The “efforts made to maintain or restore physical, mental, or emotional well-being especially by trained and licensed professionals”, more commonly referred to as healthcare, has impacted the daily lives of every person on Earth (“Health Care”). Across the globe, each country has adapted a different way of approaching healthcare, and these different ways have created a variety of impacts on the citizens of each nation. America, for one, has many issues when it comes to the healthcare system, and has been consistently trying to improve its healthcare system to be similar to many others around the world. Libya, on the other hand, struggling through tough times because of its Civil War, has been taking many steps backward in relation to healthcare in recent years. Accessibility to quality healthcare, patient safety, and cost of medical treatments have caused some of the largest impacts on the successfulness of healthcare in the United States and Libya. Some of these effects have been positive, and others have been negative, but each has similarities and differences to one another.
Due to the Libyan Crisis that has been going on since 2011, the access to quality healthcare has drastically decreased (“Libya: Health System”). In 2017, a “…Service Availability and Readiness Assessment survey, conducted by the WHO and MOH, showed that 17 out of 97 hospitals [were] closed and only 4 hospitals [were] functional between 75-80% of its capacity” (“2017 Review of Health Sector in Libya”). In addition, the same survey also found that over 20% of primary care facilities are closed, and that the vast majority of others are not prepared for service delivery (“2017 Review of Health Sector in Libya”). One of the many reasons why many of these healthcare facilities are closing is because of the lack of staff with the necessary experience (“Libya: Health System”, Newhouse). Most of the nurses who practiced in Libya were not from that country: they came from across the globe to assist the citizens (Libya: Health System). When it became unsafe because of the crisis, many nurses were sent home by their agency, or because of personal choice (“Libya: Health System”). Due to this, in 2012, not even a year after the crisis started, the number of practicing physicians was 1.9 per 1000 citizens (“Lack of Focus Hinders Investors”). Another reason why healthcare is not easily accessible in Libya is due to the lack of basic medications and equipment (“Libya: Health System”, Newhouse). Insulin, dialysis equipment, and x-ray machines, for example, are spread out throughout the country and, because of the lack of quantity, this causes patients to move from one hospital to the next to gain access to basic services (“Libya: Health System”, Elmarzugi). When Mohammed Elmarzugi broke his leg, he went to the hospital, and the orthopedist “decided that [Mohammed] should do an x-ray scan, of course because of the limited resources the hospital has, it [didn’t] have the x-ray machine” (Elmarzugi). After coming back to the original hospital, the doctor did recommend getting a cast put on, but was not entirely sure that they had the supplies in that hospital (Elmarzugi). If Elmarzugi’s case would have been severe, he would have almost needed to seek treatment outside of Libya due to the lack of professionals and equipment available for performing major surgeries or treating cancer (Elmarzugi). Libya, for nearly a decade, has been falling short in providing its citizens with quality healthcare in a time they need it more than ever.
The United States has many restrictions on quality healthcare access that can stray from the those in Libya. These issues are not necessarily the same as in Libya, where there is not enough medical care to go around, but in some rural areas, this could be the case. There will be some small towns across the nation that have only one medical facilities nearby and cannot get to a large hospital to treat their needs. However, some of the more common restrictions in the United States include cost and inadequate or no health insurance (Access to Health Services). Cost, as previously mentioned, is a major hindrance in accessing medical care in the United States. Due to the cost is so high, people look towards health insurance to pick up the bulk of medical bills. However, health insurance, when not provided by an employer, can be extremely expensive to the average working American (“Access to Health Services”). However, in 2010, the Affordable Care Act was introduced and its “opponents seemed sufficiently successful in convincing more than half the country to object to the Affordable Care Act” (Moore 103). Eventually, despite the initial objection, the act ended up providing coverage for millions, but also left millions more underinsured or uninsured (Okoro et al 1). No matter what new policies are made, the next few years do not look promising for lowering the costs of healthcare.
The patient safety that should be found when seeking medical treatment is no longer prevalent in Libya. This is because of the two different health ministries attached to the two different governments that fight for control over the country (“Libya: Health System”). The government that is seen internationally is located in Tobruk in eastern Libya, while the nation’s capital, Tripoli, is in control of the western portion of the country (“Libya: Health System”). Neither of the governments are giving adequate money and supplies to medical facilities, despite the Civil War and the number of wounded and killed Libyans (“Libya: Health System”). The conflict between the two governments has been causing armies to attack neighboring hospitals and clinics of their enemies, which is decreasing the accessibility to medical treatment as more and more people are getting injured or killed (“Libya: Health System”). Across Libya and especially in war zones, access to safe healthcare is extremely difficult to come by, and has been decreasing as the Civil War continues on. Between May 2017 and May 2018, United Nations, UN Human Rights Office, and the UN Support Mission in Libya have recorded 36 attacks on medical facilities, personnel, or patients (Schlein). However, according to U.N. Human Rights spokeswoman Ravina Shamdasani, the number of attacks is “probably significantly higher” due to the restricted notes on movements in Libya (Schlein). As expected near conflict zones, these mobile hospitals contain basic facilities that can be under attack at any time (Zeiton 1). Dr. Moez Zeiton was a part of the doctors set up in western Libya, and he describes how conditions could change in a matter of minutes, and how 20 minutes could be the difference between freedom, detaination, and death (1). He describes how one morning, “…the sound of gunfire had been getting louder” and how the doctors were required to evacuate the mobile hospital along with the patients they were treating at the time (1). Dr. Zeiton also recalls a patient that had been near the blast of an explosion where shrapnels skinned nearly his whole back, took out chunks of flesh, and scraped off parts of his head so his skull was visible (2). Due to the lack of safety and technology in the immediate area, the patient had to be sent off to the only CT scanner in the region to determine the severity of his skull injury (Zeiton 2). Even in hospitals not in war zones, there are still issues that endanger the lives of patients due to the lack of qualified health professionals taking care of more patients than a trained doctor should be able to (Rages 21-22). There is also a lack of motivation for healthcare professionals that is caused by the the poor working conditions for low amounts of money (Rages 22). Finally, there is a lack of regulation for professionals in this field, which is “linked to poor performance and is a major contributory factor to the lack of confidence that the general public has in the medical profession” (Rages 22). Overall, healthcare in Libya has been decreasing over the past decade, in the United States, the opposite is true.
Over the years, in America, safety for patients has been increasing. In 1999, the Institute of Medicine estimated that up to 98,000 patients died due to complications that should have been prevented in United States hospitals each year (Passmore). According to the Agency for Healthcare Research and Quality, “…approximately 1.3 million fewer patients were harmed in the U.S. hospitals between 2010 and 2013… that represents a cumulative 17 percent reduction, preventing about 50,000 deaths” (Passmore). The number of deaths avoided in 2013 were almost 10 times more than 2011, which ended up saving about $12 billion over three years (Passmore). In this time, many hospitals changed or adapted their regulations in order to improve the quality of care, which in turn improved the safety of the patients and all who were and still are involved (Dzau). In addition, medical schools are taking on the responsibilities in order to teach future doctors patient safety that will save millions of lives down the road (Henry). With these precautions and issues being taken care of, patient safety in the United States should continue to increase for many years to come.
In Libya, the cost of medical treatment varies drastically due to the different sectors of healthcare providers: public and private sectors. The majority of healthcare services are provided by the public sector (Msalasm 1). This is because “preventative, curative and rehabilitation services are provided to all citizens free of charge” (Msalasm 1). The private sector, however, is “paid either by health insurance, by employers and employees, or by the patients themselves” (Msalasm 1). Despite the majority of medical treatment being paid for by the government, Libya is only spending about 5.0% of the nation’s Gross Domestic Product, GDP, on the healthcare industry, and it can be seen directly in the quality of healthcare available in the country, which is also one of the issues that directly relate to America and Libya (Libya). In private sectors, there is not nearly the same patient demand as the public sector due to the having to pay for the services (Msalasm 2). The average health expenditures, in US dollars, is $1,114.85 (Libya). Many people, such as Mohammed Elmarzugi, a foreign exchange student from Tripoli, Libya, do not have the financial capability to attend the private hospitals that are neat, tidy, and sanitary, but can end up cost thousands a year (Elmarzugi). The cost of healthcare in Libya can hinder the ability to access healthcare, but does not reach the same impact as in the United States.
Cost of medical treatments in America is a large factor in determining whether a family should seek out medical care. This is because the cost of healthcare in America is extremely high. With or without health insurance, the average total health expenditures per capita in the United States is $10,348, while the average of other first-world countries, comparable country average, is $5,198 (Cox and Kamal). Although American citizens are paying about twice as much for healthcare as most other countries, the United States has about half the physicians consultations, about 3.9 visits, annually per capita when look at next to the comparable country average at 7.6 visits (Cox and Kamal). This means, that even though Americans are paying twice as much each year for medical treatment, they visit doctors about half as much. Also, medications, surgeries, and procedures in the United States are priced at rates that, by far, surpass the equivalent in any other country (Cox and Kamal). In America, a blood-thinning medication called Xarelto, will decrease the chance of stroke and treat blood clots will cost an average of $292 for a 30 day supply (Cox and Kamal). Also in America, an MRI, magnetic resonance imaging, costs an average of $1,119 compared to the free MRI in Libya (Cox and Kamal, Msalasm). However, with this price and lack of basic supplies, it is understandable how much more reliable American MRI’s are when compared to one of Libya, but not of one of a comparable country at the same standards. If one is looking at surgeries, the average cost of a total hip replacement in America is about $29,067 (Cox and Kamal). Most of the time, Libyans would not have access to this type of surgery, but would have to seek treatment outside of the country where more resources are provident. Healthcare in the United States needs to look at the true costs of what it is providing in order to make a positive impact on the lives of American citizens.
Healthcare has always been, and will continue to be, one of the most important parts of the world’s success and prosperity. Without access to quality healthcare, the world would not be as successful as it is today. There will always be setbacks, some of which are accessibility to quality healthcare, patient safety, and cost of medical treatments.