Health care models

The Bismarch Model - Germany, Japan, France, Belgium, Switzerland:

• health care providers and payers are private entities
• constructed like basic charities, they cover everybody and are non-profit
• tight regulation of medical services and fees provides cost-control for system

The Beveridge Model - Britain, Italy, Spain:

• health care provided by government and funded through taxes
• medical treatment is a public service (think fire departments and libraries)
• many (sometimes all) hospitals are owned by government
• some doctors are gov't employees some are private, all are paid by the gov't
• closest example to "socialized medicine"
• there are no bills
• government controls what doctors can do and what they can charge (using best practices)

The National Health Insurance Model - Canada:

• providers of health care are private, the payer is a government-run insurance program that every citizen pays into
• national or provincial insurance plan collects monthly premiums and pays medical bills
• no marketing, no underwriting offices needed to deny claims, no profits
• single-payer covering everybody able to negotiate for lower prices
• control costs by limiting medical services and making patients wait for treatment

The Out-of-Pocket Model - Countries too poor and disorganized (Cambodia, India, Egypt):

• rich get medical care, the poor don't
• medical care is paid for by patient, out of pocket, with no insurance or government plan to help

We use elements of all models in America.

For most working people under 65, we use the Bismarck Model - the worker and employer share the premiums for the health insurance policy. The patient pays a co-pay and insurance pays the rest.

For Native Americans, military personnel, and veterans, we use the Beveridge Model - patients never get a medical bill, doctors are government employees working in government-owned clinics and hospitals.

For those over 65, we use the National Health Insurance system, with some members receiving additional coverage through Medicare.

For the 45 million uninsured Americans, we're Cambodia. Folks in this category can access medical care only if they can pay out of pocket for it.