Health Care Systems Overview

A healthcare system where patients can only see specialists after being referred by their general practitioner (GP).

Countries with gatekeeping systems require a referral from a GP to see a specialist. Examples include Australia, Denmark, and the UK.

Countries with non-gatekeeping systems allow patients to choose whether or not to see a specialist with or without a referral from a GP. Examples include Austria, France, and the US.

A healthcare system where patients have the freedom to choose their healthcare providers, often with choices between public and private options.

Countries with complete freedom of choice allow patients to select any healthcare provider, including public and private options. Examples include Australia, Austria, and Germany.

Countries with free choice among public and approved private providers allow patients to choose from public providers or a limited selection of private providers. Examples include Denmark, Finland, and the UK.

Countries with limited choice may have restrictions on provider selection, often with some level of government control. Examples include Hungary, New Zealand, and the US.

General practitioners (GPs) can practice independently (solo practice) or as part of a group. Solo practices may have challenges with consistency and coordination while group practices can share resources and collaborate.

The idea that the dominant political culture within a nation influences its healthcare system.

A healthcare system where individuals are responsible for purchasing health insurance and accessing medical care.

A healthcare system financed through mandatory contributions from both employers and employees.

A healthcare system where the government is the primary provider of health services and funding comes from general taxation.

The political ideologies of ruling governments can influence the type of healthcare system implemented.

This model emphasizes individual choice and responsibility for health insurance.

This model prioritizes social solidarity and ensures access to healthcare for all.

This model emphasizes shared responsibility and uses social insurance mechanisms for healthcare.

A healthcare system where financing and provision are managed separately. This means insurance funds are raised through various channels like taxes or contributions but are not directly used to deliver care, which is managed by independent providers.

A healthcare system that combines financing and provision under a single, centralized organization. This means that the organization responsible for raising funds also delivers healthcare services, with a unified budget and administration.

A healthcare system where all citizens are covered for a wide range of healthcare services, regardless of their ability to pay. This is typically funded through taxes or social insurance contributions.

A healthcare system financed through mandatory contributions from individuals and employers, which funds healthcare services. This model is common in many European countries.

The core concept of healthcare that emphasizes a gradual progression of healthcare systems over time. This path typically starts with voluntary insurance, advances to mandatory social insurance, and eventually evolves towards universal healthcare coverage.

A requirement for all individuals to purchase health insurance or pay a penalty. Exemptions exist for religious reasons and low-income households. Penalties were abolished in 2019.

State-regulated marketplaces that allow individuals and small businesses to compare and purchase insurance plans.

Financial assistance provided to low-income individuals and families up to 400% of the poverty level to help them afford healthcare.

Regulations that require insurance companies to offer equal premiums to all applicants of the same age and location, regardless of gender or pre-existing conditions.

Expanding Medicaid coverage to include all individuals and families up to 138% of the poverty level.

A social insurance system where most funding comes from contributions, with a smaller portion from general taxation and out-of-pocket payments.

The percentage of funding for the German healthcare system that comes from contributions to statutory health insurance.

The percentage of funding for the German healthcare system that comes from general taxation.

The idea that different political ideologies influence healthcare systems. Conservative and liberal parties often favor different systems, with the former preferring SHI and the latter supporting NHS.

Actors like government, healthcare professionals, unions, employers, political parties, and insurance companies compete to influence healthcare policy.

The concept that three factors - ideas, interests, and institutions - influence healthcare policies. Ideas represent the overarching political beliefs, interests encompass the goals of different groups, and institutions refer to the existing healthcare system.

The highest healthcare spending among developed countries, with 16% of GDP allocated to healthcare.

A significant issue in US healthcare, with over 50 million Americans lacking health insurance.

A major challenge in US healthcare, reflecting the high cost of health insurance premiums.

The Italian healthcare system blends public and private services, with the National Health Service (SSN) providing around 51% of healthcare, while private providers contribute 49%.

The National Health Service (SSN) in Italy is funded primarily (76%) through tax revenues, while the remaining 24% comes from private sources, including out-of-pocket payments and private health insurance.

People in Italy often opt for private healthcare services, primarily because of shorter waiting times, the ability to choose their doctor, and easier access.

A growing trend in Italy is the increasing use of private health insurance, with almost 30% of the population now having some form of supplementary health coverage.

Private healthcare providers in Italy often work with the public sector through special agreements, allowing them to participate in the delivery of healthcare services.

The Italian healthcare system has undergone significant reforms over the past three decades, with a focus on increasing competition and improving efficiency.

The percentage of public healthcare spending compared to private healthcare spending across different OECD countries.

Compares hospital bed availability across different OECD countries.