How Government Should Spend On Healthcare Is Dependent On The Economic Situation

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C. Evaluation of Healthcare
General Guinea health indicators are just as abysmal as economic indicators: on average Guineans live 34 years less than their Canadian counterparts. Why are there so many issues – especially related to inequality – with the Guinean healthcare system? The answer lies in the impact Guinea’s lackluster economic development has had on her health sector.
One key factor is expenditure. There are three categories: government (which goes into directly supplied healthcare services as well as towards national health insurance schemes), private (which is split between out-of-pocket payments for healthcare services at point of delivery and private health insurance), and external sources. Guinea’s largely dysfunctional
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Kaiser Family Foundation 2010). Because of Canada’s well-developed infrastructure, she can afford to spend close to 50% of general government expenditure on healthcare (Canadian Institute of Health Information 2014).
The minimal public expenditure in Guinea over the past decade has focused mainly on urban areas, and has unequally benefited those in the wealthiest income brackets. In 1995, 48% of government expenditure in health benefited the wealthiest 20%, whereas only 4% benefited the poorest fifth. Over the years, budget allocations have remained practically unchanged, and medical personnel are concentrated in large urban centers, with over 60% of health professionals operating in the capital, Conakry. Surveys show that 30 to 40% of Guinean households experience temporary inability to pay for health services whereas the Canadian system is free at the point of use (The World Bank 2006).
Another reason for the disparity in access to healthcare is privatization. In Guinea, private expenditure on healthcare dominates: almost all spending is out-of-pocket spending at point of delivery. In Guinea private health expenditure makes up 89% of total health expenditure, but out-of-pocket expenditure represents 88% of private health expenditure and total health spending per person per year is only $23 (The World Bank 2006). A social contradiction exists here, where only a few exemptions and subsidization mechanisms are in
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