The State and Health Care
Governments in the Americas are central to de- termining who has access to health care. But do citizens believe that government should play this role? The AmericasBarometer asked respondents if they believed that their “gov-
ernment, more than the private sector, should be primar-
ily responsible for providing health care.”
Answers were recoded from a scale of 1–7, where 1 and
2 represent “Strongly disagree” and 6 and 7 represent
“Strongly agree.” We examine the responses in Figure 4.
Support for government involvement in health care
is very strong across the Americas, with the notable exception of the U.S. Only in the U.S. does the percentage
of the population that agrees that the government is responsible for health care fall below 50 percent.
That of course may be linked to the fact that the U.S.
health care system is the most privatized in the Americas.
But even excluding U.S. attitudes, there is a strong correlation between the percentage of the population reporting public health insurance and the percentage holding
the government responsible for health care.
Do citizen attitudes affect government services, or vice
versa? It’s impossible to know from these data, but we
suspect that the answer is a little of both.
Health care coverage remains far from universal; most
citizens report that they do not have health insurance.
More than 45 percent of the population in the Americas
has used some form of public health care services, but
they remain the minority. In those countries for which
we have data on both health insurance and public health
care use, the percentage reporting no health care coverage on either measure averages 34. 5 percent. Among those,
Honduran citizens are the least covered, with 70. 3 percent of residents having no health coverage of any kind,
followed by Belize at 53. 5 percent. Not surprising, the
prevalence of public insurance is the lowest in Honduras at 5. 7 percent. At the other end, fewer than 10 percent
of Uruguayans and Costa Ricans report no health care—
an indication that even without private insurance both
countries achieved near-universal coverage.
Health care remains a lottery in the Americas. One
thing is clear from the 2010 AmericasBarometer: government involvement is the surest way to improve access to
health care, especially for the poor.
For source citAtions see:
by Diana Orcés anD amy erica smith Who’s covered? Figure 4: the Government Should take an Active role in Providing Health
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DOminican rePublic 1.98%
el salvaDOr 1.03%
triniDaD & tObagO 3.02%
uniteD states 38.07%
CoStA rICA 14.00%
domInICAn rePUbLIC 17.01%
eL SALvAdor 19.66%
trInIdAd & tobAGo 15.81%
UnIted StAteS 31.80%
cOsta rica 82.65%
DOminican rePublic 81.01%
ecuaDOr 82. 71&
el salvaDOr 79.30%
triniDaD & tObagO 81.17%
uniteD states 30.13%