Bismarck model
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The Bismarck Model (also referred as "Social Health Insurance Model") is a limited health care system, in which people pay a fee to a fund that in turn pays health care activities, that can be provided by State-owned institutions, other Government body-owned institutions, or a private institution.[1] The first Bismarck model was instituted by Otto von Bismarck in 1883 and focused its effort in providing cures to the workers and their family.[2] Since the establishment of the first Beveridge Model in 1946, where the focus was into providing healthcare as a human right to everyone with funding through taxation, nearly every Bismarck system became universal and the State started providing insurance or contributions to those unable to pay.[3]
Examples
States such as Germany, Austria, Switzerland and Czech Republic have Bismarck healthcare, while States such as South Korea[4] and the Netherlands[5], while having a basic state insurance, have a much stronger private presence in the healthcare providers and insurances systems.[6]
In Europe, countries like France, Hungary and Slovakia, while theoretically Beveridge system, have some degree of Bismarck politics in their laws.[7] Some in Italy argue that the Lombard socio-health system, which prescribe equality between private and public sector and payment by performance, has some typical characteristic of a Bismarck system.[6]
Advantages
The Euro health consumer index calls the statement "Bismarck beats Beveridge" a "permanent feature" since 2014. Bismarck systems usually have a significantly higher accessibility, lower waiting times and, thanks to the competition between operators, a higher quality and a consumer oriented healthcare.[8]
Studies show that the introduction of the Bismarck system in Germany led to a significant drop of mortality.[9]
Criticism
Since in the Bismarck health system the core financing are contributions happens that people in poverty can't pay and get a limited coverage. In some country, like Switzerland, the cost of insurance is high and continue to grow, leading part of the population to be under-insured.[10]
Another criticism is that since institutions are paid by performance some isolated localities may have little hospital coverage. [1]
While primary care is significantly faster to get in a Bismarck system than in a Beveridge system some argue that some elective care may be slow to get even in a Bismarck system than in a free-market healthcare, like the US.[1]
References
- ^ a b c International Health Care Systems Part 3: The Bismarck Model
- ^ German health care: a bit of Bismarck plus more science
- ^ L’EVOLUZIONE DEI MODELLI SANITARI INTERNAZIONALI A CONFRONTO - AIOP Giovani
- ^ Republic of Korea health system review
- ^ The Dutch Health Care System - The Commonwealth Fund
- ^ a b Newsletter WYO
- ^ How European nations run national health services
- ^ Single-Payer Isn’t The Answer
- ^ Bismarck’s health insurance and its impact on mortality
- ^ In 170'000 non pagano l'assicurazione sanitaria
Category:Universal health care
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