Introduction
This topic covers the types of health care systems, how they are funded, the structure of the Bulgarian health system, the levels of health care, and the reform of the Bulgarian system around 2000. Mnemonic for the models: Charity Brings Fun People Money (Charity, Budgetary, Fund insurance, Private insurance, Mixed).
Types of health care systems
- Charity model (e.g. Italy: the Catholic church runs many hospitals)
- Budgetary model (e.g. Scandinavia, UK)
- Fund insurance model (e.g. Bulgaria; Germany has health insurance)
- Private insurance model (e.g. USA)
- Mixed
No country can currently say it has the best health care model. In health services there are 3 main groups - people (users), the government and health professionals - and it is practically impossible to satisfy all three. No country can provide limitless, affordable, high-quality services so that everyone, including the professionals, is satisfied. Australia, Canada and some Scandinavian countries currently have good systems.
Funding
1. Governmental (budget)
- Centralised: for countries with a centralised administrative structure; the government allocates money to pay for specific health services for the whole territory. E.g. Bulgaria: centralised governmental funding for all health care and medical establishments.
- De-centralised: for countries with strong regional divisions. E.g. Italy: each of the 21 regions has its own health budget, so some regions may receive better quality and quantity of services than others.
2. Non-governmental
- Health funds (sick funds)
- Municipal
- Private
- Donations, charity