INTRODUCTION TO HEALTH SYSTEMS What is Health system • is the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations. • A health system, also sometimes referred to as health care system or healthcare system Health Care Providers • Healthcare providers are institutions or individuals providing healthcare services. • Individuals including health professionals and allied health professions • be self-employed • working as an employee in a hospital, clinic, or other health care institution • work outside of direct patient care such as in a government health department or other agency, medical laboratory, or health training institution. • Examples: • doctors, nurses, midwives, dietitians, paramedics, dentists, medical laboratory technologists,therapists, psychologists, pharmacists, chiropractors, optometrists, co mmunity health workers, traditional medicine practitioners, and others. Financial resources • general taxation to the state, county or municipality • social health insurance • voluntary or private health insurance • out-of-pocket payments • donations to charities Payment models • Fee-for-service • pay practitioners based on the service • Capitation • practitioners are paid for each patient on their "list“ • Salary arrangements • practitioners are employed on salaries for the government The Beveridge Model • Britain's National Health System. • the government is responsible for financing and providing health care through taxes • if you are a British citizen and you need to see a doctor for some reason, you won't receive a bill. • most doctors are government employees. Even the few doctors that are privately owned still collect their payments from the government. • Since the funding comes from one source, the government has control over what doctors can charge. • health care systems that follow this model tend to have low costs. The Bismark Model • The system uses private insurance agencies also known as “sickness funds”. • They are run as nonprofits They required to accept all citizens without discrimination. • even though both employees and employers are contributing to an insurance policy, the insurance company is not benefiting financially. • Germany, France, the Netherlands, Belgium and Japan have also adopted versions of this model. The National Health Insurance Model • a combination of both the Bismark and Beveridge models. • Insurance companies are privately run, but payments come from a government program to which all citizens contribute. • very low costs for medical care and prescription drugs • Canada The out of pocket model • The patient himself pays for the service he receives • No insurances • NO Governmental/Public support • In many countries • Worst way to pay for health!