Looking for Content for the Following Websites, looking for developement
http://www.fundedhealthcare.com
http://www.governmentfundedheathcare.com
http://www.govfundedhealthcare.com
http://www.govgrantsfundsloans.com
http://www.govgrantsloansfunds.com
Friday 14 May 2010
Wednesday 12 May 2010
Wanted NHS Health Care Stories
Hello Everyone,
I want to know what you think of the NHS? Has it been good to you? Bad to you?
I read a story on the weekend of a woman who lost her children because she complained about a Doctor, he went to Child Services and they took her children because she had "problems in dealing with professionals"
Some of the doctors I have met shouldn't be doctors, how about you?
Post your comments here..
I want to know what you think of the NHS? Has it been good to you? Bad to you?
I read a story on the weekend of a woman who lost her children because she complained about a Doctor, he went to Child Services and they took her children because she had "problems in dealing with professionals"
Some of the doctors I have met shouldn't be doctors, how about you?
Post your comments here..
I want to Explain the Basics...
From Wikipedia, the free encyclopedia that anyone can edit
Jump to: navigation, search
Universal health care is a system of organized health-care systems built around the principle of universal coverage for almost all members of society, combining mechanisms for health financing and service provision.[1] There is no precise definition of the term "universal" to indicate what percentage comprises "universal" though the number is probably lower than 100% and higher than 95% based on usage of the term.[citation needed]
The World Health Organization regards access to primary care as fundamental to achieving universal health care.[2]
Contents [hide]
1 History
2 Implementation and comparisons
2.1 Americas
2.1.1 Argentina
2.1.2 Brazil
2.1.3 Canada
2.1.4 Colombia
2.1.5 Greenland
2.1.6 Mexico
2.1.7 Peru
2.1.8 Trinidad and Tobago
2.1.9 United States
2.2 Asia
2.2.1 Bhutan
2.2.2 Hong Kong
2.2.3 India
2.2.4 Israel
2.2.5 Macau
2.2.6 People's Republic of China
2.2.7 Singapore
2.2.8 Taiwan (R.O.C.)
2.2.9 Thailand
2.3 Europe
2.3.1 Denmark
2.3.2 Finland
2.3.3 Germany
2.3.4 Ireland
2.3.5 Italy
2.3.6 Netherlands
2.3.7 Russia
2.3.8 United Kingdom
2.3.8.1 England
2.3.8.2 Northern Ireland
2.3.8.3 Scotland
2.3.8.4 Wales
2.4 Oceania
2.4.1 Australia
2.4.2 New Zealand
2.5 Africa
3 Economics
3.1 Funding models
3.1.1 Single payer
3.1.2 Public
3.1.3 Compulsory insurance
3.1.4 Private insurance
4 See also
5 Notes
6 External links
[edit] History
Germany has the world's oldest universal health care system, with origins dating back to Otto von Bismarck's social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889. In Britain, the National Insurance Act 1911 marked the first steps there towards universal health care, covering most employed persons and their financial dependents and all persons who had been continuous contributors to the scheme for at least five years whether they were working or not. This system of health insurance continued in force until the creation of the National Health Service in 1948 which extended health care security to all legal residents. Most current universal health care systems were implemented in the period following the Second World War as a process of deliberate health care reform, intended to make health care available to all, in the spirit of Article 25 of the Universal Declaration of Human Rights of 1948, signed by every country doing so. The US did not ratify the social and economic rights sections, including Article 25's right to health.[3]
[edit] Implementation and comparisons
See also: Health care system
Universal health care systems vary according to the extent of government involvement in providing care and/or health insurance. In some countries, such as the UK, Spain, Italy and the Nordic countries, the government has a high degree of involvement in the commissioning or delivery of health care services and access is based on residence rights not on the purchase of insurance. Others have a much more pluralistic delivery system based on obligatory health with contributory insurance rates related to salaries or income, and usually funded by employers and beneficiaries jointly. Sometimes the health funds are derived from a mixture of insurance premiums, salary related mandatory contributions by employees and/or employers to regulated sickness funds, and by government taxes. These insurance based systems tend to reimburse private or public medical providers, often at heavily regulated rates, through mutual or publicly owned medical insurers. A few countries such as the Netherlands and Switzerland operate via privately owned but heavily regulated private insurers that are not allowed to make a profit from the mandatory element of insurance but can profit by selling supplemental insurance. The compulsory insurance systems of central and eastern Europe typically fail to provide truly universal coverage, leaving up to 3% of their population without coverage.[citation needed]They often operate as two-tier systems and often fail to guarantee fee reimbursement due to means testing of sickness funds, in the case of private insurance.[citation needed]
Universal health care is a broad concept that has been implemented in several ways. The common denominator for all such programs is some form of government action aimed at extending access to health care as widely as possible and setting minimum standards. Most implement universal health care through legislation, regulation and taxation. Legislation and regulation direct what care must be provided, to whom, and on what basis. Usually some costs are borne by the patient at the time of consumption but the bulk of costs come from a combination of compulsory insurance and tax revenues. Some programs are paid for entirely out of tax revenues. In others tax revenues are used either to fund insurance for the very poor or for those needing long term chronic care. The UK government's National Audit Office in 2003 published an international comparison of ten different health care systems in ten developed countries, nine universal systems against one non-universal system (the U.S.), and their relative costs and key health outcomes.[4] A wider international comparison of 16 countries, each with universal health care, was published by the World Health Organization in 2004 [5] In some cases, government involvement also includes directly managing the health care system, but many countries use mixed public-private systems to deliver universal health care.
[edit] Americas
Argentina, Brazil (see below), Canada (see below), Chile, Costa Rica, Cuba, Mexico (see below), Panama, Peru (see below), Uruguay, Trinidad and Tobago and Venezuela all have public universal health care provided.
[edit] Argentina
Main article: Health care in Argentina
Health care is provided through a combination of employer and labor union-sponsored plans (Obras Sociales), government insurance plans, public hospitals and clinics and through private health insurance plans. It costs almost 10% of GPD and is available to anyone regardless of ideology, beliefs, race or nationality.
[edit] Brazil
Main article: Health care in Brazil
The universal health care system was adopted in Brazil in 1988 after the end of the military regime's rule. However, free health care was available many years before, in some cities, once the #27 amend to the 1969 Constitution impose to the municipalities the duty of applying 6% of their income in healthcare.[6]
[edit] Canada
Main article: Health care in Canada
In 1984, the Canada Health Act was passed, which prohibited extra billing by doctors on patients while at the same time billing the public insurance system. In 1999, the prime minister and most premiers reaffirmed in the Social Union Framework Agreement that they are committed to health care that has "comprehensiveness, universality, portability, public administration and accessibility."[7]
The system is for the most part publicly funded, yet most of the services are provided by private enterprises or private corporations, although most hospitals are public. Most doctors do not receive an annual salary, but receive a fee per visit or service.[8] About 29% of Canadians' health care is paid for by the private sector or individuals.[9] This mostly goes towards services not covered or only partially covered by Medicare such as prescription drugs, dentistry and vision care.[10] Many Canadians have private health insurance, often through their employers, that cover these expenses.[11]
The Canada Health Act of 1984 "does not directly bar private delivery or private insurance for publicly insured services," but provides financial disincentives for doing so. "Although there are laws prohibiting or curtailing private health care in some provinces, they can be changed," according to a report in the New England Journal of Medicine.[12][13] The legality of the ban was considered in a decision of the Supreme Court of Canada which ruled in Chaoulli v. Quebec that "the prohibition on obtaining private health insurance, while it might be constitutional in circumstances where health care services are reasonable as to both quality and timeliness, is not constitutional where the public system fails to deliver reasonable services." The appellant contended that waiting times in Quebec violated a right to life and security in the Quebec Charter of Human Rights and Freedoms. The Court agreed, but acknowledged the importance and validity of the Canada Health Act, and at least four of the seven judges explicitly recognized the right of governments to enact laws and policies which favour the public over the private system and preserve the integrity of the public system.
[edit] Colombia
Main article: Health in Colombia
In 1993 a reform transformed the health care system in Colombia, trying to provide a better, sustainable, health care system and to reach every Colombian citizen.
[edit] Greenland
Greenland has a free medical service funded by taxation.[14] There is a hospital in all towns, and in the settlements there is usually a nursing clinic. In the event of an acute illness, treatment is free of charge even to foreign visitors to Greenland.[15]
[edit] Mexico
Further information: Health care in Mexico
Public health care delivery is accomplished via an elaborate provisioning and delivery system instituted by the Mexican Federal Government. Public health care is provided to all Mexican citizens as guaranteed via Article 4 of the Constitution. Public care is either fully or partially subsidized by the federal government, depending on the person's (Spanish: derechohabiente's) employment status. All Mexican citizens are eligible for subsidized health care regardless of their work status via a system of health care facilities operating under the federal Secretariat of Health (formerly the Secretaria de Salubridad y Asistencia, or SSA) agency. Employed citizens and their dependents, however, are further eligible to use the health care program administered and operated by the Instituto Mexicano del Seguro Social (IMSS) (English: Mexican Social Security Institute). The IMSS health care program is a tripartite system funded equally by the employee, its private employer, and the federal government. The IMSS does not provide service to employees of the public sector. Employees in the public sector are serviced by the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) (English: Institute for Social Security and Services for State Workers), which attends to the health and social care needs of government employees. This includes local, state, and federal government employees. The government of the states in Mexico also provide health services independently of those services provided by the federal government programs. In most states, the state government has established free or subsidized healthcare to all their citizens.
On December 1, 2006 the Mexican government created the Health Insurance for a New Generation also known as "life insurance for babies".[16][17][18]
On May 28, 2009 Mexico announced Universal Care Coverage for Pregnant Women.[19]
[edit] Peru
Further information: es:Aseguramiento Universal en Salud
On April 9, 2009 the Government of Peru published the Law on Health Insurance to enable all Peruvians to access quality health services, and contribute to regulate the financing and supervision of these services. The law enables all population to access diverse health services to prevent illnesses, and promote and rehabilitate people, under a Health Basic Plan (PEAS).[20][21]
On April 2, 2010 President Alan Garcia Perez on Friday signed a supreme ordinance approving the regulations for the framework law on the Universal Health Insurance, which seeks to provide access to quality health care for all Peruvian citizens.
Peru’s Universal Health Insurance law aims to increase access to timely and quality health care services, emphasizes maternal and child health promotion, and provides the poor with protection from financial ruin due to illness.
The regulation states that membership of the Universal Health Insurance (AUS for its Spanish acronym) is compulsory for the entire population living in the country. To that end, the Ministry of Health will approve, by supreme ordinance, the mechanisms leading to compulsory membership, as well as escalation and implementation.[22]
[edit] Trinidad and Tobago
Main article: Health care in Trinidad and Tobago
A universal health care system is used in Trinidad and Tobago and is the primary form of health-care available in the country. It is used by the majority of the population seeking medical assistance, as it is free for all citizens.
[edit] United States
See also: Health care reform in the United States and Health care in the United States
Health care reform in the United States
General
Healthcare Reform in USA
Patient Protection and Affordable Care Act
Healthcare Bill (PPACA): Provisions
Debate over reform
History
Public opinion
Rationing
Uninsured
[show]More Information
Legislation
Lead Proposals
Proposed system changes
Health Care and Education Reconciliation Act of 2010 (H.R. 4872)
Patient Protection and Affordable Care Act (Senate bill - H.R. 3590)
Superseded Proposals
America's Healthy Future Act (Baucus bill - S. 1796)
Healthy Americans Act (Wyden-Bennett Bill - S. 391)
United States National Health Care Act (Conyers bill, single payer - H.R. 676)
America's Affordable Health Choices Act of 2009 (Tri-Comm. Bill - H.R. 3200)
Affordable Health Care for America Act (House bill - H.R. 3962)
Systems
Comparison of Canadian and American health care systems
Free-market health care
Health insurance exchange
National health insurance
Publicly-funded health care
Single-payer health care
Two-tier health care
Universal health care
Reform advocacy groups
American Medical Student Association
California Nurses Association/National Nurses Organizing Committee
Democracy for America
Health Care for America NOW!
Healthcare-NOW!
National Physicians Alliance
Physicians for a National Health Program
Health care in the United States
--------------------------------------------------------------------------------
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Universal Health Insurance legislation (The Patient Protection and Affordable Care Act (PPAC)(Pub. L. No. 111-148) as amended by the Health Care and Education Reconciliation Act of 2010) provides for federally mandated health insurance to be implemented in the United States during the 2010-2019 decade with the Federal government subsidizing all peoples with income up to 400% of FPL.[23] Starting June 2010 adults with pre-existing conditions will be eligible to join a temporary high-risk pool.[24], although that is a very minor aspect of the 2010 legislation.
However, universal health insurance is not the same as universal health care. For example the United States, will have a policy of federally mandated health insurance to be implemented during the 2010-2019 decade. On the other hand, guaranteed access to health care has been the custom in the U.S. for decades and has been the law since the 1980s. The World Health Organization regards access to primary care as fundamental to achieving universal health care.[25]
The Federal insurance mandate will in many cases override state laws. Each US state has its own rules and regulations in terms of requiring, administering and regulating insurance of all types, including health care insurance. Many US states began instituting health care insurance laws beginning in the early years of the 20th century. Hawaii has, since 1974, required employers to provide employees working more than 20 hours per week with a comprehensive health insurance plan.[26] The Commonwealth of Massachusetts implemented a near-universal health care system by mandating that uninsured residents purchase health insurance from a private insurer by July 1, 2007.[27] About 97% of residents participate as of an October 2009 report of the Mass Health Connector, an independent state agency involved in health care.
Historically most Americans have purchased health care insurance through their employers and employers often subsidized the premiums as an employment benefit. This was particularly true during the Second World War and at other times when wage freezes were in place. However, this often left those in retirement without insurance so health care insurance for those over 65 was instituted on a federal-government basis in the 1960s, a program popularly called Medicare. Medicare is funded by a payroll tax on all workers and by premiums paid by those over 65.
The US also has a medical insurance program to help the poor or disabled people called Medicaid.[28][29] It will be expanded after 2014 to include individuals with income up to 133% of the poverty line qualify for Medicaid coverage, even if they do not have dependents.[30][23] In 2016, the FPL is projected to equal about $11,800 for a single person and about $24,000 for family of four.[31]
Premium cap for maximum "out-of-pocket" pay will be established for people with incomes up to 400% of FPL starting 2014.[23][31][32] Section 1401 of PPACA explains that the subsidy will be provided as a advanceable, refundable tax credit[33] and gives a formula for its calculation[34]. A Refundable tax credit is a way to provide government benefits to people even with no tax liability[35] (example: Child Tax Credit). According to White House and Congressional Budget Office the maximum share of income that enrollees would have to pay for the "silver" healthcare plan premium would vary depending on their income relative to the federal poverty level(FPL), as follows:[36][31] for families with income 133–150% of FPL will be 4-4.7% of income, for families with income 150–200% of FPL will be 4.7-6.5% of income, for families with income 200–250% of FPL will be 6.5-8.4% of income, for families with income 250-300% of FPL will be 8.4-10.2% of income, for families with income from 300-400% of FPL will be 10.2% of income. In 2016,the FPL is projected to equal about $11,800 for a single person and about $24,000 for family of four.[31] See Subsidy Calculator for specific dollar amount.[37]
Via Medicare, Medicaid, employer-supported insurance and insurance purchased directly by the self-employed, more than 80% of Americans and legal aliens of all ages were insured as of the beginning of 2010, based on varying estimates by the US Congressional Budget Office (CBO) starting with its 2007 Health Insurance Simulation Model.
Under the PPAC, all Americans and legal aliens in the United States will be required to carry healthcare insurance. They can do that through employers' plans, purchase it from insurance brokers, or purchase it directly from insurance companies. Special brokerages called "health insurance exchanges" will be set up by each US state (e.g., Massachusetts already has one). Those citizens or legal aliens that can find a policy that costs less than 8 percent of their income[38], but choose not to purchase one will be assessed a penalty imposed by the IRS and collected as part of the US government tax collection process[38]. Those citizens or legal aliens that cannot afford a health insurance policy will have the premium to be paid to the private insurer subsidized primarily by re-allocating money raised for Medicare, by taxation on medical device sales, and by revenue raised by a US higher education student loan program, as explained in the CBO analysis in March 2010 of the PPAC as finally passed (including the companion reconciliation legislation).[31]
It was estimated by the PPAC's proponents that about 5% of the target US population will be exempted from having to carry healthcare insurance because it will not be affordable even with the subsidy or for other reasons. This is based on CBO correspondence to proponents during the PPAC debate in 2009-2010; the percentage varies according to the proponent's assumptions (e.g., whether or not a public option is included). Another percentage of US residents will likely not carry insurance even though they will have to pay the tax penalty. Therefore in addition to its lack of other universal health care characteristics, it is hard to include the US on a list of countries having universal health care based on the fact that everyone will not be included; that is, the PPAC by definition is not universal.
Healthcare insurance trends in the US should not be confused with healthcare delivery practices. Healthcare has always been universally available in the US both based on law and healthcare practitioner ethics and customs. However the geographic breadth of the country makes it more available in or near large cities where most healthcare practitioners are trained.
[edit] Asia
Bhutan, Brunei, China, Hong Kong SAR, Macau, North Korea, Mongolia[39], Kazakhstan[40], Tajikistan[41], Turkmenistan[42], Azerbaijan[43], India[citation needed], Kuwait[citation needed], Qatar[citation needed], UAE[citation needed], Saudi Arabia[citation needed], Israel,[44] Japan, Malaysia[citation needed], South Korea, Seychelles[citation needed], Sri Lanka,[45] Taiwan(R.O.C.),[46], Turkey[47], Iran[48],Syria[49], Pakistan[citation needed], Jordan[50] and Thailand[citation needed], Oman[51][52] have universal health care.
[edit] Bhutan
Main article: Health in Bhutan
The Royal Government of Bhutan maintains a policy of free and universal access to primary health care. As hospital facilities in the country are limited, patients with diseases that cannot be treated in Bhutan, such as cancer, are normally referred to hospitals in India for treatment. Such referral treatment is also carried out at the cost of the Royal Government.[53]
[edit] Hong Kong
Main article: Healthcare in Hong Kong
Hong Kong is one of the healthiest places in the world.[54] Because of its early health education, professional health services, and well-developed health care and medication system, Hongkongers enjoy a life expectancy of 84 for females and 78 for males,[55] which is the second highest in the world, and 2.94 infant mortality rate, the fourth lowest in the world.[56][57]
There are two medical schools in Hong Kong, and several schools offering courses in traditional Chinese medicine. The Hospital Authority is a statutory body that operates and manages all public hospitals. Hong Kong has high standards of medical practice. It has contributed to the development of liver transplantation, being the first in the world to carry out an adult to adult live donor liver transplant in 1993.[58]
[edit] India
Main article: Healthcare in India
India has a universal health care system run by the local (state or territorial), governments. The government hospitals, some of which are among the best hospitals in India, provide treatment at taxpayer expense. Most essential drugs are offered free of charge in these hospitals.
Government hospitals provide treatment either free or at minimal charges. For example, an outpatient card at AIIMS (one of the best hospitals in India) costs a one time fee of rupees 10 (Around 20 cents US) and thereafter outpatient medical advice is free. In-hospital treatment costs depend on financial condition of the patient and facilities utilized by him but are usually much less than the private sector. For instance, a patient is waived treatment costs if he is below poverty line. Another patient may seek for an air-conditioned room if he is willing to pay extra for it. The charges for basic in-hospital treatment and investigations are much less compared to the private sector. The cost for these subsidies comes from annual allocations from the central and state governments.
Primary health care is provided by city and district hospitals and rural primary health centres (PHCs). These hospitals provide treatment free of cost. Primary care is focused on immunization, prevention of malnutrition, pregnancy, child birth, postnatal care, and treatment of common illnesses.[citation needed] Patients who receive specialized care or have complicated illnesses are referred to secondary (often located in district and taluk headquarters) and tertiary care hospitals (located in district and state headquarters or those that are teaching hospitals).[citation needed] However, the fact that the government sector is understaffed and underfinanced and poor services at state run hospitals forces many people to visit private medical practitioners.
Now organizations like Hindustan Latex Family Planning Promotional Trust and other private organizations have started creating hospitals and clinics in India, which also provide free or subsidized health care and subsidized insurance plans.[citation needed]
Jump to: navigation, search
Universal health care is a system of organized health-care systems built around the principle of universal coverage for almost all members of society, combining mechanisms for health financing and service provision.[1] There is no precise definition of the term "universal" to indicate what percentage comprises "universal" though the number is probably lower than 100% and higher than 95% based on usage of the term.[citation needed]
The World Health Organization regards access to primary care as fundamental to achieving universal health care.[2]
Contents [hide]
1 History
2 Implementation and comparisons
2.1 Americas
2.1.1 Argentina
2.1.2 Brazil
2.1.3 Canada
2.1.4 Colombia
2.1.5 Greenland
2.1.6 Mexico
2.1.7 Peru
2.1.8 Trinidad and Tobago
2.1.9 United States
2.2 Asia
2.2.1 Bhutan
2.2.2 Hong Kong
2.2.3 India
2.2.4 Israel
2.2.5 Macau
2.2.6 People's Republic of China
2.2.7 Singapore
2.2.8 Taiwan (R.O.C.)
2.2.9 Thailand
2.3 Europe
2.3.1 Denmark
2.3.2 Finland
2.3.3 Germany
2.3.4 Ireland
2.3.5 Italy
2.3.6 Netherlands
2.3.7 Russia
2.3.8 United Kingdom
2.3.8.1 England
2.3.8.2 Northern Ireland
2.3.8.3 Scotland
2.3.8.4 Wales
2.4 Oceania
2.4.1 Australia
2.4.2 New Zealand
2.5 Africa
3 Economics
3.1 Funding models
3.1.1 Single payer
3.1.2 Public
3.1.3 Compulsory insurance
3.1.4 Private insurance
4 See also
5 Notes
6 External links
[edit] History
Germany has the world's oldest universal health care system, with origins dating back to Otto von Bismarck's social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889. In Britain, the National Insurance Act 1911 marked the first steps there towards universal health care, covering most employed persons and their financial dependents and all persons who had been continuous contributors to the scheme for at least five years whether they were working or not. This system of health insurance continued in force until the creation of the National Health Service in 1948 which extended health care security to all legal residents. Most current universal health care systems were implemented in the period following the Second World War as a process of deliberate health care reform, intended to make health care available to all, in the spirit of Article 25 of the Universal Declaration of Human Rights of 1948, signed by every country doing so. The US did not ratify the social and economic rights sections, including Article 25's right to health.[3]
[edit] Implementation and comparisons
See also: Health care system
Universal health care systems vary according to the extent of government involvement in providing care and/or health insurance. In some countries, such as the UK, Spain, Italy and the Nordic countries, the government has a high degree of involvement in the commissioning or delivery of health care services and access is based on residence rights not on the purchase of insurance. Others have a much more pluralistic delivery system based on obligatory health with contributory insurance rates related to salaries or income, and usually funded by employers and beneficiaries jointly. Sometimes the health funds are derived from a mixture of insurance premiums, salary related mandatory contributions by employees and/or employers to regulated sickness funds, and by government taxes. These insurance based systems tend to reimburse private or public medical providers, often at heavily regulated rates, through mutual or publicly owned medical insurers. A few countries such as the Netherlands and Switzerland operate via privately owned but heavily regulated private insurers that are not allowed to make a profit from the mandatory element of insurance but can profit by selling supplemental insurance. The compulsory insurance systems of central and eastern Europe typically fail to provide truly universal coverage, leaving up to 3% of their population without coverage.[citation needed]They often operate as two-tier systems and often fail to guarantee fee reimbursement due to means testing of sickness funds, in the case of private insurance.[citation needed]
Universal health care is a broad concept that has been implemented in several ways. The common denominator for all such programs is some form of government action aimed at extending access to health care as widely as possible and setting minimum standards. Most implement universal health care through legislation, regulation and taxation. Legislation and regulation direct what care must be provided, to whom, and on what basis. Usually some costs are borne by the patient at the time of consumption but the bulk of costs come from a combination of compulsory insurance and tax revenues. Some programs are paid for entirely out of tax revenues. In others tax revenues are used either to fund insurance for the very poor or for those needing long term chronic care. The UK government's National Audit Office in 2003 published an international comparison of ten different health care systems in ten developed countries, nine universal systems against one non-universal system (the U.S.), and their relative costs and key health outcomes.[4] A wider international comparison of 16 countries, each with universal health care, was published by the World Health Organization in 2004 [5] In some cases, government involvement also includes directly managing the health care system, but many countries use mixed public-private systems to deliver universal health care.
[edit] Americas
Argentina, Brazil (see below), Canada (see below), Chile, Costa Rica, Cuba, Mexico (see below), Panama, Peru (see below), Uruguay, Trinidad and Tobago and Venezuela all have public universal health care provided.
[edit] Argentina
Main article: Health care in Argentina
Health care is provided through a combination of employer and labor union-sponsored plans (Obras Sociales), government insurance plans, public hospitals and clinics and through private health insurance plans. It costs almost 10% of GPD and is available to anyone regardless of ideology, beliefs, race or nationality.
[edit] Brazil
Main article: Health care in Brazil
The universal health care system was adopted in Brazil in 1988 after the end of the military regime's rule. However, free health care was available many years before, in some cities, once the #27 amend to the 1969 Constitution impose to the municipalities the duty of applying 6% of their income in healthcare.[6]
[edit] Canada
Main article: Health care in Canada
In 1984, the Canada Health Act was passed, which prohibited extra billing by doctors on patients while at the same time billing the public insurance system. In 1999, the prime minister and most premiers reaffirmed in the Social Union Framework Agreement that they are committed to health care that has "comprehensiveness, universality, portability, public administration and accessibility."[7]
The system is for the most part publicly funded, yet most of the services are provided by private enterprises or private corporations, although most hospitals are public. Most doctors do not receive an annual salary, but receive a fee per visit or service.[8] About 29% of Canadians' health care is paid for by the private sector or individuals.[9] This mostly goes towards services not covered or only partially covered by Medicare such as prescription drugs, dentistry and vision care.[10] Many Canadians have private health insurance, often through their employers, that cover these expenses.[11]
The Canada Health Act of 1984 "does not directly bar private delivery or private insurance for publicly insured services," but provides financial disincentives for doing so. "Although there are laws prohibiting or curtailing private health care in some provinces, they can be changed," according to a report in the New England Journal of Medicine.[12][13] The legality of the ban was considered in a decision of the Supreme Court of Canada which ruled in Chaoulli v. Quebec that "the prohibition on obtaining private health insurance, while it might be constitutional in circumstances where health care services are reasonable as to both quality and timeliness, is not constitutional where the public system fails to deliver reasonable services." The appellant contended that waiting times in Quebec violated a right to life and security in the Quebec Charter of Human Rights and Freedoms. The Court agreed, but acknowledged the importance and validity of the Canada Health Act, and at least four of the seven judges explicitly recognized the right of governments to enact laws and policies which favour the public over the private system and preserve the integrity of the public system.
[edit] Colombia
Main article: Health in Colombia
In 1993 a reform transformed the health care system in Colombia, trying to provide a better, sustainable, health care system and to reach every Colombian citizen.
[edit] Greenland
Greenland has a free medical service funded by taxation.[14] There is a hospital in all towns, and in the settlements there is usually a nursing clinic. In the event of an acute illness, treatment is free of charge even to foreign visitors to Greenland.[15]
[edit] Mexico
Further information: Health care in Mexico
Public health care delivery is accomplished via an elaborate provisioning and delivery system instituted by the Mexican Federal Government. Public health care is provided to all Mexican citizens as guaranteed via Article 4 of the Constitution. Public care is either fully or partially subsidized by the federal government, depending on the person's (Spanish: derechohabiente's) employment status. All Mexican citizens are eligible for subsidized health care regardless of their work status via a system of health care facilities operating under the federal Secretariat of Health (formerly the Secretaria de Salubridad y Asistencia, or SSA) agency. Employed citizens and their dependents, however, are further eligible to use the health care program administered and operated by the Instituto Mexicano del Seguro Social (IMSS) (English: Mexican Social Security Institute). The IMSS health care program is a tripartite system funded equally by the employee, its private employer, and the federal government. The IMSS does not provide service to employees of the public sector. Employees in the public sector are serviced by the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) (English: Institute for Social Security and Services for State Workers), which attends to the health and social care needs of government employees. This includes local, state, and federal government employees. The government of the states in Mexico also provide health services independently of those services provided by the federal government programs. In most states, the state government has established free or subsidized healthcare to all their citizens.
On December 1, 2006 the Mexican government created the Health Insurance for a New Generation also known as "life insurance for babies".[16][17][18]
On May 28, 2009 Mexico announced Universal Care Coverage for Pregnant Women.[19]
[edit] Peru
Further information: es:Aseguramiento Universal en Salud
On April 9, 2009 the Government of Peru published the Law on Health Insurance to enable all Peruvians to access quality health services, and contribute to regulate the financing and supervision of these services. The law enables all population to access diverse health services to prevent illnesses, and promote and rehabilitate people, under a Health Basic Plan (PEAS).[20][21]
On April 2, 2010 President Alan Garcia Perez on Friday signed a supreme ordinance approving the regulations for the framework law on the Universal Health Insurance, which seeks to provide access to quality health care for all Peruvian citizens.
Peru’s Universal Health Insurance law aims to increase access to timely and quality health care services, emphasizes maternal and child health promotion, and provides the poor with protection from financial ruin due to illness.
The regulation states that membership of the Universal Health Insurance (AUS for its Spanish acronym) is compulsory for the entire population living in the country. To that end, the Ministry of Health will approve, by supreme ordinance, the mechanisms leading to compulsory membership, as well as escalation and implementation.[22]
[edit] Trinidad and Tobago
Main article: Health care in Trinidad and Tobago
A universal health care system is used in Trinidad and Tobago and is the primary form of health-care available in the country. It is used by the majority of the population seeking medical assistance, as it is free for all citizens.
[edit] United States
See also: Health care reform in the United States and Health care in the United States
Health care reform in the United States
General
Healthcare Reform in USA
Patient Protection and Affordable Care Act
Healthcare Bill (PPACA): Provisions
Debate over reform
History
Public opinion
Rationing
Uninsured
[show]More Information
Legislation
Lead Proposals
Proposed system changes
Health Care and Education Reconciliation Act of 2010 (H.R. 4872)
Patient Protection and Affordable Care Act (Senate bill - H.R. 3590)
Superseded Proposals
America's Healthy Future Act (Baucus bill - S. 1796)
Healthy Americans Act (Wyden-Bennett Bill - S. 391)
United States National Health Care Act (Conyers bill, single payer - H.R. 676)
America's Affordable Health Choices Act of 2009 (Tri-Comm. Bill - H.R. 3200)
Affordable Health Care for America Act (House bill - H.R. 3962)
Systems
Comparison of Canadian and American health care systems
Free-market health care
Health insurance exchange
National health insurance
Publicly-funded health care
Single-payer health care
Two-tier health care
Universal health care
Reform advocacy groups
American Medical Student Association
California Nurses Association/National Nurses Organizing Committee
Democracy for America
Health Care for America NOW!
Healthcare-NOW!
National Physicians Alliance
Physicians for a National Health Program
Health care in the United States
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Universal Health Insurance legislation (The Patient Protection and Affordable Care Act (PPAC)(Pub. L. No. 111-148) as amended by the Health Care and Education Reconciliation Act of 2010) provides for federally mandated health insurance to be implemented in the United States during the 2010-2019 decade with the Federal government subsidizing all peoples with income up to 400% of FPL.[23] Starting June 2010 adults with pre-existing conditions will be eligible to join a temporary high-risk pool.[24], although that is a very minor aspect of the 2010 legislation.
However, universal health insurance is not the same as universal health care. For example the United States, will have a policy of federally mandated health insurance to be implemented during the 2010-2019 decade. On the other hand, guaranteed access to health care has been the custom in the U.S. for decades and has been the law since the 1980s. The World Health Organization regards access to primary care as fundamental to achieving universal health care.[25]
The Federal insurance mandate will in many cases override state laws. Each US state has its own rules and regulations in terms of requiring, administering and regulating insurance of all types, including health care insurance. Many US states began instituting health care insurance laws beginning in the early years of the 20th century. Hawaii has, since 1974, required employers to provide employees working more than 20 hours per week with a comprehensive health insurance plan.[26] The Commonwealth of Massachusetts implemented a near-universal health care system by mandating that uninsured residents purchase health insurance from a private insurer by July 1, 2007.[27] About 97% of residents participate as of an October 2009 report of the Mass Health Connector, an independent state agency involved in health care.
Historically most Americans have purchased health care insurance through their employers and employers often subsidized the premiums as an employment benefit. This was particularly true during the Second World War and at other times when wage freezes were in place. However, this often left those in retirement without insurance so health care insurance for those over 65 was instituted on a federal-government basis in the 1960s, a program popularly called Medicare. Medicare is funded by a payroll tax on all workers and by premiums paid by those over 65.
The US also has a medical insurance program to help the poor or disabled people called Medicaid.[28][29] It will be expanded after 2014 to include individuals with income up to 133% of the poverty line qualify for Medicaid coverage, even if they do not have dependents.[30][23] In 2016, the FPL is projected to equal about $11,800 for a single person and about $24,000 for family of four.[31]
Premium cap for maximum "out-of-pocket" pay will be established for people with incomes up to 400% of FPL starting 2014.[23][31][32] Section 1401 of PPACA explains that the subsidy will be provided as a advanceable, refundable tax credit[33] and gives a formula for its calculation[34]. A Refundable tax credit is a way to provide government benefits to people even with no tax liability[35] (example: Child Tax Credit). According to White House and Congressional Budget Office the maximum share of income that enrollees would have to pay for the "silver" healthcare plan premium would vary depending on their income relative to the federal poverty level(FPL), as follows:[36][31] for families with income 133–150% of FPL will be 4-4.7% of income, for families with income 150–200% of FPL will be 4.7-6.5% of income, for families with income 200–250% of FPL will be 6.5-8.4% of income, for families with income 250-300% of FPL will be 8.4-10.2% of income, for families with income from 300-400% of FPL will be 10.2% of income. In 2016,the FPL is projected to equal about $11,800 for a single person and about $24,000 for family of four.[31] See Subsidy Calculator for specific dollar amount.[37]
Via Medicare, Medicaid, employer-supported insurance and insurance purchased directly by the self-employed, more than 80% of Americans and legal aliens of all ages were insured as of the beginning of 2010, based on varying estimates by the US Congressional Budget Office (CBO) starting with its 2007 Health Insurance Simulation Model.
Under the PPAC, all Americans and legal aliens in the United States will be required to carry healthcare insurance. They can do that through employers' plans, purchase it from insurance brokers, or purchase it directly from insurance companies. Special brokerages called "health insurance exchanges" will be set up by each US state (e.g., Massachusetts already has one). Those citizens or legal aliens that can find a policy that costs less than 8 percent of their income[38], but choose not to purchase one will be assessed a penalty imposed by the IRS and collected as part of the US government tax collection process[38]. Those citizens or legal aliens that cannot afford a health insurance policy will have the premium to be paid to the private insurer subsidized primarily by re-allocating money raised for Medicare, by taxation on medical device sales, and by revenue raised by a US higher education student loan program, as explained in the CBO analysis in March 2010 of the PPAC as finally passed (including the companion reconciliation legislation).[31]
It was estimated by the PPAC's proponents that about 5% of the target US population will be exempted from having to carry healthcare insurance because it will not be affordable even with the subsidy or for other reasons. This is based on CBO correspondence to proponents during the PPAC debate in 2009-2010; the percentage varies according to the proponent's assumptions (e.g., whether or not a public option is included). Another percentage of US residents will likely not carry insurance even though they will have to pay the tax penalty. Therefore in addition to its lack of other universal health care characteristics, it is hard to include the US on a list of countries having universal health care based on the fact that everyone will not be included; that is, the PPAC by definition is not universal.
Healthcare insurance trends in the US should not be confused with healthcare delivery practices. Healthcare has always been universally available in the US both based on law and healthcare practitioner ethics and customs. However the geographic breadth of the country makes it more available in or near large cities where most healthcare practitioners are trained.
[edit] Asia
Bhutan, Brunei, China, Hong Kong SAR, Macau, North Korea, Mongolia[39], Kazakhstan[40], Tajikistan[41], Turkmenistan[42], Azerbaijan[43], India[citation needed], Kuwait[citation needed], Qatar[citation needed], UAE[citation needed], Saudi Arabia[citation needed], Israel,[44] Japan, Malaysia[citation needed], South Korea, Seychelles[citation needed], Sri Lanka,[45] Taiwan(R.O.C.),[46], Turkey[47], Iran[48],Syria[49], Pakistan[citation needed], Jordan[50] and Thailand[citation needed], Oman[51][52] have universal health care.
[edit] Bhutan
Main article: Health in Bhutan
The Royal Government of Bhutan maintains a policy of free and universal access to primary health care. As hospital facilities in the country are limited, patients with diseases that cannot be treated in Bhutan, such as cancer, are normally referred to hospitals in India for treatment. Such referral treatment is also carried out at the cost of the Royal Government.[53]
[edit] Hong Kong
Main article: Healthcare in Hong Kong
Hong Kong is one of the healthiest places in the world.[54] Because of its early health education, professional health services, and well-developed health care and medication system, Hongkongers enjoy a life expectancy of 84 for females and 78 for males,[55] which is the second highest in the world, and 2.94 infant mortality rate, the fourth lowest in the world.[56][57]
There are two medical schools in Hong Kong, and several schools offering courses in traditional Chinese medicine. The Hospital Authority is a statutory body that operates and manages all public hospitals. Hong Kong has high standards of medical practice. It has contributed to the development of liver transplantation, being the first in the world to carry out an adult to adult live donor liver transplant in 1993.[58]
[edit] India
Main article: Healthcare in India
India has a universal health care system run by the local (state or territorial), governments. The government hospitals, some of which are among the best hospitals in India, provide treatment at taxpayer expense. Most essential drugs are offered free of charge in these hospitals.
Government hospitals provide treatment either free or at minimal charges. For example, an outpatient card at AIIMS (one of the best hospitals in India) costs a one time fee of rupees 10 (Around 20 cents US) and thereafter outpatient medical advice is free. In-hospital treatment costs depend on financial condition of the patient and facilities utilized by him but are usually much less than the private sector. For instance, a patient is waived treatment costs if he is below poverty line. Another patient may seek for an air-conditioned room if he is willing to pay extra for it. The charges for basic in-hospital treatment and investigations are much less compared to the private sector. The cost for these subsidies comes from annual allocations from the central and state governments.
Primary health care is provided by city and district hospitals and rural primary health centres (PHCs). These hospitals provide treatment free of cost. Primary care is focused on immunization, prevention of malnutrition, pregnancy, child birth, postnatal care, and treatment of common illnesses.[citation needed] Patients who receive specialized care or have complicated illnesses are referred to secondary (often located in district and taluk headquarters) and tertiary care hospitals (located in district and state headquarters or those that are teaching hospitals).[citation needed] However, the fact that the government sector is understaffed and underfinanced and poor services at state run hospitals forces many people to visit private medical practitioners.
Now organizations like Hindustan Latex Family Planning Promotional Trust and other private organizations have started creating hospitals and clinics in India, which also provide free or subsidized health care and subsidized insurance plans.[citation needed]
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