Friday, 19 April 2013

Healthcare Systems

Emergent:

  • Healthcare viewed as an item of personal consumption
  • Physician operates as a solo entrepreneur
  • Professional associations are powerful
  • Private ownership of facilities
  • Direct payment of physicians
  • State's role in healthcare is minimal
  • Development of local health workers 
Eg, in India healthcare is highly diversified with both western and traditional practises operating.

Socialised:
  • Healthcare is a state-provided service
  • Physicians are state employed 
  • Professional associations are weak or non existenet
  • Facilities are wholly publicly owned
  • Payments for services are entirely indirect
  • State's role in healthcare is total
Cuba's health service is very effective, with the WHO ranking it just below the USA's despite the fact it spends 10x less. 

1 in 6 doctors in South Africa are Cuban partly because there are 21 medical schools providing free training.

Pluralistic:
  • Healthcare viewed as a consumer product 
  • Physician operates as a solo entrepreneur
  • Professional associations are powerful
  • Private and public ownership of facilities
  • State's role in healthcare is minimal and indirect
In the USA the health system is provided by thousands of independent doctor, clinics and pharmacies however the federal government recently introduced Medicaid and Medicare.

Insurance/social security:
  • Healthcare is an insured and guaranteed consumer product 
  • Physicians operate as social entrepreneurs and as members of strong professional associations
  • Private and public ownership of facilities
  • Payment for services mostly indirect
  • State's role in healthcare is evident but indirect
WHO judged the French healthcare system to be the most effective in the world, but it also very expensive accounting for 10% of France's GDP.

National Health Service:
  • Healthcare is a state supported service
  • Physicians operate as solo entrepreneurs and as members  
  • Facilities are mainly publicly owned 
  • State's role in healthcare is central and direct
The only countries with national health care are the UK and Canada. Canada's aim is to provide its citizens with equal access to healthcare regardless of their ability to pay in a scheme known as Medicare.


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