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PHA Lecture 4

The document discusses the elements within a health care system including functions like health care delivery and meeting population health expectations. It describes different types of health systems like the Beveridge model used in Britain and Bismarck model used in Germany. The document also discusses the National Health Insurance model used in countries like Canada and elements of a health care system like regulatory bodies that provide access to care.

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Kami Sookram
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18 views3 pages

PHA Lecture 4

The document discusses the elements within a health care system including functions like health care delivery and meeting population health expectations. It describes different types of health systems like the Beveridge model used in Britain and Bismarck model used in Germany. The document also discusses the National Health Insurance model used in countries like Canada and elements of a health care system like regulatory bodies that provide access to care.

Uploaded by

Kami Sookram
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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PHA 012 National Health Care System for Pharmacy Assistants

Lecture 4
Date:2022-11-07
Lecturer: Mr. Marvin Dindyal. BSoc.Sc. M.P.A.
Elements Within the Health System

Health System
This is the sum total of all organizations, institutions, and resources whose primary purpose is to
improve health. To provide service there is a need for staff, funds, information, supplies,
communication, and overall guidance and direction to provide a service.

Functions of a Healthcare System


-Health care delivery.
-Fair treatment to all.
-Meeting the health expectation of the population.
Group in the Healthcare System
-Government or Public Facilities
-Private facilities
-International Health Organizations
-Informal Providers.
Reason for Health Care System
-To maintain the health of the population.
-To provide services to the sick and wounded.
-To prevent morbidity.
Types of Health System
The Beveridge Model
-Health care is provided and financed by the government through tax payments.
-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.
-For example: In Britain, you never get a doctor’s 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.
-Countries using the Beveridge plan or variations on it include its birthplace Great Britain, Spain,
most of Scandinavia, and New Zealand.

The Bismarck Model


-Uses an insurance system: the insurance is called “sickness funds”
-It is usually financed jointly by employers and employees through payroll deduction.
-The health insurance plans cover everybody and they are nonprofit. Doctors and hospitals tend
to be private in Bismarck countries.
-For example, Germany has about 240 different funds- tight regulations give the government
much of the cost control clout that the single-payer Beveridge Model provides.
-The Bismarck model is found in Germany of course and France, Belgium, the Netherlands,
Japan, Switzerland, and to a degree in Latin America.

The National Health Insurance Model


-Has 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.
-There’s no need for marketing.
-No financial motive to deny claims and no profit.
-A universal insurance program that tends to be cheaper and much simpler administratively.
The single-payer tends to have the considerable market power to negotiate for lower prices;
Canada’s system for example has negotiated such low prices from pharmaceutical companies.
-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.

The Out-of-Pocket Model

-Present mostly in developed industrialized countries- perhaps of the world’s 200 countries.

-Have established health care systems.

-The basic rule is that the rich get medical care; the poor stay sick or die.

-The United States is unlike every other country because it maintains so many separate systems
for separate classes of people.

-All other countries have settles on one model for everybody. This is much simpler than the U.S.
system; it’s fairer and cheaper too.

Elements of a Health Care System


Health care system are complex organizations comprising regulatory, funding and service
provision bodies that provide access to health care in accordance with social goals and values.
The metaphor of a house can be useful in describing health care systems. The roof corresponds
to the societal goals and values that shelter service provision, which is founded on legislation and
regulations that control the relationships among providers (the rooms of the house), funding
agencies (the power source) and citizens. Regulations also control who can provide care (back
door) and who can access it (main door).

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