Halima Begum HEALTHCARE

Aim To have an overview of the structure of health care in the UK

Learning Outcomes By the end of this lesson you will be able to:  Explain what is healthcare  Identify features of healthcare models  Present healthcare models

Healthcare- Task 1 Explain what do you think healthcare means.  A preventive measure or medical procedures to improve a person’s wellbeing. How do you think this is delivered?  Delivered through healthcare systems. The health care delivery system.docx

Health Care Systems Why do you think health care systems are needed? A health care system is constructed for three reasons: Maintain the health of the community Provide services to the sick and wounded Help curb the costs of expensive medical bills

Models of Health - Task 2  Do you know of any models of health?  What are they? Currently, we recognize four different types of health care systems. Some countries base their system upon one model while others choose a combination. The choices they have to choose from include:  The Beveridge Model  The Bismark Model  The National Health Insurance Model  The Out-of-Pocket Model.

Group work  In groups, identify features of each model and note the advantages or disadvantages of each model

The Beveridge Model  The Beveridge Model was created by social reformer, William Beveridge, who designed Britain's National Health System. With this model, the government is responsible for financing and providing health care through taxes.  This means that if you are a British citizen and you need to see a doctor for some reason, you won't receive a bill. The reason behind this is that most doctors are government employees. Even the few doctors that are privately owned still collect their payments from the government.

The Bismarck Model  The Bismarck Model was named after the Prussian Chancellor, Otto von Bismark, who implemented it during the unification of Germany.  The system uses private insurance agencies also known as sickness funds. They are run as non- profits and are required to accept all citizens without discrimination. As a result, even though both employees and employers are contributing to an insurance policy, the insurance company is not benefiting financially.

The National Health Insurance Model  The National Health Insurance model places a foot in both the Bismarck and Beveridge camps. Like the Bismarck Model, it is insurance-based; like Beveridge, it is single payer. The most familiar application of National Health Insurance to Americans is Medicare: Employer-employee contributions are used by the federal government as an insurance fund. The government in turn pays private providers. That's the essence of the NHI model.  As the government is the sole payer, it can exert tremendous bargaining influence on the prices of medical services and drugs. That's why Canada -- whose Medicare system is the most well-known version of NHI -- has cheap drug prices that lure Americans north of the border even though it is illegal to purchase prescription medication abroad. NHI countries generally control costs by limiting the services they will pay for and by limiting the availability of certain services, thus creating the lengthy waits for non-acute secondary care.  Therein, lies the essential tradeoffs of the NHI model; to achieve universal coverage with cost controls, the government  strongly influences prices and therefore provider compensation  limits the services covered by the national insurance  limits the volume of selected services and procedures  Besides Canada, Australia, South Korea, and Taiwan have adopted the National Health Insurance model.

The Out-of-Pocket Model  Only the developed, industrialised countries -- perhaps 40 of the world's 200 countries -- have established health care systems. Most of the nations on the planet are too poor and too disorganized to provide any kind of mass medical care. The basic rule in such countries is that the rich get medical care; the poor stay sick or die.  In rural regions of Africa, India, China and South America, hundreds of millions of people go their whole lives without ever seeing a doctor. They may have access, though, to a village healer using home-brewed remedies that may or not be effective against disease.  In the poor world, patients can sometimes scratch together enough money to pay a doctor bill; otherwise, they pay in potatoes or goat's milk or child care or whatever else they may have to give. If they have nothing, they don't get medical care.  These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus. When it comes to treating veterans, we're Britain or Cuba. For Americans over the age of 65 on Medicare, we're Canada. For working Americans who get insurance on the job, we're Germany.  For the 15 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you're sick enough to be admitted to the emergency ward at the public hospital.  The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody. This is much simpler than the U.S. system; it's fairer and cheaper, too.