Universal Health Insurance

. Rhheumatic heart disease and universal health care | Policy Brief.

History[edit]

In 1883, the first step towards state health insurance was taken in Germany with the Health Insurance Act. Industry employer were given the task of taking out accident and health insurance for their low-paid worker, and the system was financed and managed by employee and employer through "sickness insurance funds", which were deducted from employee pay and employer contribution.

The United Kingdom's National Insurance Act of 1911 provided basic (but not specialised or hospital) insurance for employees, which covered about one third of the UK workforce. Similar schemes were in place in almost all of West and Central Europe in the 1930s. Here, the system is based on a combination of the two. In 1927 Japan enacted a health insurance act for employees, which was further expanded in 1935 and 1940.

After the Russian Revolution of 1917, the Soviet Union in 1920 set up a fully functioning and centralised health system. 6 ][7] At that time, however, it was not yet a truly universal system, as the country dwellers were not included. A universal health system was set up in New Zealand in several stages, from 1939 to 1941.

After the Second Word War, the development of universal health services all over the globe began. The United Kingdom started its universal national health service on 5 July 1948. General health services were next established in the northern European states of Sweden (1955),[10]Iceland (1956),[11]Norway (1956),[12]Denmark (1961),[13] and Finland (1964). 14 ] General health insurance was then gradually implemented in Japan (1961) and Canada, beginning with the provinces of Saskatchewan in 1962, followed by the remainder of Canada from 1968 to 1972.

8 ][15] In 1969, the Soviet Union expanded the universal health services of its people. 8 ][16] Italy established its Servizio Sanitario Nazionale (National Health Service) in 1978. In Australia, universal health insurance was established, starting with the Medibank system, which resulted in universal Medicare insurance cover. South and West Europe began to introduce universal health insurance from the seventies to the 2000s, mostly based on earlier health insurance programmes covering the entire populations.

France, for example, based its 1928 health insurance system on its own, with successive laws spanning an increasing proportion of the country's total health care system until the other 1% of the non-insured were covered in 2000. 17 ][18] In a number of Asiatic states, such as South Korea (1989), Taiwan (1995), Israel (1995) and Thailand (2001), general health insurance was also established.

In the aftermath of the break-up of the Soviet Union, Russia maintained and reformed its universal health system[19], as did other former USSR states and East Block states. As a result, overseas insurance firms entered the Ireland insurance markets and offered relatively sound markets low-cost health insurance, which then generated higher profit at the cost of VHI.

Governments later reinstated communal ratings through a pools system, and at least one large insurance firm, BUPA, retreated from the Ireland one. Health insurance with a sole funding body is a system in which the health insurance companies, not the public ones, cover all the health insurance expenses. 34 ] Single-payer schemes may own and use health service from either individual organisations (as in Canada) or health resource and staff (as in England before the Health and Social care Act was introduced).

"Individual payer" thus merely designates the financial mechanisms and relates to health coverage funded by a unique government agency from a unique endowment and does not indicate what kind of supply or for whom physicians work. When it comes to fiscal finance, individual persons make a contribution to the rendering of health benefits through various types of income taxes. A number of Member States (notably the United Kingdom, Canada, Ireland, New Zealand, Italy, Spain, Portugal and the Scandinavian countries) opt to finance health directly from VAT alone.

Others with insurance-based schemes actually bear the costs of insurance for people who cannot be insured through tax-funded welfare schemes, either by direct payment of their health invoices or by payment of insurance premium for those concerned. Some universally covered jurisdictions often exclude from personal insurance many health situations that are costly and can be provided by the public health system.

In the UK, for example, one of the biggest privately owned healthcare service provider is BUPA, which even in its highest cover policy has a long history of general exceptions[39], most of which are provided on a routine basis by the National Health Service. U.S. governments, rather than insurance companies, generally pay for end of line kidney disease treatments.

Medicare Advantage patients are the exceptional ones who have to pay for their treatment through their insurance companies, but in the case of end-stage kidney disease they generally cannot buy Medicare Advantage treatment at all. In the Netherlands, which have organised rivalry over their primary insurance system (but are capped ), insurance companies must provide a base coverage for all applicants, but can select what benefits they want to include in other, extra schemes (which most individuals have - quotation required).

India's Planning Commission has also proposed that the nation should take out insurance to obtain general health insurance. 41 ] The general income is currently used to satisfy the basic health needs of all human beings. One particular type of health insurance that has often developed when the effects of purely financially sound protective measures are restricted is community-based health insurance.

Some members of a particular municipality contribute to a joint health insurance scheme, from which they can receive health assistance if necessary. The universal health system varies according to the level of public participation in long-term nursing and/or health insurance. However, in some jurisdictions, such as the UK, Spain, Italy, Australia and the Nordic region, the UK has a high level of participation by the governments in contracting or delivering health service and accessibility is dependent on residency rather than insurance.

Some have a much more pluralist supply system, with compulsory health care as the basis, with contribution levels related to wages or incomes, usually co-financed by employer and beneficiary. Sometimes health insurance schemes are made up of a mix of insurance premia, compulsory salary-related payments by workers and/or the employer to statutory health insurance schemes and state taxation.

Those insurance-based schemes have a tendency to pay back either commercial or government health care provider, often at highly competitive tariffs, through reciprocal or government health underwriters. Certain jurisdictions, such as the Netherlands and Switzerland, act through highly regulatory yet independent insurance companies that are not permitted to make a gain from the obligatory insurance component but can benefit from the sale of supplementary insurance.

The universal health system is a comprehensive approach that has been put into practice in various ways. All these programmes share a single negative denominator: a type of governance that aims to maximise health services and set minimal norms. The majority implements universal health services through law, regulations and taxes.

Law s and regulations determine what kind of nursing services are to be provided, to whom and on what bases. Usually some expenses are paid by the patients at the moment of use, but the majority of the expenses come from a mixture of mandatory insurance and fiscal revenue. Others use taxes either to finance insurance for the very needy or the very needy.

In 2003, the UK National Audit Office released an internationally comparative report on ten different health schemes in ten advanced economies, nine universal schemes versus one non-universal system (the United States) and their comparative cost and main health outcome. A more comprehensive comparative study of 16 universal healthcare jurisdictions was released by the World Health Organization in 2004.

In some cases, participation by the authorities also involves direct management of the health system, but many governments use joint public-private schemes to provide general health services. o n e r Weltgesundheitsorganisation (22 November 2010). "Weltgesundheitsbericht: Finanzierung der Gesundheitssysteme: der Weg zur flächendeckendeckendecken Versorgung". I' m not the only one in the WHO.

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