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Article #1: The health care system

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here are generally five primary methods labor unions and the government.
of funding health care systems In the Netherlands, a system of
1. direct or out-of-pocket payments, standardised and mandatory health
2. general taxation, insurance is in place, meant to encourage
3. social health insurance, competition between healthcare providers
4. voluntary or private health insurance, and insurers. The insurance policies are
and paid for through a system of levies and
5. donations or community health subsidies as well as a premium paid by
insurance. the insured, from which children under 18
Although some view health care from an are exempt.
economic perspective as being no In New Zealand hospitals are public and
different from other products or treat citizens or permanent residents
services, others believe it has many free of charge and are managed by
characteristics that encourage government District Health Boards. Under the current
intervention or regulation: Labour coalition governments, 1999 -
The provision of critical health care present, there are plans to make primary
treatment is often regarded as a basic health care available free of charge. At
human right, regardless of whether the present government subsidies exist in
individual has the means to pay—some health care. This system is funded by
treatments cost more than a typical taxes. The New Zealand government agency
family's life savings. PHARMAC subsides certain pharmaceuticals
Health care professionals are bound by depending upon their category.
law and their oaths of service to provide Co-payments exist however these are
lifesaving treatment. ignored if the user has a community
People often lack the information or health services card or high user health
understanding to be able to choose card.
rationally between competing health care In South Africa, parallel private and
providers when they need treatment, public systems exist. The public system
particularly in the event of the need of serves the vast majority of the
urgent or emergency treatment. population, but is chronically
Health care systems models underfunded and understaffed. The
Purely private enterprise health care wealthiest 20% of the population uses the
systems are comparatively rare. Where private system and are far better served.
they exist, it is usually for a In Sweden, the publicly funded medical
comparatively well-off subpopulation in a system is comprehensive and compulsory.
poorer country with a poorer standard of Physician and hospital services take a
health care–for instance, private small patient fee, but their services are
clinics for a small, wealthy expatriate funded through the taxation scheme of the
population in an otherwise poor country. County Councils of Sweden.
But there are countries with a In 1948, the United Kingdom passed the
majority-private health care system with National Health Service Act that provided
residual public service free physician and hospital services to
The other major models are public all people resident in the United
insurance systems: Kingdom. Hospital staff are salaried
Social security health care model, where employees according to nationally agreed
workers and their families are insured by contracts, whilst primary care is largely
the State. provided by independent practices, who
Publicly funded health care model, where are paid, again via a nationally agreed
the residents of the country are insured contract, according to the number of
by the State. patients registered with them and the
Social health insurance, where the whole range of additional services offered. The
population or most of the population is a National Health Service has been amended
member of a sickness insurance company. from time to time, but is largely intact.
In almost every country with a government Around 86% of prescriptions are provided
health care system a parallel private free. Prescriptions are provided free to
system is allowed to operate. This is people who satisfy certain criteria such
sometimes referred to as two-tier health as low income or permanent disabilities.
care. The scale, extent, and funding of People that pay for prescriptions do not
these private systems is very variable. pay the full cost. For example, in 2004
Examples most people in will pay a flat fee of
In Australia the current system, known as £6.40 (€9.64, US$11.76) for a single
Medicare, was instituted in 1984. It drug prescription regardless of the cost
coexists with a private health system. (average cost to the health service was
Medicare is funded partly by a 1.5% £11.10--about €16.70, US$20.40--in
income tax levy (with exceptions for 2002). (Charges are lower in Wales, and
low-income earners), but mostly out of the administration there is committed to
general revenue. An additional levy of 1% their eventual elimination.) Funding
is imposed on high-income earners without comes from a hypothecated health
private health insurance. As well as insurance tax and from general taxation.
Medicare, there is a separate Private health services are also
Pharmaceutical Benefits Scheme that available. Private health care continued
heavily subsidises prescription parallel to the NHS, paid for largely by
medications. private insurance, but it is used only by
Canada has a federally sponsored, a small percentage of the population, and
publicly funded Medicare system. Each generally as a top-up to NHS services.
province may opt out, though none The United States is alone among
currently do. Canada's system is known as developed nations with the absence of a
a single payer system, where basic universal healthcare system. The U.S.
services are provided by private doctors, health system does, however, have
with the entire fee paid for by the significant publicly funded components.
government at the same rate. These rates Medicare for the elderly and disabled
are negotiated between the provincial with a historical work record, and
governments and the province's medical Medicaid for indigents, provides
associations, usually on an annual basis. taxation-financed coverage. This care is
A physician cannot charge a fee for a generally provided by privately owned
service that is higher than the hospitals or physicians in private
negotiated rate - even to patients who practice, but public hospitals are common
are not covered by the publicly funded in older cities. Medicare is a federal
system - unless he opts out of billing government program providing coverage to
the publicly funded system altogether. people age 65 or older. Medicaid is a
Other areas of health care, such as federal and state program providing
dentistry and optometry, are wholly coverage to low-income and disabled
private. persons. The Department of Veterans
Cuba has a wholly government-controlled Affairs directly provides health care to
system that consumes a large proportion injured U.S. military veterans and
of the nation's GDP. The system does work current servicemen and women through a
on a for profit basis in treating nationwide network of government
patients from abroad. Cuba attracts hospitals (non-injured veterans are often
patients mostly from Latin America and not covered). A significant and growing
Eastern Europe by offering care of number of people cannot obtain health
comparable quality to a developed nation insurance through their employer, or are
but at much lower prices. While the unable to afford individual coverage.
government system is free to all, Currently, it is estimated that 17% of
patients frequently pay out-of-pocket for the U.S. population is uninsured. This
drugs that are in short supply in the number is growing rapidly as increasing
public system. numbers of employers cannot afford the
In Finland, the publicly funded medical ever-growing costs of the insurance. For
system is funded by taxation and every those that continue to provide
citizen has state-funded health employer-based programs, the employee
insurance. The system is comprehensive percentage share is increasing year by
and compulsory, like in Sweden, and a year. The cost of medicines is frequently
small patient fee is also taken. not covered by insurances and it is
In France, most doctors remain in private common for U.S. citizens to travel to
practice; there are both private and Canada and Mexico for drug purchases at
public hospitals. Social Security prices far below those in their home
consists of several public organizations, areas. A few states have taken serious
distinct from the state government, with steps toward universal health care
separate budgets that refunds patients coverage, most notably Minnesota and
for care in both private and public Massachusetts, with a recent example
facilities. It generally refunds patients being the Massachusetts 2006 Health
70% of most health care costs, and 100% Reform Statute. Other states, while not
in case of costly or long-term ailments. attempting to insure all of their
Supplemental coverage may be bought from residents, cover large numbers of people
private insurers, most of them nonprofit, by reimbursing hospitals and other
mutual insurers. Until recently, social health-care providers using what is
security coverage was restricted to those generally characterized as a charity care
who contributed to social security scheme; New Jersey is perhaps the best
(generally, workers or retirees), example of a state that employs the
excluding some poor segments of the latter strategy. It is typical for most
population; the government of Lionel forms of general liability insurance sold
Jospin put into place the "universal in the U.S., such as home, automobile, or
health coverage". In some systems, business insurance to have a significant
patients can also take private health premium allocation for medical damages.
insurance, but choose to receive care at The U. S. legal system, which has the
public hospitals, if allowed by the highest number of attorneys per 100,000
private insurer. population of any country in the world,
Germany has a universal multi-payer is available to assist in proving
system with two main types of health liability and collecting the money for
insurance: "Compulsory health insurance" medical bills from such insurances.
(Gesetzlich) and "Private" (Privat). The Indian Health Service provides public
In Ghana, most health care is provided by funded care for indigenous peoples.
the government, but hospitals and clinics Employer benefit based health insurance
run by religious groups also play an remains quite common with larger
important role. Some for profit clinics employers. Workers injured on the job are
exist, but they provide less than 2% of covered by government mandated worker
health services. Health care is very compensation insurance and wage
variable through the country. The major replacement benefits. These benefits vary
urban centres are well served, but rural considerably state-to-state and employers
areas often have no modern health care. bear the cost of this insurance.
Patients in these areas either rely on Businesses with considerable risks, such
traditional medicine or travel great as bridge-building, mining, or meat
distances for care. processing face far higher worker
In Hong Kong, both private and public compensation insurance costs than do
clinics are common, while public office based clerical businesses.
hospitals account for the majority of the In Italy the public system has the unique
market. feature of paying its doctors a fee per
In Israel, the publicly funded medical capita per year, a salary system, that
system is universal and compulsory. does not reward repeat visits, testing,
Payment for the services are shared by and referrals






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