the system to
st
upper-middle-income countries like Jamaica (Planning accommodate urgent needs (WHO, 2000a), although even
Institute of Jamaica & Statistical Institute of Jamaica, 1997). this system was severely tested in the COVID-19 pandemic.
In the UK, 16.1% of healthcare is privately sourced versus The third intrinsic factor determining the standing of
29.5% in Canada and 46.9% in the US. This latter figure a health-care system is FFC. The goal of FFC is fairness in
is comparable to Jamaica’s, where 46.7% of healthcare is financing and financial risk protection. FFC, a term created
privately sourced. Healthcare represents roughly 10 – 12%
of GDP in Canada and most European countries and and included in the World Health Report 2000 of the WHO
almost 18% in the US. By comparison, in 2015, only (2000b), defined fairness as an equal burden where every
4.8% of Jamaica’s GDP could be allocated to healthcare. household contributes an equal share of its capacity to pay
Despite the small per capita allocation of just US$512, to the health system. In essence, it is an index of inequality
Jamaica ranks 53 of 191 countries in the World Health in the burden of health costs across households in different
rd
Organization (WHO) health-care ranking, underscoring countries.
the comparatively low cost of meeting the relatively basic The principle here is that poor households should not pay
health needs that prolong life (Table 1). a higher share of their discretionary expenditure on health

Several measures are applied to evaluating a national than richer households and that all households should be
health system, with three being the most important: protected against catastrophic financial losses related to ill
Efficiency, responsiveness, and fairness of financial health. In this regard, the US does not perform as well as
contribution (FFC). First, consider efficiency, Jamaica many other Organization for Economic Co-operation and
th
is highly efficient, ranking eighth globally regarding the Development (OECD) countries, ranking 55 in the world
amount spent per capita vs outcomes. This efficiency (Table 1), principally because of the high cost of healthcare
significantly contributes to Jamaica’s relatively good WHO in that country. In 2018, 8.5% of the US population was
ranking. Canada is 35 , France 4 , and the US a distant uninsured (U.S. Census Bureau, 2019). Many more are also
th
th
72 , primarily due to the disproportionate percentage of underinsured, and these subpopulations are at great risk
nd
GDP and the absolute amount of money spent per person of developing and suffering complications from chronic
(WHO, 2000a). This implies that with proper management medical conditions that would, under other circumstances,
of primary healthcare, sanitation, and infrastructure, be prevented or controlled by regular medical attention.
such as clean water supply, electricity, and personal safety, When uninsured or underinsured individuals do get
individuals can achieve a good lifespan. sick and must access care, they are financially vulnerable
However, regarding another important measure of the and often suffer massive financial losses, either personally
health system’s adequacy, responsiveness, or the ability of a or affecting their families. Jamaica also performs poorly
person to access medical care in a timely manner, Jamaica in this measure, ranking 115 , although the situation
th
Table 1. Health-care comparison in selected countries of varying development (N=191)

Country % GDP % privately Per capita WHO female WHO health Fairness of financial Global Philanthropy
spent (2012) sourced spending lifespan (2015) ranking contribution Environment Index
(US$) (maximum=1) (GPEI*)/5 2022
1997 data # (Philanthropy, 2022)
Jamaica 4.8 46.7 512 77 53 0.921 (rank 115) 3.53
USA 17.9 46.9 8,900 81 37 0.954 (rank 55) 4.77
Qatar 1.8 22.5 1,890 80 44 0.944 (rank 70) 2.07
France 11.9 22.2 5,084 85 1 0.971 (rank 27) 4.67
Sweden 9.6 18.9 5,657 84 23 0.976 (rank 13) 4.30
UK 9.6 16.1 4,448 83 18 0.977 (rank 9) 4.18
Canada 11.3 29.5 5,675 84 30 0.974 (rank 18) 4.38
Kenya 4.5 59.1 98 63 140 0.939 (rank 80) 2.87
South Africa 8.9 51.6 1,091 64 175 0.904 (rank 143) 3.80
Notes: WHO World Health Report 2000 (WHO, 2000b); *GPEI: A measure of how well-developed philanthropy is in each country listed above.
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Volume 2 Issue 3 (2024) 4 https://doi.org/10.36922/ghes.2709