Global Health Issues and Health System Flashcards
Entered England in 1348 through this port. It killed 30-
50% of the country’s total population. Caused by Yersinia pestis
Black Death
1918; Infected 500 million people; 50-100 million died; World War I
Spanish Flu
1980’s to present; 36 million deaths
AIDS/HIV
2002; 775 deaths; Spread to 37 countries
SARS
2009; 284, 500 died
SWINE FLU
2014; 5,000 deaths; drastic, hemorrhagic
EBOLA
1.8 million die per year; Children mostly
DIARRHEA
Composition of health system
- Organizations
- Institutions
- Resources
Primary intent of Health System
improve health
What Are The Essential Functions Of Health System?
Service provision
Resource generation
Health financing
Stewardship
Source of Funding of Healthcare Systems
Direct or Out-of-pocket Payments General Taxation Social Health Insurance Voluntary or Private Health Insurance Donations or Community Health Insurance/NGO
Relatively rare; Well-off subpopulation in a poorer country with a poorer standard of health care
Examples are private clinics for a small
expatriate population in an otherwise poor country
Purely Private Enterprise
Types Of Public Insurance Systems
- Social Security Health Model
- Publicly Funded Healthcare Model
- Social Health Insurance
Workers and their families are insured
by the State; E.g. SSS
Social Security Health Model
Residents of the country are insured by
the State
Publicly Funded Healthcare Model
Whole population or most of the population is a member of a sickness insurance company
Social Health Insurance
Government health care system; Parallel private system
Two-Tier Health Care
Mode of Payment for Doctors
- Fee of service (out of pocket)
- Insurance payments
- Salary
- Capitation
Universal health care system since 1962
Funding:
1. Income tax
2. Patient fees
Doctor payment: mostly salaries
Co-pays are capped with limits on how much a person is
required to contribute annually
Tuition fee for medical and nursing education is free
Sweden
Funding: progressive income taxes Doctor payments: 1. Hospitalists/GPs: salaries 2. Specialists: mostly fee-for-service GP consult: mostly free All medical and nursing education is free
Denmark
healthcare since 1984 (National Health Service)
government is a purchaser and provider of
health care; decides on annual budget
Funding:
1. Income taxes
2. National insurance contributions (88% of population)
3. Private insurance (12% of population)
United Kingdom
GP consults: free
GPs act as gate keepers
United Kingdom
GP consult : mostly free
Specialist consult: fee-for-service
Health expenditures:
Government: 42%
Private sector: 58%
South Africa
see inexpensive, traditional healers
before seeking treatment from a physician; Heavy reliance on out-of-pocket payments and uneven
distributions of facilities
South Africa
No universal health care system
Significantly publicly funded components (27% of the
population):
Medicare covers the elderly and disabled with historical work record
Medicaid is available for the poor
United States
covers children of low income families
State Children’s Health Insurance Program
Cost of medicines is frequently not covered by insurance
United States
Universal health care
Patients have access to 24-hour, neighborhood doctor
and nurse team
Cuba
Doctors spend mornings in their practice and PMs making house calls to elderly and infirm
Every patient is seen at least twice a year
Cuba
Near universal coverage for curative services
Government directly funds health services
Capitation is the preferred payment scheme
Shifting from specialist care to family practice
Mongolia
No universal health care
National Insurance: Philhealth
Patients are free to seek their choice of doctor
Philippines
An Act Instituting a National Health Insurance Program
for all Filipinos and Establishing the Philippine Health
Insurance Corporation (PhilHealth) for the Purpose
Republic Act 7875 (Philhealth Act)
Section 11, Article XIII of the 1987 Constitution of the Republic of the Philippines
Republic Act 7875 (Philhealth Act)
Purpose Of Philhealth
To ensure the provision of affordable, available and accessible health care for ALL citizens of the Philippines
Goal Of Philhealth
Universal coverage (defined as 85% of the Philippine population) by the year 2010
Philhealth Coverage
covered beneficiaries or to purchasing health services on behalf of the beneficiaries
Philhealth Does Not…
Provide health care directly
Buy or dispense drugs and pharmaceuticals
Employ doctors and other professionals for the purpose
of directly rendering care
Own or invest in health care facilities
Source Of Funds
Premiums
Individual
National government Local government
Grants and Donations Investment Earnings Sin Taxes
Indigent members
premium is shared by national and local government depending on the class of the city or municipality