Question

What are the three models for structuring a universal or national healthcare system?

Answer 1

Ans)

4 Basic Systems:

1. The Beveridge Model
2. The Bismarck Model
3. National Health Insurance Model
4. Out of pocket model

The Beveridge Model:

-Named after William Beveridge-designed Britain's NHS
-health care is provided and financed by the government through tax payments, just like the police force or the public library.

-Many, but not all, hospitals and clinics are owned by the government; some doctors are government employees, but there are also private doctors who collect their fees from the government. In Britain, you never get a doctor bill. These systems tend to have low costs per capita, because the government, as the sole payer, controls what doctors can do and what they can charge.

-Great Britain, Scandanavia, Spain, Hong Kong
-Cuba represents the extreme application of the Beveridge approach; it is probably the world's purest example of total government control.

TheBismarck Model:

Prussiun Chancellor Otto Von Bismarck-invented the welfare state as part of the unification of Germany in the 19th century

-European heritage but similar to American system in that it uses insurers, and paid for by employee and employer contributions to "sickness funds"

-Bismarck-type health insurance plans have to cover everybody, and they don't make a profit. Doctors and hospitals tend to be private in Bismarck countries; Japan has more private hospitals than the U.S. Although this is a multi-payer model -- Germany has about 240 different funds -tight regulation gives government much of the cost-control clout that the single-payer Beveridge Model provides.

Found in:Germany, France, Belgium, the Netherlands, Japan, Switzerland, and, to a degree, in Latin America.

National Health Insurance Model:

-Elements of both Beveridge and Bismarck
-It uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into.
-Single universal insurance program is simpler and cheaper since they have no marketing, no profit, no incentive to deny claims. Single payer has considerable market power to lower prices.
-Canada's system, for example, has negotiated such low prices from pharmaceutical companies that Americans have spurned their own drug stores to buy pills north of the border. National Health Insurance plans also control costs by limiting the medical services they will pay for, or by making patients wait to be treated.

The classic NHI system is found in Canada, but some newly industrialized countries -- Taiwan and South Korea, for example -- have also adopted the NHI model.

Out of Pocket System:

-Only the developed, industrialized countries -- perhaps 40 of the world's 200 countries -- have established health care systems.
-Rich get medical care, the poor get sick and die
-In rural regions of Africa, India, China and South America, hundreds of millions of people go their whole lives without ever seeing a doctor. They may have access, though, to a village healer using home-brewed remedies that may or not be effective against disease.