January 20, 2013
Clarke “Health Care Systems in International Context”
• Health care systems internationally in the context of globalization
o Globalization eliminates the boundaries the separates societies from one another
Changes the sovereignty of states
Imperatives to profit often supersede state-level policy regarding safety,
equity, and an adequate standard of living
Spreads diseases such as SARS, malaria, dengue fever
Associated with climate change
Extension of knowledge and technologies of health
Powerful global organizations such as WHO, travel and tourism, research
and so forth.
Diffusing the Western biomedical model
• Alma Alta Record called for the worldwide expansion of Primary Health Care, defined by
principles of community participation, appropriate technology, and principles of equity.
• WHO conceptualizes distinctions among countries for comparative and statistical
purposes based on related ideas; region and level of income.
• Traditional medicine is still widespread; in the developed world it is known as alternative
medicine. It isn’t really a health system but a group of disparate methods of health,
incorporating herbals, spiritual practices, manual treatments and indigenous medicines.
o 80% of India and Africa rely on TM, as do 40% in China
o WHO works to evaluate and monitor TM and oversee impacts of safety, quality,
accessibility, and rational use.
o Medical tourism involves travelling just to seek medical treatment for reasons
such as insurance.
o The idea of a birth attendant has played a significant role in the decreases of
infant and maternal mortality.
• US health system is expensive but under-performing.
o Ranks poorest among leading developed nations, 37 among 191 countries.
o Discrepancy between cost and value due to healthcare being treated as a
commodity rather than a human