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MEDICAL ENGLISH · MEDICAL ISSUES · PRE-INTERMEDIATE (A2-B1)

HEALTHCARE
SYSTEMS

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1 Warm up

In pairs, discuss the questions below.

1. How does healthcare work in your country?

2. Do you have to pay for it? How?
3. Who provides it: the government or private companies?
4. Do you think the system is efficient? How could it be better?
5. Do you know any other healthcare models around the world?

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HEALTHCARE SYSTEMS

2 Prepare for reading

You are going to read a text about healthcare systems. Match some of the words in the text with their
meanings.

1. contribute a. work in a given way

2. health fund b. be in charge of a business

3. operate c. that has lots of industries

4. run d. something that you have to pay for when you use it

5. industrialised e. the effect something has on somebody or something

6. out-of-pocket f. an amount of money that has been saved to spend on

health
7. impact g. give money or goods

3 Reading for gist

Read the article and complete the table with the words below.

the Beverdige the Bismarck the National the

Model Model Health Insurance Out-of-Pocket
Model
2
Where? Spain and Canada and Parts of
1 3 4
and Japan
and South
America

Who pays for it? the government businesses and the government the
5 7
(through
6
) (when using)

8
Who provides it? private private private
healthcare companies companies and
organisations doctors

Advantages controlled cheaper for the cheaper to run low cost for
9
government government

Disadvantages long waiting problem for long many people

11
times those without don’t see the
10
times doctor
12

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HEALTHCARE SYSTEMS

Healthcare systems around the world

Public health is an important issue in any country, but different governments deal with the issue in
different ways. In this article, we will see the four main healthcare models around the world.

1. The Beveridge Model

In this model, which can be seen in countries like Spain and the UK, the government controls both sides. Through
taxes, it collects the funds to provide healthcare to all citizens. So, there is no extra payment when the service
is provided. This system has the advantage of keeping costs low because healthcare professionals work for the
government, which also controls prices of medication. On the other hand, in this model there may be long waiting
times for surgeries and treatments as people might overuse the system.

2. The Bismarck Model

In this system, found in countries like France and Japan, healthcare is paid for by companies and their employees.
Businesses have to collect money from their workers and contribute themselves, creating a health fund. Private
healthcare organisations usually provide medical services, although the government still controls prices tightly.
This system is less expensive for the government, but it is centred on employed citizens and can be a problem for
those who are unemployed. It is also more expensive for international companies in countries with this system,
so they might prefer to operate from other places.

3. The National Health Insurance

This healthcare model, seen in countries like Canada and Australia, mixes the first two systems: the state collects
money through an insurance* system and pays for healthcare, as in the Beveridge model, but the services are
provided by private companies, as in the Bismarck model. The insurance programs are cheap to run because there
is no profit and prices are controlled but waiting times can also be high.

4. The Out-of-Pocket Model

Mostly developed, industrialized countries - about a fifth of the world - have an organised healthcare system. In
the rest of the world, the population have to pay private companies and doctors for healthcare when they need
to use it. The out-of-pocket model can be found in large areas of Africa and South America, but also parts of the
population in developed countries like the USA also depend on this system. Although the cost for the government
is low, the problem with this system is that the quality of the healthcare people receive is directly related to how
much money they have. Therefore, many people don’t visit the doctor regularly, which can have a strong impact
on individual and public health.

Source: pnhp.org

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HEALTHCARE SYSTEMS

4 Reading for detail

Read the text again and complete the sentences with words from the text.

1. In the Beveridge model, the government employs healthcare professionals and controls the prices
of .

2. However, people might the system, which can cause long waiting times.

3. One of the disadvantages of the Bismarck system is that it is more expensive for
to operate in the country.

4. The National Healthcare Insurance model elements of the Beveridge and the
Bismarck models.

5. Only a of the countries in the world have an organised healthcare system.

6. The out-of-pocket system is used mostly in underdeveloped countries, but also parts of the
population in developed countries like .

7. There is an impact on individual and health when people don’t visit the doctor as
regularly as they should.

5 Speaking

In groups of four, choose a healthcare system and explain it to the others.

You should mention:

• how it works,
• who pays for it,
• who provides the healthcare services,
• the advantages and disadvantages of the system.

6 Writing preparation

Read the following text about Healthcare in the UK and mark the sentences true (T) or false (F).

1. The NHS has existed for over seventy years.

2. The government uses tax money to pay for healthcare.

3. Patients usually see a specialist first.

4. You might have to wait a lot for some procedures in the UK.

5. The NHS system costs less to the government in times of a crisis.

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HEALTHCARE SYSTEMS

Healthcare in the UK

The current healthcare system in the UK, the National Health System (or NHS) was created
in 1948 and is based on the Beveridge model of healthcare.
The NHS is free at the point of delivery, which means anyone can use it without paying
extra. Healthcare is provided by a single payer – the government – and is paid for by
taxes, just like education and other services. The government also employs most healthcare
professionals and buys medication at controlled costs.
When using the NHS, patients are usually first seen by their GP, or General Practitioner,
at a clinic near their homes. If necessary, they are then referred to other services and
professionals within the NHS.
In this system, everyone has access to healthcare, but as the services are free, the waiting
times can be quite long, especially for specific procedures. Another problem with this type
of healthcare is that when there is a crisis and people need to use the system more, the
government has to spend a lot more public money. COVID-19 was a good example of this:
the economic effects of the pandemic will be felt for many years.

7 Writing

Research and write a blogpost about the healthcare system in your country.

You should mention:

• what type of system it is (e.g., Beveridge, Bismarck, National Insurance, out-of-pocket),

• how it works,
• who pays for it,
• who provides the healthcare services,
• the advantages and disadvantages of the system.

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HEALTHCARE SYSTEMS

8 Extension activity 1: vocabulary

Find words in the article that match the definitions below.

1. (n.): the activity of providing medical care

2. (n): money that the population pays to the government for services

3. (n): how long a patient needs to wait for a treatment

4. (adj.): without a job

5. (n): an agreement in which you pay a company money, and they pay your
costs in case of an emergency, etc.
6. (n): money that businesses make after paying costs

7. (adj.): having developed industries

9 Extension activity 2: project

Record a video talking about healthcare in your country.

You should mention:

• what type of system it is

• what you think of it
• your personal experience with it

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