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WHO TB.Pages ISRMUN 2017 Ave. Real San Agustín No. 4 CP. 66260 Garza García, N.L México. + (52) (81) 8625 1500 [email protected] THE UNITED NATIONS World Health Organization ! ISRMUN 2017 Ave. Real San Agustín No. 4 CP. 66260 Garza García, N.L México. + (52) (81) 8625 1500 [email protected] Committee: World Health Organization (WHO) Topic B: The consequences of the privatization of healthcare in developing nations Written by: Gerardo Medellín, Katia Peña, Estefania Sepulveda, Alexia Hernández and Guillermo Maldonado I. Committee Background The World Health Organization (WHO) is the main health authority of the United Nations (UN). This organization was established on April 7, 1948 and its headquarters are located in Geneva, Switzerland. The organization’s main goal is to provide the highest possible level of healthcare to all people regardless of religion, race, sexual orientation, etc. In order to do this, WHO has 150 regional offices staffed by more than 7,000 people around the world. It regularly collaborates with governments and non- governmental organizations (NGOs) to deliver healthcare and react to pressing health issues worldwide. As of 2017, the committee is responsible for promoting healthy choices, supporting the fight against pandemic and epidemic diseases and providing accessible medical treatment in developing and war torn regions (About WHO, WHO, 2017). ! ISRMUN 2017 Ave. Real San Agustín No. 4 CP. 66260 Garza García, N.L México. + (52) (81) 8625 1500 [email protected] II. Topic information A) History of Topic Privatization is defined by the Oxford Dictionary as “the transfer of a business, industry, or service from public to private ownership and control” (Privatization, Oxford Living Dictionaries, 2017). Healthcare is listed as “the organized provision of medical care to individuals or a community” (Healthcare, Oxford Living Dictionaries, 2017). So, with these two definitions, it can be concluded that the privatization of healthcare is to deny a service to the public where only privileged individuals have access to medical assistance. Millions of people around the world die each year from diseases and infections humankind knows how to cure; these include: malaria, diarrhea, fever, lead exposure and unintentional poisonings. In fact, in 2015, more than 1.2 million children died due to the fact that they did not have access to medical care (Children: Reducing Mortality, WHO, 2016). These deaths are related to the fact that millions of people around the world, especially in developing nations, do not have equal access to medical care. This is in part due to the rise of private health facilities and insurance policies that benefit the wealthy, but marginalize the poor who cannot afford treatment. The privatization of healthcare has become more prevalent in developing nations because private health facilities offer “better and more flexible access, shorter waiting, greater confidentiality, and greater sensitivity to user needs.” Many world leaders have called for a greater use of private health facilities because they “offer patients greater choice; increase competition in the healthcare market; and remove ! ISRMUN 2017 Ave. Real San Agustín No. 4 CP. 66260 Garza García, N.L México. + (52) (81) 8625 1500 [email protected] state responsibility for service provision, thereby encouraging its role as regulator and guarantor” (Zwi, Brugha and Smith, The BMJ, 2001). However, academic studies have shown that while private healthcare has its benefits, it is highly disadvantageous to the poor. In a 2001 study conducted by Anthony B Zwi, Ruairi Brugha and Elizabeth Smith, it was found that the poor are either shut out of medical care due to the cost of private facilities or pay substantially more than the wealthy for lower quality healthcare. Many people in the poorest nations end up paying more for lower quality care because they put trust in the provider to “act in their best interests.” Unfortunately, this does not always happen because private healthcare is a business and cost cutting to increase profit is a common occurrence (Zwi, Brugha and Smith, The BMJ, 2001) The UN has highlighted how privatization has created a system of inequality in developing nations. In its 2008 World Health Report, the organization stated: “In far too many cases, people who are well-off and generally healthier have the best access to the best care, while the poor are left to fend for themselves” (UN New Centre, 2008). For instance, in South Africa, those who can pay for private healthcare do not receive the same type or quality of care as others. The system is based on an individual's income. Those who earn more receive more benefits than those who earn less. This system of inequality further divides classes and reinforces upper class privilege (Price, Social Science & Medicine, 1988). Even to this day, many healthcare companies can only be accessed by the privileged. According to the US National Library of Medicine: “Academics and World Bank officials argue that, by reducing out-of-pocket expenditures, expanded private insurance may improve access to needed health services in less developed countries.” ! ISRMUN 2017 Ave. Real San Agustín No. 4 CP. 66260 Garza García, N.L México. + (52) (81) 8625 1500 [email protected] This means that when removing some of these costs, the private health companies can access a greater population including those from developing countries (Waitzkin, Jasso-Aguilar and Iriart, US National Library of Medicine, 2007). The solution to improve privatization of healthcare in developing countries is there, but it has not been implemented, and many people that are not privileged face the consequences of this unequal system. B) Current Issues Guatemala: The healthcare system in Guatemala is divided into three parts: public, private non-profit, and private for profit. The non-profit private zone is composed of non-governmental organizations (NGOs), which currently operate 1,000 medical clinics across the country. The private sector is made up of hospitals, laboratories and clinics. Public healthcare is not completely free and patients need to pay for certain services. However, not a lot of people chose to have public healthcare due to long wait times. More than 40% of people in the country who live in rural regions do not have access to healthcare. Moreover, hospitals in remote areas are usually under-funded and unhygienic (Pacific Prime International, 2017). Argentina: In Argentina, the healthcare system is divided in three main providers: the public sector, mutuals or social plans, and the private sector. The public sector supplies free clinic care for hospitals and covers 50% of the population. The mutuals or social plans are when employees of a company pay a fixed fee. Over the past decade, this has covered around 45% of the population. The private sector is where patients must pay for the complete cost of the medical care they receive and this covers around 5% ! ISRMUN 2017 Ave. Real San Agustín No. 4 CP. 66260 Garza García, N.L México. + (52) (81) 8625 1500 [email protected] of the population. Argentina’s government offers free medical care to all of its inhabitants, but the quality of care in public hospitals vary from area to area. This is because funds that go into public hospitals are administered by municipal governments. What is not covered at all levels are prescription medications. These must be paid for in full by all patients (Angloinfo, 2017). Brazil: According to Brazil’s constitution, every citizen has the right to healthcare. Healthcare in Brazil is provided by both the government and private institutions. Public hospitals are free and patients do not have to pay doctor fees, lab fees, for surgery or prescription drugs. Around 80% of the nation’s population uses this system regularly. This is because the private system is expensive and is only accessible to the wealthy, so around 20% of the population. It features shorter wait times and up-to-date medical equipment (Living International, 2017). China: In China, the healthcare system is administered by the federal government. Each year, the nation spends approximately 5.6% of its gross domestic product (GDP) on healthcare. Around 30% of China’s healthcare system is financed by local governments and 36% is publicly financed through health insurance, private health insurance or social health donations. Chinese citizens can access healthcare through three different types of plans or insurance. The first two ways are the urban employment-based basic insurance plan and the new cooperative medical scheme, which are financially supported by the government. The other way is through private companies, although this type is usually only available in larger cities and is quite expensive. Therefore, the majority of China’s population use the government funded plans as they are free and well supported (Fang, The Commonwealth Fund, 2017). ! ISRMUN 2017 Ave. Real San Agustín No. 4 CP. 66260 Garza García, N.L México. + (52) (81) 8625 1500 [email protected] Ghana: The Ghana Health Service was established in 1996 and is responsible for the country’s healthcare system. It is publically funded and supported by the National Health Insurance Scheme. However, this scheme has been criticized for being corrupt and mismanaging funds. Also, in order to run the healthcare system, all Ghanaians must pay 0.66 dollars monthly, which is difficult because a third of all citizens live on less than a dollar a day. Also, most Ghanaians live 15 kilometers from their local health center. This means that the healthcare system they are forced to pay into is not even accessible to them. As a result, many people in Ghana choose to use traditional healers instead of the healthcare system (Our Africa, 2017). Iran: According to Iran’s constitution, all citizens are entitled to basic healthcare. There are three sectors in Iran’s healthcare system: public, private and NGOs.
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