2005 Winner: Aranxta Cedillo

PROPOSAL - HEALTHCARE IN NORTH AMERICA

New York's health-care system is widely recognized as the one of the best and most expensive in the nation.

Although the privatization of healthcare is on the rise in the United States, there is still at least one place where insured and uninsured people alike can receive equal medical attention. There is one hospital that is the local medical facility for both many of New York's homeless as well as the President of the United States.

Bellevue Hospital was founded in 1736 and has since been credited as one of the most important hospitals in the country. Employing perhaps the best emergency care in the world (1), it offers the American public a healthcare service that is second to none.

People of all different nationalities, as well as prisoners, homeless people, and law enforcement officials are treated equally and with the same dignity and professionalism inside the emergency room at Bellevue.

I started this project in April 2005 after finding that public insurance services, both medicaid and medicare, were not obtainable for the whole of the population. Specifically, New York State's health-care-cost explosion has left many individuals unable to afford insurance, and it has made businesses, especially small ones, unable to offer it.

Why is the price of U.S. health care so high? One of the main answers could be that America's health care system has an economically disadvantageous relationship with the privatized pharmaceutical industry, forcing many people without financial resources to rely on other countries for cheaper drugs (2). Compared to the United States, many countries offer the same drugs either in a generic form or simply at a fraction of the cost. Another answer may be found by investigating the cost of healthcare administration. Canada, for example, has a government-run insurance system which has much less bureaucracy and lower administrative costs than the system inside the United States. Although it has waiting lists for certain procedures (3), Canadians still spend far less money on medicine than Americans do (4).

Canada's health care system is the subject of much political controversy and debate in that country. Some question the efficiencies of the current system to deliver treatments in a timely fashion, and advocate adopting a private system similar to the United States.

Recently the Canadian Supreme Court struck down a Quebec law banning private medical insurance, dealing a blow to the publicly financed national health care system (5). Consequently, there are worries that privatization would lead to inequalities in the health system with only the wealthy being able to afford certain treatments.

The photo-documentary that I am planning will offer a comparison of both the American and Canadian public healthcare systems. I will focus on the advantages and disadvantages of both public and private health care systems established in each country in order to show the importance of maintaining a healthcare systems that is affordable for the entire population.

As I have photographed at Bellevue Hospital in New York City, I will show through images the function of other hospitals and healthcare organizations in both the United States and Canada. Ultimately the project will have a social focus and attempt to capture the role that public healthcare systems play within North American society.

(1) Bellevue Hospital proved its effectiveness on September 11, 2001 and was recognized for its emergency psychiatric care.
(2) A 2003 study in estimated that administrative costs took 31 cents out of every dollar the United States spent on health care, compared with only 17 cents in Canada, New England Journal of Medicine, 2003.
(3) The British healthcare system historically had long waiting lists for elective surgery, International Herald Tribune, April 16, 2005.
(4) In 2002, the latest year for which comparable data are available, the United States spent $5,257 on health care for each man, woman and child. Of this, $2,364 or 45 percent, was government spending, mainly on Medicare and Medicaid. Canada spent $2,931 per person, of which $2,048 came from the government, The New York Times, April 16, 2005.
(5) "Canadian Court Chips Away at National Health Care", The New York Times, June 9, 2005.