| Social security primarily refers to a field of social | | | | Varieties of public systems |
| welfare service concerned with social protection, | | | | Most developed countries currently have publicly |
| or protection against socially recognized conditions, | | | | funded health systems that cover the great |
| including poverty, old age, disability, | | | | majority of the population. The notable exception |
| unemployment, families with children and others. | | | | is the United States. For some examples, see the |
| Although some publications use the terms "social | | | | United Kingdom's National Health Service (NHS), or |
| security" and "social protection" interchangeably, | | | | the Medicare systems in Canada and in Australia. |
| social security is used both more narrowly (to | | | | In the United States, the role of the government |
| refer only to schemes with the formal title of | | | | in healthcare provision is a source of continued |
| 'social security') and more widely (referring to | | | | and sharp debate. |
| many kinds of social welfare scheme). Social | | | | Even among these countries, different approaches |
| security may refer to | | | | exist to the funding and provision of medical |
| social insurance, where people receive benefits or | | | | services. Systems may be funded from general |
| services in recognition of contributions to an | | | | government revenues (as in Italy and Canada), or |
| insurance scheme. These services typically include | | | | through a government social security system (as |
| provision for retirement pensions, disability | | | | in France, Belgium, Japan, and Germany) with a |
| insurance, survivor benefits and unemployment | | | | separate budget and hypothecated taxes. The |
| insurance. | | | | proportion of the cost of care covered also |
| income maintenance—mainly the | | | | differs: in Canada, all hospital care is paid for by |
| distribution of cash in the event of interruption of | | | | the government, while in Japan patients must pay |
| employment, including retirement, disability and | | | | 10 to 30% of the cost of a hospital stay. |
| unemployment | | | | Services provided by public systems vary. For |
| services provided by administrations responsible | | | | example, the Belgian government pays the bulk |
| for social security. In different countries this may | | | | of the fees for dental and eye care, while the |
| include medical care, aspects of social work and | | | | Australian government covers neither. |
| even industrial relations. | | | | Publicly funded medicine may be administered and |
| More rarely, the term is also used to refer to | | | | provided by the government, as in the United |
| basic security, a term roughly equivalent to | | | | Kingdom; in some systems, though, medicine is |
| access to basic necessities—things such | | | | publicly funded but most health providers are |
| as food, clothing, shelter, education and medical | | | | private entities, as in Canada. The organization |
| care. | | | | providing public health insurance is not necessarily |
| Income maintenance | | | | a public administration, and its budget may be |
| Social security policy is usually applied through | | | | isolated from the main state budget. Some |
| various programs designed to provide a population | | | | systems do not provide universal healthcare, or |
| with income at times when they are unable to | | | | restrict coverage to public health facilities. Some |
| care for themselves. Income maintenance is | | | | countries, such as Germany, have multiple public |
| based in a combination of five main types of | | | | insurance organizations linked by a common legal |
| program: | | | | framework. |
| social insurance, considered above | | | | Innovations in health care can be very expensive. |
| means-tested benefits. This is financial assistance | | | | Population aging generally implies more health care, |
| provided for those who are unable to cover basic | | | | at a time when the taxed working population |
| needs, such as food, clothing and housing, due to | | | | decreases. |
| poverty or lack of income because of | | | | Two-tier health care |
| unemployment, sickness, disability, or caring for | | | | Almost every country that has a publicly funded |
| children. While assistance is often in the form of | | | | health care system also has a parallel private |
| financial payments, those eligible for social welfare | | | | system, generally catering to private insurance |
| can usually access health and educational services | | | | holders. While one goal of public systems is to |
| free of charge. The amount of support is enough | | | | provide equal service to all, this egalitarianism is |
| to cover basic needs and eligibility is often subject | | | | often partial. Every nation either has parallel |
| to a comprehensive and complex assessment of | | | | private providers or its citizens are free to travel |
| an applicant's social and financial situation. | | | | to a nation that does, so there is effectively a |
| non-contributory benefits. Several countries have | | | | two-tier healthcare system that reduces the |
| special schemes, administered with no | | | | equality of service. Private hospitals often get |
| requirement for contributions and no means test, | | | | newer and better equipment and facilities, and |
| for people in certain categories of need - for | | | | since private providers are typically better paid, |
| example, veterans of armed forces, people with | | | | some medical professionals motivated by |
| disabilities and very old people. | | | | remunerative concerns migrate to the private |
| discretionary benefits. Some schemes are based | | | | sector.[citation needed] |
| on the discretion of an official, such as a social | | | | From the inception of the NHS model (1948), |
| worker. | | | | public hospitals in the United Kingdom have |
| universal or categorical benefits, also known as | | | | included "amenity beds" which would typically be |
| demogrants. These are non-contributory benefits | | | | siderooms fitted more comfortably, and private |
| given for whole sections of the population without | | | | wards in some hospitals where for a fee more |
| a test of means or need, such as family | | | | amenities are provided. These are predominantly |
| allowances or the public pension in New Zealand | | | | used for surgical treatment, and operations are |
| (known as New Zealand Superannuation). | | | | generally carried out in the same operating |
| Publicly funded health care systems are financed | | | | theatres as NHS work and by the same |
| in one of two ways: tax-based financing or social | | | | personnel. These amenity beds do not exist in |
| security financing. In some systems, taxation is | | | | other socialized healthcare systems, such as the |
| the primary means of financing health care. | | | | Spanish one. From time to time, the NHS pays for |
| Everyone receives the same level of coverage | | | | private hospitals (arranged hospitals) to take on |
| regardless of their ability to pay, their level of | | | | surgical cases for which NHS facilities do not have |
| taxation, or risk factors. In others, compulsory | | | | sufficient capacity. This work is usually, but not |
| membership in a social health insurance "sickness | | | | always, done by the same doctors in private |
| fund" finances health care through premiums | | | | hospitals. |
| determined by a percentage of a person's wage. | | | | |