Running head: HEALTH CARE MODELS

Health Care Models

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HEALTH CARE MODELS

Health Care Models

Various options for healthcare systems exist throughout the world. Option whether a
particular healthcare system is correct or incorrect often depends on if the person being asked
leans more left or right. Each country has a different and sometimes similar healthcare models,
and the current model that is in place in the United States is changing since the onslaught of
Obamacare. This essay will investigate four healthcare systems throughout the world including
public payer/public provider, private payer/private provider, private provider/public payer, and
public provider/private payer. In investigating each of these models, the benefits and drawbacks
of each will be examined. Ultimately, the mixed model system in the United States is effective at
addressing the healthcare needs of the majority of people, and is the most beneficial system for
the public.
Public Payer/Public Provider
The public payer and public provider model, also known as universal healthcare, is a
system in place in Canada and England, and is a component of the United States healthcare
system. One of the major concerns with the universal healthcare model is the fact that costs to
the taxpayer can be significant. This is because in order to fund the system, it is necessary to use
public funds. This can result in people paying higher taxes, and it can diminish the amount of
public money that is available to other public services, such as roads and social programs, for
example.
The benefits of universal healthcare include:
-

People do not remain in jobs they do not like because they are afraid of losing coverage

(Lavidge, 2008).
People do not have to go into significant debt, such as mortgaging their house so they can
pay medical bills (Lavidge, 2008).

HEALTH CARE MODELS

-

No one has to worry about having a serious illness and to worry about the insurance
company not paying for medical costs due to reaching maximum coverage, for example
(Lavidge, 2008).
Private Payer and Private Provider
The private payer and private provider model sometimes referred to as the Bismarck

model provides health care to the citizens. The model uses an insurance system where the
insurers are referred to as the sickness funds (Boylan, 2008). It is financed by both the workers
and their employers through a deduction in their payroll. Bismarck model usually covers
everyone in the society, an indication that it serves the interest of the people. It is a not-for-profit
plan. The health practitioners and the health facilities tend to be private in the regions that
practice private payer and private provider model. Most the regions have more private hospitals
as compared to the public facilities (Fincham, 2009).
Benefits of private payer and private provider model

Holders of the insurance are safer with their insurance as the charges from their payroll is
insignificant

Holders of the insurance are assured of the services since they were guaranteed by their
employers

Payment of the premiums is constant though it depends on the employer

The choice of the insurance company depends on the employer

The holder has the advantage of benefiting from getting the best services from the best
insurance company

f.

People should not be worried about being ill or worry about the amount they will

have to pay provided it does not exceed the limit they had insured their lives

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Private provider and public player

The private provider and public player model sometimes referred to as the out-of-pocket
model, is a form of cover that is used mostly in the poor regions (Boylan, 2008). These regions
have minimal health cover available for them and thus, will have to depend on the government
for their medical cover. The large population of these regions may not afford any insurance
cover. In a case where the citizens in these regions need health care, they have to pay for the
services they get on the spot, or they may not receive the services (Fincham, 2009). Based on the
world health organization statistics, people living in such regions have a lower life expectancy.
Based on what is known, the government has to intervene in such regions and introduce a
better way to help these individuals. One way that the government assists these people is through
Medicare and Medicaid. These are health covers that help those who are less fortune in life
(Boylan, 2008). Medicare is a program used to provide the health coverage for people who are
65 years and above, or for those with severe disability despite their level of income. Medicaid is
a state program that offers health coverage to the population that earns a low income. These are
people who are less fortuned when it comes to their living standards. In such cases, the state has
to intercede to ensure that they live in a safer environment (Fincham, 2009).
Benefits of private provider and public player model include the following:
1.

The public does not contribute towards the cover

2.

The holder does not need an insurance company

Public Provider/Private Payer
Public Provider/Private Payer, sometimes called the Beveridge model is a system where

the provider of the health care is the government. The state uses tax payments to finance the
health care services of the members. Most hospitals are normally owned by the federal

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government as some of the practitioners in the hospitals are state employees. However, there are
some who are private doctors, who as part of their duty collect extra fees from the state. Under
the Beveridge model, patients should access to any form of care that they need. It will help in
settling all of their medical bills (Boylan, 2008). Countries that utilize Public Provider/Private
Payer model of health care services usually make payments of their medical care via their tax
system. That means that their tax rate is higher as compared to regions that do not use Public
Provider/Private Payer model. Doctors in such regions are public servants, and most of the
hospitals are state-owned. Every person in the region is given an opportunity to attend any health
care facility of his or her choice (Fincham, 2009). The main goal of the Public Provider/Private
Payer system is to offer high-quality services of medical care to their citizens rather than just
make profits. The government works hard to ensure that the public gets the best out of what they
consider as good health care services.
Benefits of Public Provider/Private Payer model include:
a. Citizens are treated free of charge from any hospital
b. The public does not have to make extra payments as the services are the same

HEALTH CARE MODELS

References
Boylan, M. (2008). International public health policy and ethics. [Dordrecht]: Springer.
Fincham, J. E. (2009). Health policy and ethics. London: Pharmaceutical Press.
Lavidge, K. (2008). Does universal healthcare make everyones life better? Yale University.
Retrieved from http://insights.som.yale.edu/insights/does-universal-healthcaremake-everyones-life-better