Healthcare Systems

Question 1

What are the four models of healthcare provision?

Answer 1

• out of pocked model
• Bismarck model
• national health insurance
• beveridge model

Question 2

Explain the out of pocket model

Answer 2

Individual liability

Most countries

Only those rich enough receive healthcare

Some have free public hospitals for only emergency care

Those who can afford pay for healthcare insurance so don’t have to go to public hospitals

Question 3

Explain the bismarck model

Answer 3

Multi-payer insurance

Invented in Germany

Healthcare is provided by private healthcare providers and doctors, financed by insurance system (non profit sickness fund) funded by employers and employees through payroll deduction

E.g Germany, France, Belgium, Switzerland

Question 4

Explain the national health insurance model

Answer 4

Single player

After Lloyd George’s national insurance act

Employers and employees pay national insurance contributions

Healthcare is provided by private healthcare providers and doctors, financed by government run insurance scheme funded by citizens contributions

Doctors either send cheque to: government if applicable, private insurance or patient

E.g. Canada, Taiwan, South Korea

Question 5

Explain the Beveridge model

Answer 5

Single payer and provider

Healthcare provided mostly by state controlled healthcare providers and doctors, financed by the government funded by general taxation

E.g. UK, Spain, most Scandinavian countries, NZ, Cuba

Question 6

Similarities between: Bismarck model, national health insurance, beveridge model

Answer 6

• all involve people paying into a pool
• none are payments at the point of service
• all may require invoices for things not covered

Question 7

Question of privatisation?

Answer 7

Whether doctors should be employed and paid by state or healthcare services should decide and send invoices to patients

Question 8

What is England’s internal market healthcare scheme?

Answer 8

Commissioning groups (NHS England, clinical commissioning groups decided who to give money to)

Providing groups - NHS trusts (who needs the money)

Regulated

Question 9

What is Scotland’s integrated healthcare scheme?

Answer 9

Scottish parliament -> planning and providing groups

Scrutinising groups

Question 10

What is wales planned healthcare scheme?

Answer 10

Heirachry arranged

Welsh government -> planning (+ advising groups) -> providing

Separate regulation groups

Question 11

What is Northern Ireland’s health and social care scheme?

Answer 11

Health and social care come into same model

5 local commissioning groups -> providing

Separate advising, regulating, supporting-groups