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Introduction

Many industrialized nations have an interest in measuring and improving quality in medical care. However, there is no data that can be used to compare the quality of healthcare in most countries. Lack health information remains particularly severe in medical care intervention. Policymakers, clinicians the media and the public in the US through institute of medicine (IOM) is focusing their attention to fill the gaps in healthcare provision. Policy makers in the US believe that they have the best healthcare system on earth (Bello, & Willis, 2007). Despite this belief, the truth remains unclear due to lack of empirical global information on the existing quality. The available data shows United States have the highest infant mortality rate and lowest life expectancy compared to other industrialized nations. This condition however cannot be attributed directly on medical care system.

In 1999, the Commonwealth Fund did a research in five countries including the US and New Zealand, on medical care quality management. Data was collected on 21 quality indicators in an attempt to improve their medical care. The group examined the level at which healthcare services for the various populations in these countries increase the likelihood of better health. the results obtained were standardized so that the country with the most awful result for a particular indicator scores 100. Any higher score above 100 indicate better quality. For illustration, the rate of breast cancer survival is 11 % higher in New Zealand than in the US. Suicide rate is 20% lower in New Zealand than in US (Rea, & Parke, 2001). The results were intended to increase inquiry by policy makers in each country. The efforts to improve the quality of healthcare in thee US and New Zealand is focused on people with chronic needs.

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These people need intensive care and attention. Adults are the most vulnerable thus more dependant on intensive care. Focusing on the needs of the sicker adults in the two countries, the "commonwealth fund international healthcare policy of sicker adults" seeks the views of these sick adults concerning healthcare systems in their respective countries (Kaakinin, 2009). Therefore it did a survey on areas such as the patients' experiences with healthcare, their communication with physicians, the types of drugs that were prescribed and difficulty in getting the same.   The results of the survey showed that out of 100 sicker adults interviewed in the United States, 44 were not very satisfied with the countries, health care system. However, in New Zealand out of the same number of patients, 48 had the same response (Scott, 2001).     

Healthcare systems in New Zealand embrace reforms that are taking place due to the technological changes. The alliance government in New Zealand propagated further changes in 1999 thus interfacing public and private health care systems. New Zealand health care system is serving 3.8 million people. Healthcare expenditure as a percentage of the gross domestic product is approximately close to that of the United States. For illustration, the expenditure on health in New Zealand in 1998 was 8%. Funding of the healthcare programs comes majorly from general tax. New Zealand does not have explicit insurance arrangements (Hunter, & Marks, 2005).    

Healthcare and social media

There have been great developments in medical treatment and health service providers from this beginning the century, but the changes observed during the last few years have been more rapid.  Hospitals and healthcare providers are today reaching patients through social media. Research conductd by health and wellness in America shows that over 30 % of consumers use social media when searching for information regarding health issues. However, in New Zealand, the number of consumers using the social media searching for the same information is much less. It lies between 15% and 25% (Rea, & Parke, 2001). The practice of medicine has gone through change too, it first gone through a period of mechanization followed by computerization. Patients today can be hooked up to computerized medical device with ability to take pictures of their inner bodies. The photographed inner organs can thus be interpreted by a doctor and administer treatment. The use of computerized medical devices is much higher in the United States than all other countries in the world (Kaakinin, 2009).

Nursing shortage

Nursing shortage is a circumstance where the required number of registered nurses (RN) exceeds the supply. In such a case, the nurse to patient ratio necessitates the addition of more nurses in a given health facility. In the United States, the shortage is due to factors such as, inadequate staffing ratios in health care facilities and hospitals (Joel, 2009). Placement of registered nurses is not smooth and retention of the same is even more difficult. In New Zealand, nursing shortage is not a major issue compared to American states (Goldberg, 1998; Waldfogel, 1997).

One may ask, how comes that the shortage of registered nurses is so severe in the US? The answer lies in the following factors. Research done by Bryant Turner outlined some of nurses' complaints. Nurses feel that they are subordinates in the medical profession. There is too much regulation under difficult working conditions. There are rapid schedule changes. They also complain that superiors and colleagues do not appreciate them. They complain of work overload and shift work. Too many patients assigned to an individual, lots of paperwork. The list is endless. The shortage has made hospitals to be managed like businesses. Thus, the issue of patient care becomes of minor importance. The shortage has caused movement of nurses from developing countries to the US to fill the employment gap (Wanless, 2002).

Family health assessment

The main purpose of family health assessment (FHA) is to offer the family and the entire community with holistic approach of health in order to provide it with the best services.  In the United States, families are encouraged to acknowledge there health needs so that they can tackle them. After identifying health issues, they should plan intervention strategies in partnership with FHA in addressing them. In order to gain sustainable health, individuals, families and communities should have a regular intervention program. FHA ensures that clients are actively involved in a process that enables them to know there own health needs (Glied, 2008).

This will enhance working together with health professionals and other health related agencies. In identifying the medical problems, a family or an individual gets a head start thus; they can inform their family doctors in time (Page, 2003). The doctor will therefore provide preventive measures in early stages of the disease or before the actual illness. FHA is important since it brings to light all the health details of everyone in a family. The health information is important especially when the family consults a healthcare professional. The healthcare professionals assist in laying strategies that prevents the disease. FHA also assists doctors in predicting the illnesses that a family or an individual is likely to suffer from. In New Zealand however, patients seek solutions to health problems as individuals. Family health assessment is nott as pronounced as it is in the United States (Evans, 2004).

Marijuana and health

Cannabis sativa, commonly called marijuana, is the most widely used illegal substance in the world. Marijuana consists of flowers and leaves subtending from the stalks of its female plants. Marijuana contains over 400 different compounds; the major compound in marijuana is tetrahydrocannabinol (Bello & Willis 2007). Other chemical compounds found in Cannabis are cannabidiol also known as CBD, cannabinol and tetrahydrocannabivarin. Marijuana is used in various ways ranging from recreational purposes to medicinal and spiritual purposes. The drug is illegal in various parts of the world (Blendon, et al. 2003). The United Nations estimations show that over 160 million people use marijuana annually. The UN also estimates that over 20 millions use the drug on daily basis.

In 2005, the US Supreme Court ruled that marijuana could be used for medicinal purposes. The ruling awakened debates from various stakeholders with views on marijuana use. Scientists, legislatures and activists had their own opinions on how to control the drugs benefits and at the same time reduce its potential for abuse. A scientist at the University of Aberdeen's Institute of medical services, Mr. Roger Pertwee noted that the most active chemical in cannabis sativa is delta-9-teterahydrocannabinal (THC). He explained that THC binds itself to a number of specific receptors in the human mind. His research showed that human beings also produce substances that are similar to THC (McLaughlin, et al. 1997). These substances have two roles. They stimulate our appetite and assist in controlling pain. He concluded that human beings also produce cannabis, which provide protective role. In New Zealand however, the use of marijuana for health purposes is strictly banned (Tatauranga, 2007) There are debates about legalization of the same due to its health benefits but no implementation has taken place. Therefore, the use of the drug remains illegal in New Zealand.    

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Fetal Alcohol Syndrome

Fetal alcohol syndrome (FAS) refers to the development of mental and physical problems that occur in a fetus if a pregnant mother drinks alcohol (Rosset, 2003). There are many risks associated with drinking alcohol during pregnancy. A child under the age of one year may suffer various defects if her mother was a habitual drinker when he or she was in the womb. The child may suffer defects such as growth deficiencies such as poorly formed bones, heart abnormalities, retarded intellect and thinking capacity, delayed motor development, poor coordination, behavioral problems and learning disabilities (Streissguth, 1997). Various factors lead to a fetus developing these problems. They include the frequency of consumption of alcohol by the mother and the timing of drinking during pregnancy. Alcohol is known to cause the most damage on the fetus during the fist 90 days of the pregnancy. 

The same risks that are associated with using alcohol in general are the very risk that abusing alcohol during pregnancy may cause. The problem comes in because drinking poses more risk to the fetus.   Alcohols, including wine beer or any form of liquor are the main cause of mentally or physically associated birth defects in the United States. This is because the ratio of women who drink while pregnant in the US and New Zealand is 3 to 1(Guba & Lincoln 1989). Therefore, the numbers of children who have defects associated with FAS are higher in the US compared to New Zealand. Apart from these differences in the two countries health systems, many other standards are the same.

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