FUTURE PAYMENT MODEL FOR MEDICAL ENTREPRENUERSHIP

The Different Forms of Health Payment

1. Fee-for- Service
2. Scheme Payment
3. Out-of-Pocket
4. Cost Sharing
5. Capitation
6. Co-payment Scheme
7. Retrospective Payment (Forms) e.g Fee-for Service
8. Prospective Payments (Forms) e.g Capitation, case-based payments/diagnostic related group and
Salary and global budget
9. Pay-for- Performance (Performance Incentives)
10. Mixed Financing Moedl ( a PPS and performance bonus)

Jabeen, Rabbani and Feroz (2021) investigated into the comparative analysis of health care
system of Iran and Nigeria: using WHO Building blocks. The comparative was based on
building blocks of health services deliveries, Human resources capacity and training,
innovativeness of pharmaceutical services, availability of health information systems, financial
patterns to health care services and payments and regulatory and governance of the health sector.
The study concludes that the national budget should improve the percentage apportioned to
health care services, delivery of health care should be accessible to all classes of citizens, the
health Insurance welfare scheme of Nigeria, been 5% one of the lowest in West African
countries should be revitalized, they should be a consensus between prescription of modern and
traditional medicine, so has to improve foreign pharmaceutical companies.
Tikkanes. Osburn, and Mossales (2020) investigated into the International Profits of Health Care
System across the Developed countries. The Australian health care system induce their payment
system to various age group through the use of federal and state scheme having the categorical
distribution of the population eligible to the scheme (it is funded by tax revenue). The Brazil
health care system made us of the SUS Financing method, but to larger perspective the health
care system is a bit porous un terms of the ideology of the out of pocket and cost-sharing reality
to all the populace in the region.
The Canadian health care is funded and administered primarily by the country’s 13 provinces
and territories, the benefits and delivery approaches vary in terms of the class of citizens. The
Chinese health care is funded primarily via employer and employee payroll taxes for urban
settlers, the Urban-Rural resident basic Medical Insurance is financed by the central and local
governments through individual premium subsides. The copayment and out-of-the pocket model
is employed in this country. The Danish health care system practice a health care system that is
publicly financed by the government giving block grants from tax revenue to recognized regions
and municipalities. Other health needs could be reached by the copayments model for outpatient
drugs, dental care and other services. The English health care is attributed with the fact that all
residents either citizens or immigrants are entitled health care services under the National Health
service that is funded through taxation.
The French health care sets the national health strategy and allocates budgeted expenditures to
regional health agencies which are responsible for planning and service delivery. The French
health care system adopts that Danish and English health care model. The German health care is
a mandatory statutory health insurance scheme, that provides inpatient outpatient, mental health
and prescription of drug coverage. The health scheme is termed sickness fund that is deducted
from the wages and salary of employers and worker. The copayments model is also used by
inpatient. The India health care is a decentralized approach in delivery of health care to its
citizens. The states are primarily responsible for health care services through the national health
Protection scheme that is sectionalized for specific population and factory worker. In order to
meet their immediate health needs the out-of-the-pocket model is also attained by the populace
due to the poor infrastructural amenities and always rising birth rate.
The Israeli health care is a universal coverage national health insurance scheme, enacted by law.
But residents have the benefits of choosing among the four non-profit health plans that have
similar mandated benefit package. The Italy health care covers all citizens and legal foreign
residents and it is funded by corporate and value-added tax revenue collected by the central
governments and distributed to the regional governments. The Japanese health care is a universal
coverage health care scheme, funded primarily by taxes and individual contributions. The
enrollment is either an employment-based or residence based health insurance plane. The system
requires an annual household out-of-the-pocket fund maximum for citizens to meet young
children and older adult’s health needs. The Dutch Health Care System merges public and
private social health insurance, it is expected that all residents purchase statutory health
insurance from private insurers, which are required to accept all applicants. It financed through
premiums, tax revenue and government grants. The New Zealand health care is publicly funded
and regionally administered delivery system. The systems are financed through tax revenue from
the central government. The Norwegian health care is a universal health coverage, funded
primarily by general taxes and by payroll contributions funded by the employers and employees.
The Singapore health care is a mixed financing system of the public statutory insurance system
and MediShield Life. The MediShield covers large bills for hospital care, at a particular limit for
individuals and receives subsidies. And also a health savings account is maintained by the
residents. The Swedish health care nationally regulated and administered locally. The funding
comes primarily from the regional and municipal level taxes. The regions set provider fees and
copayment models at all levels of care.
The Switzerland health care is highly decentralized with states playing a key role in its
operations. The system is funded through enrollee premiums, taxes. Social insurance
contributions and out-of-payments models. It is expected that residents are to purchase health
insurance from private non-profit insurer. The Taiwan’s health care is universal and mandatory,
it is a single-payer system and funded primary through premiums, government subsidies to low-
income earners. The contracted private providers of health care receive out-of-the pocket costs
for some services and products. The U.S health system is a mix of public and private, for profit
and non-profit insurers and health care providers. The federal government provides funding
under some programs to some special groups of citizens and the state also fund some local areas,
while other are private insurance is provided by employers. The Affordable Care act allows that
private insurers to set the benefits and cost-sharing structures with the federal and state
regulations.
Si Yun- Tan and Meledez- Torres (2017) examines the cost-effect, benefits and implementation
practices of PPS (Prospective payment System) in the middle- income countries. The PPS
theoretical ideal is to increase efficiency and reduce the triad healthcare problem between
providers, payers and patients. The study was able to empirically conduct a systematic review of
health policy journals of 14 databases using Drummond 10-tem checklist, Cochrane
Collaboration’s tool and Risk of Bias evaluation to draw the cogent theme of prospective
payment system in the selected continents. The findings revealed that PPS (Prospective payment
system) has been able to be beneficial to the demand side and supply side of health parties. The
policy and model has been able to curb wastage and implore efficiency and confidence on the
part of the parties to health care in an economy.
Randall, Chen and Luscombe (2014) examines the comparisons of health insurance system in
developed countries beaming light to who bears the risk, what choices are allowed, how much
health spending burdens are redistributed, sources of revenue, cost savings strategies and the use
of specialized and secondary insurance. The study was able to various agents in the health
insurance system explaining the roles and responsibilities and function in the proposed and
practiced scheme. It also depicts the dual responsibility of the agents. The four structure of health
care payments includes; private good market without insurer; Reimbursement Insurance;
Conventional Insurance and Sponsored health insurance. The contractual relationship between
agents of the health insurance scheme differentiated in accordance to money and service
rendered. The breath of coverage of the primary insurance programs in the developed countries
are in certain higher percentage to the lower percentage. U.S population has 83% coverage of
citizens that have access to health insurance schemes. The cost containment strategy includes the
demand side cost sharing; supply-side cost sharing and non-price rationing.