Koji bi model zdravstevnog osiguranja najbolje odgovarao Hrvatskoj?

[InterMezzo]

Predlazem 4 moguca sistema za anketu. Podrobnije na engleskom jeziku ispod...

Beveridge Model - po uzoru na britanski, financiran od strane vlade kroz poreze.

Bismarckov Model - po uzoru na onaj u Njemackoj, ukljucuje osiguranja

Nacionalni Model Zdravstvenog Osiguranja - hibrid Beveridge i Bismarckovog modela, prisutan u Kanadi

Model u kojem pacijent sve placa iz svojega dzepa - prisutan u zemljama treceg svijeta, bez utjecaja drzave i bez osiguranja.

The Beveridge Model

Named after William Beveridge, the daring social reformer who designed Britain’s National Health Service. In this system, health care is provided and financed by the government through tax payments, just like the police force or the public library.

Many, but not all, hospitals and clinics are owned by the government; some doctors are government employees, but there are also private doctors who collect their fees from the government. In Britain, you never get a doctor bill. These systems tend to have low costs per capita, because the government, as the sole payer, controls what doctors can do and what they can charge.

Countries using the Beveridge plan or variations on it include its birthplace Great Britain, Spain, most of Scandinavia and New Zealand. Hong Kong still has its own Beveridge-style health care, because the populace simply refused to give it up when the Chinese took over that former British colony in 1997. Cuba represents the extreme application of the Beveridge approach; it is probably the world’s purest example of total government control.

The Bismarck Model

Named for the Prussian Chancellor Otto von Bismarck, who invented the welfare state as part of the unification of Germany in the 19th century. Despite its European heritage, this system of providing health care would look fairly familiar to Americans. It uses an insurance system — the insurers are called “sickness funds” — usually financed jointly by employers and employees through payroll deduction.

Unlike the U.S. insurance industry, though, Bismarck-type health insurance plans have to cover everybody, and they don’t make a profit. Doctors and hospitals tend to be private in Bismarck countries; Japan has more private hospitals than the U.S. Although this is a multi-payer model — Germany has about 240 different funds — tight regulation gives government much of the cost-control clout that the single-payer Beveridge Model provides.

The Bismarck model is found in Germany, of course, and France, Belgium, the Netherlands, Japan, Switzerland, and, to a degree, in Latin America.

The National Health Insurance Model

This system has elements of both Beveridge and Bismarck. It uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into. Since there’s no need for marketing, no financial motive to deny claims and no profit, these universal insurance programs tend to be cheaper and much simpler administratively than American-style for-profit insurance.

The single payer tends to have considerable market power to negotiate for lower prices; Canada’s system, for example, has negotiated such low prices from pharmaceutical companies that Americans have spurned their own drug stores to buy pills north of the border. National Health Insurance plans also control costs by limiting the medical services they will pay for, or by making patients wait to be treated.

The classic NHI system is found in Canada, but some newly industrialized countries — Taiwan and South Korea, for example — have also adopted the NHI model.

The Out-of-Pocket Model

Only the developed, industrialized countries — perhaps 40 of the world’s 200 countries — have established health care systems. Most of the nations on the planet are too poor and too disorganized to provide any kind of mass medical care. The basic rule in such countries is that the rich get medical care; the poor stay sick or die.

In rural regions of Africa, India, China and South America, hundreds of millions of people go their whole lives without ever seeing a doctor. They may have access, though, to a village healer using home-brewed remedies that may or not be effective against disease.

In the poor world, patients can sometimes scratch together enough money to pay a doctor bill; otherwise, they pay in potatoes or goat’s milk or child care or whatever else they may have to give. If they have nothing, they don’t get medical care.

The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody.

Note - Reid’s “Beveridge” model corresponds to what PNHP would call a single payer national health service (UK); “Bismark” model refers to countries that PNHP would say use non-profit “sickness funds” or a “social insurance model” (Germany); and “National health insurance” corresponds to single payer national health insurance (Canada, Taiwan). Reid’s “out-of-pocket” model is what PNHP would call “market driven” health care. Some countries have mixed models (e.g. Sweden has some features of a national health service such as hospitals run by county government; but other features of national health insurance such as physicians being paid on a FFS basis). This explains why Reid might classify the Scandinavian systems as “Beveridge” while PNHP classifies them as “single payer national health insurance.”

[nasmijanonebo]

Koji model je u praksi ispao najbolji za najsiri krug stanovnistva?
Bismarckov?

Pitam jer me vise zanima praksa nego teorija.

[kuroishijin]

Jugoslovenski model , cemu izmisljanje tople vode lol.

[InterMezzo]

nasmijanonebo kaže:

Koji model je u praksi ispao najbolji za najsiri krug stanovnistva?
Bismarckov?

Pitam jer me vise zanima praksa nego teorija.

Primjeri zemalja su navedeni, a u tim zemljama vec postoji odredjena, cak i dugorocna, praksa.

Od zemalja koje sam posjetio ili u kojima sam zivio, negdje sam izmedju Kanadskog i Njemackog sistema. Glas bih dao lagano vise onom Kanadskom.

[InterMezzo]

Trebao sam temu postaviti nesto kao: "Da li je Yu 1989. godine imala bolje zdravstveno osiguranje no Hrvatska danas". Sigurno bi bilo puno vise odgovora.

[nasmijanonebo]

Haha, tocno..
Ne znam, mislim da je njemacki sustav (Bismarckov) najefikasniji po pricama s ljudima iz Kanade i Njemacke.
Pricali su mi Kanadjani o dugim cekanjima, o losem stanju u odredjenim bolnicama i sl. Cak i lijecnik u Kanadi se zali. Od nasih u Njemackoj sam cula same pohvale, kao i od Nijemaca, samo se neki lijecnici zale da ima i tu malo previse birokracije.

Ako moram birati od svih modela, intuitivno biram Bismarckov.

[InterMezzo]

Ex Yu je bila najbliže Beveridge modelu. ???

[nasmijanonebo]

Ne znam, valjda.
Ma u danasnjem hr zdravstvu se ima novaca, izdvajaju se veliki novci, samo je najveca boljka organizacija poslovanja u zdravstvu, rasporedjivanje novaca..ne zna se tko pije, tko placa, tu lijecnici mogu najmanje nesto napraviti..jedino da se udruze i pokrenu stvari..