Health system as an integral component of the social system. Fundamental goals and functions. Principles of organization and activity.
Health system:
- Definition: WHO: „all organizations that promote, restore and maintain health“
- Goal: improve health of population, respond to peoples expectations, financial protection against costs of illness
- Systems:
- Bismark System:
- social security, payment of employer for health found ex.: Germany, Japan
- Beverage System:
- by government - fees, taxes ex.: GB
- mixed, national, regional, local taxation ex.: Scandinavian countries
- Semashko System:
- ex.: Government - fees and taxes ex.: former Soviet Union
- Douglas System:
- Taxes, distribution of expenditures btw. Local and federal governments ex.: Australia
- Mixed private/public System:
- Private insurance by employer & public insurance by social security ex.: USA
Xs
- Types:
- State monopolist:
- state owns health institutions & resources
- budged by taxes
- Polyclinical organization
- Centralized by state management
- no self-regulation of the market
- no coverage of health needs
- no sustainable development
- typical in socialist countries
- Liberal Pluralism
- Private sector is predominant, economic freedom, ownership of health resources
- primary and secondary health care are privatized
- developed market mechanisms, but also state regulated
- sustainable due to high resources and market orientation (orientation toward demand)
- money by great number of sources
- ex: USA
- Health insurance system:
- State regulated by legislation
- Pluralistic (public & private) ownership of health resources
- well developed marked mechanisms
- orientation towards demand of health services
- sustainable due to high resources, well market mechanism, normative regulation
- dezentralized managend
- Money by health insurance funds
- ex: Germany, France