Whether it’s about Obamacare, Medicare, or another program, proposed changes to the US healthcare system always seem to be on the horizon. In trying to improve our system, we might do well to observe other nations and their approaches to healthcare.
Countries across the world organize their healthcare systems differently, with each individual system having its advantages and disadvantages. Among the healthcare systems of over 200 countries, four models dominate: the Beveridge Model, the Bismarck Model, the National Health Insurance Model, and the Private Health Insurance Model.
Under the Beveridge Model, which originated in Britain, most hospitals are government-owned, and medical bills are incorporated into taxes. Thus, while people in nations using the Beveridge Model pay high taxes, they also have an incentive to make use of health services, as well as the reassurance that should they require an expensive medical treatment or procedure, it will all be paid for. Such healthcare systems, however, rely heavily on the proficiency of the government in managing the system. In addition to Britain, Italy, Denmark, Hong Kong, Spain, New Zealand, Norway, Finland, and Sweden also use the Beveridge Model.
The Bismarck Model is comprised of employers paying for insurance on behalf of employees, who also contribute to “sickness funds” via payroll deduction. Under the Bismarck Model, insurance is a non-profit venture which, much like the Beveridge Model, is run by the government. Simultaneously, the majority of doctors and hospitals are private. The model operates in Germany, where it was founded, as well as Japan, the Netherlands, Belgium, France, and Switzerland.
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The National Health Insurance Model is seen in countries such as Canada, South Korea, and Taiwan, and it is a combination of the Beveridge and Bismarck systems. Every citizen pays their share toward a national health insurance program, which then organizes private-sector providers. National health insurance allows for financial flexibility, which leads to reduced prices for pharmaceutical products and cost-effective healthcare.
The Private Health Insurance Model is also known as the Out-of-Pocket Model, as citizens must pay for their own health insurance regardless of the expense. Private insurance is the dominating model of healthcare in lesser developed nations, since the wealthy have the greatest access to health services and the poor are left to fend for themselves.
Interestingly, the Private Health Insurance Model is also the primary healthcare system of the United States–that is, although many people benefit from employer-provided insurance and national health insurance programs like Medicare and Medicaid, at the core of it all, the US does not provide universal coverage for all its citizens. With the US spending exorbitant amounts on healthcare and yet coming in only 37th on the 2000 World Health Report, such a model of healthcare appears costly, unfair, and ineffective. Gradually, though, the system is slowly changing, particularly with the advent of the Patient Protection Act and the Affordable Care Act, both of which aim to increase health service provision to legal US residents. With continued efforts, we may eventually achieve truly universal healthcare.
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