数学中国 Ww. madio net 140 The UMAP Journal 29.2(2008) by selecting a healthcare component; for each of the metrics corresponding Determine the maximum and minimum values of the metric for a large sampleof countries; if a large samplenot available, then the metriccannot be used reliabl Scale each countrys datum linearly into the interval [0, 1] where the minimum value is mapped to o and the maximum value to I If the metric is undesirable (e. g, prevalence of obesity), subtract the scaled values from 1 to transform the metric into a desirable metric(e.g, lack of obesity). Then calculate the average value of all metrics associated with a country and define this number to be the country smeta-metric value for the chosen healthcare component. A meta-metric represent how well a country performs, on average, rel- ative to the rest of the world for a given healthcare component. A value close to 1 signifies that the component delivers care of the highest quality currently available; a value near O signifies that the country delivers some f the poorest quality care. Because of their compactness, meta-metrics are easy to use for comparisons between existing and potential healthcare systems Comparing Healthcare Systems United States The U.S. is the only developed country that does not employ universal coverage [Torrens 1978]. Instead, healthcare is different for every person, and consists of a loose association of coverage plans provided by private sources,the government and employers. The average middle-class person is usually covered by some sort of insurance and employs a private physi cian in sole charge of managing the individuals healthcare. Physicians exercise substantial influence on the U.S. system, because of their position in healthcare administration, as well as general tendencies of policy to favor private medical practice. This influence leads to the question of whether or not physicians or the federal government should control healthcare. More pressing issues are also troubling the U.S., as the increasing health budget is yielding little advance in the overall quality of care Torrens 1978]. To test the effectiveness of the meta-metrics, we compare several coun- tries for which there is a clear ranking of healthcare already established Based on "financial faimess, " the WHO ranked the healthcare systems of Sweden, the U.S., and Nigeria as 12th, 54th, and 180th in the world [2000bl Meta-metric values, calculated from the metrics and processes described earlier, are given in Table 1
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数学中国 Ww. madio net Better Living through Mat 141 Table 1. Meta-metric US. Sweden Nigeria Accessible Treatment 38 Sweden Sweden operates a nationalized healthcare system that every citizen contributes to based on a proportion of income. As a result, the OECD asserts that citizens enjoy roughly equal benefits, regardless of economic status ITengstam 1975]. The system is heavily regulated and is run by the National Board of Health and Welfare, which is responsible for sup medical care in both the public and private sectors. In addition, this Board is in charge of certifying ph sIclans, nurses, an nd midwives, and also su- pervises and reviews the decisions of the County Councils, where most of the responsibility for funding and maintaining healthcare falls [Tengstam 1975]. Anderson [1972] suggests that in many ways the Swedish system is superior to that of the United States because of Sweden s longstanding commitment to, and enforcement of, universal healthcare eas but treatment. However, the treatment meta-metric is calculated w me Nigeria Nigeria operates a three-tiered health system comprised of a national healthcare system financed by all citizens; government health insurance that is provided for government employees; and firms that contract with private healthcare providers. However, a significant number of Nigerians do not enjoy all the benefits of this system. Like many other African coun- tries, the roots of the Nigerian healthcare system can be traced back to a British colonial era. During this period, the health system was equipped to provide care only asmal portion of the population; the system wasnever adequately adapted to handle the region's growing population[ World Bank 1994. An additional hindrance in the system is an incredible disparity of wealth between upper- and lower-class citizens [World Bank 1994].Exam ples of failures in the health system abound. In one case, a 1985 outbreak of yellow fever devastated a small town(killing more than 1,000 people) despite the fact that a vaccine has been available since 1930[ Vogel 19931 Compared to the U.S. and Sweden, Nigeria'smeta-metrics place it at the ottom
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