The Dominican Republic HealthCare System
The Dominican Republic is a country in Central America. The state occupies the eastern part of the island of Haiti and a number of small neighboring islands. The territory of the country is divided into provinces. The Dominican Republic is an agro-industrial country with a rapidly growing economy. In terms of economic growth, it is one of the most economically developed country in Latin America. The government of the country constantly improves many spheres of social life. Nevertheless, the system of healthcare in the Dominican Republic is often criticized. The country should adopt the international experience and create a qualified health system. The governments of the United States and the Dominican Republic conduct health reforms. Despite the differences in their healthcare systems, two countries have many common problems, and their solution requires joint efforts.
Nowadays, many medical workers in the Dominican Republic criticize the healthcare system in the country (Sadler & Wilson, 2015). However, a thorough study of the situation shows that the healthcare systems in almost all countries of the world have problems of rising costs and inaccessibility of health care for certain categories of the population. A universal model of healthcare organization that is suitable for everyone does not exist. A level of centralization, regulation, and distribution of costs among all citizens, as well as the role of private insurance in health services greatly vary in different countries.
The health system of the Dominican Republic is more developed that it may seem. The state pays significant attention to the level of medicine (Boslaugh, 2013). Medical personnel in this country consist of highly qualified professionals (Sadler & Wilson, 2015). They have international diplomas (Sadler & Wilson, 2015). This fact allows them to work in bigger and more developed countries such as the United States, Canada, and many other developed states. The majority of interns from the Dominican Republic are trained in large countries. This fact allows them to gain a wider experience. In the Dominican Republic, there are physicians who have been awarded the Nobel Prize (Sadler & Wilson, 2015). Many of them are known not only in the Dominican Republic but also throughout the world. It is known that medical personnel in the United States are considered some of the most qualified in the world (Sadler & Wilson, 2015). Doctors and nurses obtain education of high quality and undergo practice in the best clinics of the country. Despite this fact, both in the United States and the Dominican Republic, there is an acute shortage of medical personnel in remote areas. Besides, about 30% of the Dominican population lives there (Sadler & Wilson, 2015). It is a problem of big countries, which is the provision of the availability and a unified quality standard. A traditional healthcare system is unable to provide this.
Despite the fact that the Dominican Republic is a small country, all innovations in medicine are implemented there more often and quicker than in larger countries. According to the agreement on the integration with the United States, modern equipment for diagnostics and surgery was brought to the Dominican Republic (Boslaugh, 2013). Currently, many doctors from the Dominican Republic are trained in the United States (Sadler & Wilson, 2015). Referring to the fact that the country gives great importance to the development of medicine, many hospitals and clinics of different directions were built in the country (Sadler & Wilson, 2015). In addition to public hospitals, private clinics are also widely developed in the Dominican Republic (Boslaugh, 2013). They range from small to moderately large. Many of them have a specific direction, for instance, private maternity homes and private dental offices. In addition to all of the above, the Dominican Republic provides a large assortment of drugs for any occasion. Prices for medicines are relatively low in contrast to most European countries and the United States.
Nevertheless, the situation in the country is not the same in all regions. Many remote areas of the country do not have such advanced clinics. In rural areas, hospitals are entirely devoid of modern equipment. Moreover, the lack of sanitation in these hospitals can cause serious harm to patients. It mostly refers to mothers and children. Because of the existing sanitary problems in hospitals and numerous health problems, mothers and children in the Dominican Republic frequently suffer from severe complications that may occur during childbirths or surgeries. According to estimates, children up to two years in the Dominican Republic die seven times more often than children of the same age in the United States (Boslaugh, 2013). In the country, mothers frequently die during the childbirth. In the book Health Care Systems around the World, it is stated that “The Dominican Republic’s maternal mortality rate was estimated in 2008 as 100 maternal deaths per 100,000 live births” (Boslaugh, 2013, p. 137). Women in the Dominican Republic die during the childbirth 30 times more often than women in the United States (Boslaugh, 2013). These data suggest that the government of the country should pay more attention to the health of mothers and children as they are the future of the country.
However, not only mothers and children have problems with health in the Dominican Republic. Vulnerable groups of people including the elderly, mentally ill, poor, and people with disabilities experience more serious problems in terms of inadequate healthcare than in the United States (Boslaugh, 2013). For instance, people with disabilities in the United States receive more help from the government. Adolescents in the United States are also more protected. In the delivery of reproductive and sexual health services, adolescents in the Dominican Republic experience earnest deficiencies (Boslaugh, 2013).
A specific feature of the healthcare system in the Dominican Republic lies in the fact that all the services should be paid for except for emergency first aid. However, if a person has a medical insurance, it covers a large percentage of the cost of medicines. In many cases, it covers from 80 to 100% of the drugs’ cost. In such a way, the insurance system in the Dominican Republic is well-developed. The government of the country provided the system of medical insurance in 2001 (Krasnoff, 2013). In the book Building Partnerships in the Americas, it is stated that “In 2001, to address some of health services problems, the Dominican Republic enacted laws that laid the foundation for the development of a national health and social security system” (Krasnoff, 2013, p. 224). Without medical insurance, the price for health services would have increased by several times. The insurance cost varies depending on the age of the patient and also presence of chronic diseases. Wealthy citizens or visiting guests, for whom the full medical insurance is available, the level of medical care seems particularly high. In the most severe cases, the patient can be sent promptly to some medical institution in the United States. Moreover, medical insurance covers this service.
The reverse side of medicine in the country is life without insurance. Many people live beyond the poverty level (Boslaugh, 2013). Thus, they cannot afford buying medical insurance. They only apply to medical institutions in case of a serious condition. It leads to the fact that many patients go to the doctor when the disease is not treatable. This fact about the healthcare in the Dominican Republic is rather similar to the situation with the healthcare system in the United States (Boslaugh, 2013). In latter case, a person must pay much money to use medical services. Moreover, medical insurance in the United States also covers a great part of the cost of drugs.
In the Dominican Republic, there are almost all the infectious diseases recorded in the temperate zone. Besides, there are also many diseases typical for the tropical climate. Latin American countries are characterized by extremely humid and hot climate and presence of specific diseases and infections.
Malaria is one of the most common and serious diseases. Mostly men aged from 19 to 50 years old suffer from it (Boslaugh, 2013). In 2008, the number of people suffering from this disease reached 75% of the total population of the country (Boslaugh, 2013). To avoid a lethal outcome, doctors use special anti-malarial drugs. The cost of these drugs is about $100, which is rather expensive for a person that does not have the medical insurance (Boslaugh, 2013). It covers the greatest part of the cost of anti-malarial drugs. In contrast to the Dominican Republic, malaria is not typical for the United States. In the US, malaria epidemic used to be spread in the South (Niles, 2014). However, by the mid of the XX century, the disease virtually disappeared (Niles, 2014).
Cholera is another disease that is also highly common for the Dominican Republic. Its causative agents penetrate into the human body through infected food or drink not subjected to thermal treatment. It should be noted that the cholera epidemic in the country began in December 2010 (Boslaugh, 2013). By the end of 2013, the number of officially reported cases exceeded 31,000 people (Boslaugh, 2013). Like malaria, cholera rarely occurs in the United States. Annually, there are about ten cases of cholera in the country, and half of them are among foreigners (Niles, 2014). Occasionally, infected food may be a cause of cholera outbreaks in the United States.
On the territory of the Dominican Republic, a person can easily be infected with hemorrhagic fevers such as Ebola, Marburg, and Laos. These diseases are also quite rare on the territory of the United States. Tuberculosis is a priority healthcare problem of the Dominican Republic and the United States. In these countries, the therapeutic DOTS program has been introduced (Niles, 2014). The program is recommended by the World Health Organization. It increases the efficiency of treatment of tuberculosis.
It should be noted that in the Dominican Republic, there are no special bodies that control the purity and safety of donated blood (Boslaugh, 2013). In such a way, HIV can be transmitted not only through sexual contact or injection of non-sterile syringes but also during an unplanned surgery associated with transfusion of blood or dental treatment. In the United States, the situation is quite different. The country has the American Association of Blood Banks (Niles, 2014). About 80% of transfusion services are members of AABB (Niles, 2014). Among its numerous functions is to control the quality of the blood transmitted.
As for non-communicable diseases, people of the Dominican Republic suffer from cardiovascular diseases, malignant neoplasm, diabetes, and numerous nutritional problems (Boslaugh, 2013). The percentage of people suffering from these diseases in the Dominican Republic is higher than in the United States (Boslaugh, 2013).
Many health problems in the Dominican Republic are associated with climate. Nevertheless, other factors that increase the risks of the disease occurrence include poverty of the population and the lack of clean drinking water (Castro & Heller, 2013). Poor people do not have an opportunity to acquire medical insurance. They also cannot afford good treatment by qualified doctors. Thus, they often seek help in cheap clinics, which are often devoid of any sanitary conditions. A great number of people do not have access to clean water (Castro & Heller, 2013). It is especially a problem for elder people who live in the rural areas. This fact causes numerous health problems. People from the United States do not experience such a severe problem with drinking water (Castro & Heller, 2013).
All countries pay special attention to health promotion. There are various means of the health promotion and disease prevention in both the United States and the Dominican Republic. However, in the United States, there are more programs oriented on health promotion (Boslaugh, 2013). The US government carried out extensive health promotion campaign. In particular, it was related to the harm of smoking propaganda. The program to combat hypertension was adopted at the state level (Boslaugh, 2013). In several years, a decrease in the number of cardiovascular diseases and mortality was observed in the country (Boslaugh, 2013).
Currently, in the United States, there is a program aimed at increasing the quality and duration of healthy life and the nation’s health, as well as the elimination of the difference in the quality of life between different social classes (Boslaugh, 2013). The project includes the promotion of recommended measures including moderate exercises. Vaccination is one of the most typical methods of combating numerous diseases. Both the United States and the Dominican Republic implement vaccination programs. Vaccination in the Dominican Republic is used for such diseases as tuberculosis, hepatitis B, measles, diphtheria, tetanus, polio, and rubella (Boslaugh, 2013). However, only a small percent of people in the country use vaccination as a preventive measure. This situation is quite typical for all developing countries. In most developing countries preventive measures are rare. Most parents in the Dominican Republic start treatment when their children already suffer from disease (Boslaugh, 2013). Parents do not engage in preventive measures including vaccination, nutritional supplementation, and growth monitoring. This situation causes numerous complications in both small children and adolescents.
The health systems in the Dominican Republic and the United States are different. Nevertheless, both countries need changes in healthcare systems. Both of these countries have the insurance system. Without it, treatment of diseases would be rather expensive. In the Dominican Republic, there are many diseases that are associated with the climate. Many of them are not typical for the United States. Despite the fact that the healthcare systems of the United States and the Dominican Republic are highly developed, the main aim remains to ensure a universal access to healthcare services and improve their quality.