How health care system works


Health care systems models

Social security primarily refers to a fieldinsurance "sickness fund" finances health
of social welfare service concerned withcare through premiums determined by a
social protection, or protection againstpercentage  of  a  person's  wage.
socially recognized conditions, including
poverty, old age, disability, unemployment,Varieties  of  public  systems
families with children and others. Although
some publications use the terms "socialMost developed countries currently have
security" and "social protection"publicly funded health systems that cover the
interchangeably, social security is used bothgreat majority of the population. The notable
more narrowly (to refer only to schemes withexception is the United States. For some
the formal title of 'social security') andexamples, see the United Kingdom's National
more widely (referring to many kinds ofHealth Service (NHS), or the Medicare systems
social welfare scheme). Social security mayin Canada and in Australia. In the United
refer  toStates, the role of the government in
healthcare provision is a source of continued
social insurance, where people receiveand  sharp  debate.
benefits or services in recognition of
contributions to an insurance scheme. TheseEven among these countries, different
services typically include provision forapproaches exist to the funding and provision
retirement pensions, disability insurance,of medical services. Systems may be funded
survivor benefits and unemployment insurance.from general government revenues (as in Italy
and Canada), or through a government social
income maintenance—mainly thesecurity system (as in France, Belgium,
distribution of cash in the event ofJapan, and Germany) with a separate budget
interruption of employment, includingand hypothecated taxes. The proportion of the
retirement,  disability  and  unemploymentcost of care covered also differs: in Canada,
all hospital care is paid for by the
services provided by administrationsgovernment, while in Japan patients must pay
responsible for social security. In different10 to 30% of the cost of a hospital stay.
countries this may include medical care,Services provided by public systems vary. For
aspects of social work and even industrialexample, the Belgian government pays the bulk
relations.of the fees for dental and eye care, while
the  Australian  government  covers  neither.
More rarely, the term is also used to refer
to basic security, a term roughly equivalentPublicly funded medicine may be administered
to access to basic necessities—thingsand provided by the government, as in the
such as food, clothing, shelter, educationUnited Kingdom; in some systems, though,
and  medical  care.medicine is publicly funded but most health
providers are private entities, as in Canada.
Income  maintenanceThe organization providing public health
insurance is not necessarily a public
Social security policy is usually appliedadministration, and its budget may be
through various programs designed to provideisolated from the main state budget. Some
a population with income at times when theysystems do not provide universal healthcare,
are unable to care for themselves. Incomeor restrict coverage to public health
maintenance is based in a combination of fivefacilities. Some countries, such as Germany,
main  types  of  program:have multiple public insurance organizations
linked  by  a  common  legal  framework.
social  insurance,  considered  above
Innovations in health care can be very
means-tested benefits. This is financialexpensive. Population aging generally implies
assistance provided for those who are unablemore health care, at a time when the taxed
to cover basic needs, such as food, clothingworking  population  decreases.
and housing, due to poverty or lack of income
because of unemployment, sickness,Two-tier  health  care
disability, or caring for children. While
assistance is often in the form of financialAlmost every country that has a publicly
payments, those eligible for social welfarefunded health care system also has a parallel
can usually access health and educationalprivate system, generally catering to private
services free of charge. The amount ofinsurance holders. While one goal of public
support is enough to cover basic needs andsystems is to provide equal service to all,
eligibility is often subject to athis egalitarianism is often partial. Every
comprehensive and complex assessment of annation either has parallel private providers
applicant's  social  and financial situation.or its citizens are free to travel to a
nation that does, so there is effectively a
non-contributory benefits. Several countriestwo-tier healthcare system that reduces the
have special schemes, administered with noequality of service. Private hospitals often
requirement for contributions and no meansget newer and better equipment and
test, for people in certain categories offacilities, and since private providers are
need - for example, veterans of armed forces,typically better paid, some medical
people with disabilities and very old people.professionals motivated by remunerative
concerns migrate to the private
discretionary benefits. Some schemes aresector.[citation  needed]
based on the discretion of an official, such
as  a  social  worker.From the inception of the NHS model (1948),
public hospitals in the United Kingdom have
universal or categorical benefits, also knownincluded "amenity beds" which would typically
as demogrants. These are non-contributorybe siderooms fitted more comfortably, and
benefits given for whole sections of theprivate wards in some hospitals where for a
population without a test of means or need,fee more amenities are provided. These are
such as family allowances or the publicpredominantly used for surgical treatment,
pension in New Zealand (known as New Zealandand operations are generally carried out in
Superannuation).the same operating theatres as NHS work and
by the same personnel. These amenity beds do
Publicly funded health care systems arenot exist in other socialized healthcare
financed in one of two ways: tax-basedsystems, such as the Spanish one. From time
financing or social security financing. Into time, the NHS pays for private hospitals
some systems, taxation is the primary means(arranged hospitals) to take on surgical
of financing health care. Everyone receivescases for which NHS facilities do not have
the same level of coverage regardless ofsufficient capacity. This work is usually,
their ability to pay, their level ofbut not always, done by the same doctors in
taxation, or risk factors. In others,private hospitals.
compulsory membership in a social health



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