Sierra Leone ranks last with a life expectancy of just over 50 years. Monaco is first on this list ofwith an average life expectancy of Chad is last with Aa National Research Council study stated that, when considered as one of 17 high-income countriesthe United States was at or near the top in infant mortalityheart and lung disease, sexually transmitted infectionsadolescent pregnanciesinjurieshomicidesand rates of disability.
History[ edit ] The first move towards a national health insurance system was launched in Germany inwith the Sickness Insurance Law.
Industrial employers were mandated to provide injury and illness insurance for their low-wage workers, and the system was funded and administered by employees and employers through "sick funds", which were drawn from deductions in workers' wages and from employers' contributions.
Other countries soon began to follow suit. In the United Kingdomthe National Insurance Act provided coverage for primary care but not specialist or hospital care for wage earners, covering about one third of the population.
The Russian Empire established a similar system inand other industrialized countries began following suit. By the s, similar systems existed in virtually all of Western and Central Europe.
Japan introduced an employee health insurance law inexpanding further upon it in and Following the Russian Revolution ofthe Soviet Union established a fully public and centralized health care system in In New Zealanda universal health care system was created in a series of steps, from to Following World War IIuniversal health care systems began to be set up around the world.
Universal health care was next introduced in the Nordic countries of Sweden Iceland Norway Denmark and Finland Universal health insurance was implemented in Australia beginning with the Medibank system which led to universal coverage under the Medicare system.
From the s to the s, Southern and Western European countries began introducing universal coverage, most of them building upon previous health insurance programs to cover the whole population. Following the collapse of the Soviet Union, Russia retained and reformed its universal health care system,  as did other former Soviet nations and Eastern bloc countries.
Health care economics Universal health care in most countries has been achieved by a mixed model of funding. Almost all European systems are financed through a mix of public and private contributions. Some nations, such as Germany and France  and Japan  employ a multipayer system in which health care is funded by private and public contributions.
However, much of the non-government funding is by contributions by employers and employees to regulated non-profit sickness funds. Contributions are compulsory and defined according to law. A distinction is also made between municipal and national healthcare funding.
For example, one model is that the bulk of the healthcare is funded by the municipality, speciality healthcare is provided and possibly funded by a larger entity, such as a municipal co-operation board or the state, and the medications are paid by a state agency.
A paper by Sherry A. Glied from Columbia University found that universal health care systems are modestly redistributive, and that the progressivity of health care financing has limited implications for overall income inequality.
National health insurance This is usually enforced via legislation requiring residents to purchase insurance, but sometimes the government provides the insurance. Sometimes, there may be a choice of multiple public and private funds providing a standard service as in Germany or sometimes just a single public fund as in Canada.
Thus, a fund with a predominantly healthy, younger population has to pay into a compensation pool and a fund with an older and predominantly less healthy population would receive funds from the pool. In this way, sickness funds compete on price, and there is no advantage to eliminate people with higher risks because they are compensated for by means of risk-adjusted capitation payments.
Funds are not allowed to pick and choose their policyholders or deny coverage, but they compete mainly on price and service.
In some countries, the basic coverage level is set by the government and cannot be modified. The government later opened VHI to competition but without a compensation pool. That resulted in foreign insurance companies entering the Irish market and offering cheap health insurance to relatively healthy segments of the market, which then made higher profits at VHI's expense.
The government later reintroduced community rating by a pooling arrangement and at least one main major insurance company, BUPA, then withdrew from the Irish market. Among the potential solutions posited by economists are single-payer systems as well as other methods of ensuring that health insurance is universal, such as by requiring all citizens to purchase insurance or limiting the ability of insurance companies to deny insurance to individuals or vary price between individuals.
Single-payer health care Single-payer health care is a system in which the government, rather than private insurers, pays for all health care costs. Although the fund holder is usually the state, some forms of single-payer use a mixed public-private system. Tax-based financing[ edit ] In tax-based financing, individuals contribute to the provision of health services through various taxes.
These are typically pooled across the whole population, unless local governments raise and retain tax revenues. Other countries with insurance-based systems effectively meet the cost of insuring those unable to insure themselves via social security arrangements funded from taxation, either by directly paying their medical bills or by paying for insurance premiums for those affected.
Social health insurance[ edit ] In a social health insurance system, contributions from workers, the self-employed, enterprises, and governments are pooled into a single or multiple funds on a compulsory basis. It is based on risk pooling.
Preventive and public health care may be provided by these funds or responsibility kept solely by the Ministry of Health. Within social health insurance, a number of functions may be executed by parastatal or non-governmental sickness funds or in a few cases, by private health insurance companies.
Social health insurance is used in a number of Western European countries and increasingly in Eastern Europe as well as in Israel and Japan.Guidance, advice and information services for health, public health and social care professionals.
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