As healthcare costs continue to balloon across the world, it has become increasingly difficult for most people to afford the services they need to stay healthy. Even in countries that are not facing public health crises like the current Ebola outbreak, HIV or endemic malnutrition, many people are forced to go without access to quality healthcare.
And, as anyone that has ever spent hours in an overcrowded and understaffed emergency room knows, just getting to the hospital or clinic is no guarantee of fast or effective service. Still, when it comes to efficient health care, some countries are doing a much better job than others.
A recent Bloomberg study that compared the efficiency of health care services in 51 different countries gave overall low marks to Latin American countries, with Brazil taking the dubious honor of coming in at second-to-last place.
Of the 51 countries ranked, Singapore took the top spot, followed by Hong Kong, Italy, Japan and South Korea. The highest-ranked country in Latin America was Mexico, which came in at #12, followed by Ecuador at 13 and Chile at 17 — above more supposedly “advanced” countries like Finland, Sweden and Canada.
The rest of Latin America saw significantly less encouraging results, with Argentina at 33rd on the list, then Peru at 36 and Venezuela coming in at 38. The Dominican Republic slid it at 43 — one spot above the United States — and Colombia (47) and Brazil (50) rounded out the bottom end of the rankings, below countries including Iran, Bulgaria and Serbia. Brazil, in fact, only scored higher than Russia, the lowest-ranked country in the analysis.
The Bloomberg analysis based efficiency on the average cost of health care as a share of GDP and the cost per person, as well as each country’s average life expectancy and the change in these numbers since last year.
Brazil at the bottom
Though Brazil’s life expectancy of 73.6 years is higher than most of the other countries on the bottom of the list, the astronomical cost of healthcare landed Latin America’s most populous country right at the bottom when it comes to efficiency. The analysis found that the average cost of healthcare services in Brazil was equivalent to $1,056 per person — amounting to 9.3 percent of the country’s GDP.
In comparison, the costs in Mexico and Ecuador, the two highest-ranking countries in the region, were $618 and $361 per person, respectively.
Brazil’s per-person healthcare costs were higher than any other Latin American country with the exception of Chile, where health services average $1,103 per capita. Though the numerical cost is higher, Chile’s long life expectancy of 79.6 years and strong economy put that cost at 7.2 percent of GDP — a full two percentage points lower than Brazil.
Of course, the two countries have very different demands placed on their health care systems. Narrow Chile has just 17.6 million people, mostly concentrated in the country’s urban centers where there is better access to hospitals, clinics and other services, while enormous Brazil has more than 200 million inhabitants spread across the largest country on the continent.
Despite the statistics, many still consider Brazil’s public health care system to be an important model that is in some ways much more advanced than those in countries like the United States. Brazil’s constitution, passed in 1988, guaranteed universal health care for all residents, and improvements in vital indicators like infant and maternal mortality since then have been astronomical.
Still, those who can afford to pay for higher-quality private healthcare do so, while the poorer part of the population is forced to endure lengthy delays and dire shortages in hospital space to get the care they desperately need. Brazil has fewer doctors per capita than many other wealthier countries, and has an average of only one nurse per every two doctors (for an efficient system, that ratio should be three to one).
A 2013 poll found that almost 50 percent of Brazilians saw healthcare as the country’s biggest issue — more of a problem than education, corruption, security or unemployment. This was an 8 percent increase from the previous survey — and as Brazilians go to the polls later this month to elect their president for the next four years, healthcare is sure to be on the minds of many voters.