Session 4 Flashcards
Four Basic Models of Healthcare Provision
• Out-of-Pocket Model • Bismarck Model • National Health Insurance • Beveridge Model
Out-of-Pocket Model (‘Individual Liability’)
• Most countries in the world do not have universal
healthcare provision for their citizens. • In those countries, only those rich enough
receive healthcare, the others do not. • Some have public hospitals that provide free
emergency care, but only emergency care.
Thereafter, all costs are borne by the patient. • Those who can afford to do so, pay for
healthcare insurance so that they do not have to
go to public hospitals.
Bismarck Model (‘Multi-Payer’ Insurance)
• Named after Otto von Bismarck, Chancellor of
Prussia, who invented the welfare state in 1883
as part of the unification of Germany. • Healthcare is:
• Examples include Germany, France, Belgium,
Netherlands, Switzerland, Japan and in Latin
America.
– provided by private healthcare providers and doctors – financed by an insurance system (not-for-profit
‘sickness funds’ that are strictly regulated) that is
funded jointly by employers and employees through
payroll deduction.
National Health Insurance (‘Single Payer’)
• Named after Lloyd George’s National Insurance
Act (1911) in the UK in which employers and
employees pay National Insurance contributions. • Healthcare is:
– provided by private healthcare providers and doctors – financed by a government run insurance scheme that
is funded by citizens’ contributions.
• Examples include Canada, Taiwan and South
Korea.
Beveridge Model (‘Single Payer and Provider’)
• Named after William Beveridge, author of the
“Social Insurance and Allied Services” report
(1942) that formed the basis of the post-WWII
welfare state in the UK including the NHS.
• Healthcare is:
• Examples include UK, Spain, most Scandinavian
countries, New Zealand and Cuba.
– provided mostly by state controlled healthcare
providers and doctors – financed by the government funded by general
taxation.
What is ‘Privatisation’?
• Bismarck Model
– private healthcare providers and doctors
– not-for-profit ‘sickness funds’. • National Health Insurance
– private healthcare providers and doctors
– citizens’ insurance scheme. • Beveridge Model
– state controlled healthcare providers and doctors
– general taxation.
Healthcare: Consequences for Financing
Panopto
United Kingdom: Devolved Healthcare
P
England: ‘Internal Market’ Healthcare
P
Scotland: ‘Integrated’ Healthcare
P
Wales: ‘Planned’ Healthcare
P
Northern Ireland: ‘Health and Social Care’
P
Healthcare: Can One Size Fits All?
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