Governmental healthcare centers concentrate on providing primary care to individuals and to control and manage the spread of infectious diseases and to manage natural disasters (Christian et al., 2008). However, in the public domain, health care differs from one country to another. This can be specifically applied in developed nations, where social, economic and political factors are most likely to influence public health policies and centers and their accessibility and availability (Christian et al., 2008). This research proposal concentrates on presenting an overview and detailed background of health centers in English-speaking countries. The countries selected are Australia, Canada, the United Kingdom and the United States. Chapter One:

Introduction

Governmental health care centers concentrate on the provision of primary care to individuals and on controlling and managing the spread of infectious diseases and managing responses to natural disasters (Christian et al., 2008). However, in the public domain, health care differs -- sometimes dramatically -- from one country to another. This can be specifically analyzed in developed nations where social, economic and political factors are most likely to influence public health policies and centers and their accessibility, availability and quality (Christian et al., 2008). Therefore, this study concentrated on presenting an overview and detailed background of health centers in English-speaking countries. The countries selected were Australia, Canada, United Kingdom and United States. These four countries have their own public health policies and have installed several governmental health centers in order to provide primary care to individuals and to effectively manage disasters and epidemic outbreaks. In terms of availability, accessibility and quality of care provided in these centers vary from one nation to another and this study therefore analyzed these differences. Furthermore, emergency preparedness plans, natural disaster management plans, performance, funding and demographic data were also analyzed in order to understand the respective efficiency and effectiveness of these health care centers.

Research Objectives

The objective of this study was to analyze and review the health care centers that are sponsored at the national level in different English-speaking countries to evaluate their respective effectiveness in responding to emergencies. The countries selected were the United States of America, the United Kingdom, Canada and Australia. This study concentrates on presenting a detailed and comprehensive history on the health centers that have been sponsored by the government. Furthermore, an assessment concerning how these centers effectively manage disasters and respond to emergencies as well as their effectiveness and efficiency is provided in order to better understand how they respond to the needs of their communities. Preparedness plans and emergency plans from the wide-ranging governmental health centers in countries are also analyzed and compared. Based on the analysis, the salient effectiveness and flaws of these plans are outlined, followed by an assessment concerning opportunities for improving emergency responsiveness in these national health care systems.

Research Questions

This study was guided by the following questions:

1. What are health centers?

2. How governmental health centers contribute towards providing universal healthcare to citizens in Australia, Canada, United Kingdom and United States?

3. To what extent have governmental healthcare centers contributed towards universal health in respective countries in terms of accessibility, availability and quality?

4. To what extent have governmental sponsored health centers been successful in managing and responding to emergencies and natural disasters?

5. To what extent have governmental sponsored health centers been successful in introducing emergency plans and disaster management plans to effectively manage disasters?

6. What emergency and disaster management plans have been incorporated by different health centers in United States, United Kingdom, Canada and Australia?

7. What are the strengths and weaknesses of these plans?

8. How successful are these plans in managing disasters in their respective countries?

9. How politics influence governmental health centers?

10. What is link between demographic need and the accessibility of health centers?

11. What is the relationship between quality, availability and accessibility of health centers?

Background to the Study

Health Care Systems in Australia

Of the 18 developed nations in the world, Australia is ranked fourth with respect to health status, after Japan, Switzerland, and France (O'Donnnell, 2005). This health status is supported by commonly used outcome measures for quality of care such as life expectancy (Comparing the U.S. And Canadian health care systems, 2013). By contrast, the United States is ranked dead last (O'Donnell, 2005). According to the Australia Commonwealth Fund (2013), "Most health services are financed and regulated by the federal government, although the states and territories have responsibility for public hospital care" (The health care system and performance reporting, and strengthening primary care" (The health care system and health policy in Australia, 2013, para. 3).

The national health care system in Australia has been criticized for using an ethno-specific delivery model that fails to provide the cross-cultural competence needed for the country's marginalized populations, most especially Indigenous and migrant people. For instance, according to Renzaho (2008), "The demographic profile of the Australian population indicates that Australia is a rich and complex multicultural society with more than six million migrants resettling in Australia since 1945" (p. 223). The research to date indicates that about one-third of all Australians have a culturally and linguistically diverse ancestry; nearly one-quarter (23%) were born outside of Australia and another 15% of the population speaks a language besides English at home (Renzaho, 2008).

Clearly, in a country of 22 million people, these percentages represent a substantial number of Australian citizens who may require specialized interventions by virtue of their linguistic and cultural differences. Moreover, the highly mobile nature of some other segments of Australian society make responding to the health care needs of these citizens especially challenging (Renzaho, 2008). According to Renzaho, "The challenge for health and welfare agencies is to provide a system of services to respond to the needs of diverse communities and individuals regardless of their backgrounds. However, resources are scarce and not all needs can be met" (p. 224).

Complicating matters even further is the fact that in an effort to optimize the available health care resources, government programs are designed to be "one size fits all" and there has been little progress in implementing culturally sensitive and appropriate interventions for some segments of the Australian population (Renzaho, 2080). In this regard, Renzaho emphasizes that, "For small marginal ethnic groups, an ethno-specific response becomes arguably unjustifiable" (p. 224). Nevertheless, because health care resources are by definition scarce, there will likely remain a paucity of informed interventions available for these marginalized populations in the foreseeable future. As Renzaho points out, "Although the ethno-specific model of service delivery is long recognized as more viable for larger ethnic communities, small communities are left with fewer options where there are no alternative models of service delivery" (p. 224). Taken together, Australia's national health care system is modern and comprehensive, but there are some areas that require improvement in order to improve accessibility and availability of these services for mobile and Indigenous segments of society.

Health Care Systems in Canada

The current Canadian Medicare model is the result of a half a century of health care administration experience -- and a good deal of negotiation. According to Romanow and Marchildon (2003), the first effort of the Canadian public health care system was implemented in 1947 in Saskatchewan; this initiative was mirrored and amplified in British Columbia and Alberta. In 1957, following the passage of the Hospital Insurance and Diagnostic Services Act by the national government together with the provision of federal cost-sharing transfers, the Saskatchewan model of universal public hospital insurance was formally adopted by all Canadian provinces and territories by 1961 (Romanow & Marchildon, 2003).

The next stage in the development of universal health care in Canada was another initiative by Saskatchewan in 1962 to provide public health insurance for primary medical care services provided outside of hospitals (Romanow & Marchildon, 2003). Following a review of other health care models, including Alberta's targeted subsidy approach, the Saskatchewan model was recommended by the Royal Commission on Health Services ("the Hall Commission") for nationwide implementation to the federal government in 1962 (Romanow & Marchildon, 2003). Although the Saskatchewan-based initiative ultimately required another 50:50 cost-sharing offer by the national government as well as several years of wrangling over details, universal Medicare was implemented by all Canadian provinces and territories by 1972 (Romanow & Marchildon, 2003).

In Canada's case, though, "universal" does not necessarily means what the term is generally understood to mean. For instance, according to Romanow and Marchildon (2003), the national parliament passed the Canada Health Act (CHA) in 1984 which restricted billing practices for medical services provided outside hospitals which had grown to ponderous levels. A concomitant consequence of this law was to "entrenched the hospital and physician-centered model of Medicare by limiting insured health services covered by the five governing principles of…