Healthcare Papers on Basic Health Care Systems Model

Basic Health Care Systems Model

Summary

The Beveridge, Bismarck, the out-of-pocket, and the National Health Insurance programs are different in terms of their structures, means of payment and number of patients served. According to Yalin & White (2013), the national health insurance covers a majority of the citizens. This is because of the elements realized in Bismarck and Beveridge models. Both public and private hospitals provide services for their patients. National health insurance employs the private sector to offer payment process. The government releases money for the insurance programs. This money comes from the taxes, which the American citizens contribute. The private sector offers insurance and services which the public partakes. No profits and marketing is required in this model. Hence, the insurers make no claims. The government, on the other hand, has no financial motives. This model is fairer compared to Bismarck and Beveridge. The processes are also much easier when getting the services and making payments (Joshi, 2014). National insurance is preferable to the rest of the insurance programs as it is non-profitable, and hence the cost is fair. In this model, the citizens have more power in negotiating for the costs of products like drugs. The insurance, on the other hand, has more control over the costs. This comes as they can manage the services rendered to the patients.

In the Beveridge model, taxes from the public cater for the services, which are offered in health institutions. A majority of the institutions are therefore part of the government possessions. Doctors also rely on the government for their pay as the doctors in the public institutions wait for payment from the government while doctors in the private institutions wait for their fees from the government (Joshi, 2014). The government is also, in charge of what the patients are to pay in addition to the cover (Romano, Hadley & Reschovsky, 2013). A majority of the citizens, therefore, manage to get minimum health attention from the hospitals. This form of cover is at times perceived to be for profit.

The Bismarck model applies the insurance system through the government. Both the employees and the employers share in the cost of the services. This program deducts money through the payroll system. All working class is covered in this model. These categories of citizens can use private health institutions that accept the insurance cover. The Bismarck model therefore gives quality care as hospitals choose to remain private. The government has to cater for part of the costs (Yalin & White, 2013). Everybody is assumed to be covered by model, as it is non-profitable.

The out-of-pocket model is found in industrialized countries such as America. This model does not rely on management as much as Bismarck, Beveridge, and national insurance. The wealthy are entitled to this type as the services are to be paid as soon as they are required. The best form of services is assumed to be attained through this mode as most of the doctors and caregivers are assured of good pay for the quality services rendered (Joshi, 2014). Health insurance is, therefore, unnecessary for this mode. This mode has given rise to diverse groups of health institutions. The systems are also different from the national insurance, Bismarck, and Beveridge.

Future of the American health insurance model

The American health sector is perceived to be among the most developed structure (Romano, Hadley & Reschovsky, 2013). This is due to the presence of various programs, which cater for the heath care of its citizens. All these models are different in their terms. The Beveridge is the same as the single payer national service. Payment is released from the taxpayer’s money only. The Bismark model is non-commercial while the out-of-pocket program is market oriented. As the public hospitals fail to offer quality care, most of the rich citizens go for the private hospitals to get the deserved attentions. There is therefore variation when the government fails to honor the policies. National health insurance cover majority of the citizens. Health complications have been met through the present systems. The citizens have choices on the kind of health program to enroll. There is, however, a necessity for the unitary structure to manage the health sector. In as much as the USA health department is perceived to be developed, there is a need to incorporate reforms such as individual episode bundled payments (Romano, Hadley & Reschovsky, 2013).

Features of capitation like the global payments should be integrated into the system. The present payment system can be upgraded to meet the market demands. Different regions have different spending rates. This is attributed to the choice of cover and the population income. There is the need for the government to uphold its policies so that the public doctors should offer the same quality services to the patients in public hospitals as in the private hospitals. If this policy can be exercised fully, then the citizens will enjoy the same services offered in the hospitals. The result will be maintained health services and reduced development of private hospitals. This policy should also foresee the fair costs of the services and drugs. Private entities are not to commercialize the health sector at the expense of the lives of the citizens.

 

References

Joshi, M. Journal of Health Care Quality: National Association of Health Care Quality. 2014.

36(6)

http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291945-1474

Romano, S. P., Hadley, J. & Reschovsky, D. J. Geographic Variation in Fee-for-Service Medicare Beneficiaries’ Medical Costs Is Largely Explained by Disease Burden: Medical Care
Research and Review, OnlineFirst. 2013.

http://www.hschange.com/…/1347/

Yalin, W. V. & White, C. How Do Hospitals Cope with Sustained Slow Growth in Medicare Prices: Health Services Research, Early View. 2013.

http://www.hschange.com/…/1385/