Although different countries have different models, the purpose is to protect national health.
United Kingdom: National Health Service System
"Britain is the first in the world to establish a' welfare state' from cradle to grave." As the then British Prime Minister Attlee declared in 1950, the British National Health Service (NHS) is considered by the World Health Organization as the largest publicly-funded medical institution in Europe and one of the best medical service systems in the world. All taxpayers and people with the right of abode in Britain have the right to use the service of the system free of charge. The service principle of NHS is to provide people with comprehensive free medical services according to their different needs, regardless of their income.
The British medical system adopts a grading system. When British residents have health problems, they will first make an appointment with a family doctor in a small clinic or community hospital near their place of residence, so family doctors are considered to be the main force in the British medical system. These basic nursing institutions, such as community hospitals, are also called the first-class medical service institutions of NHS. As the largest part of the national medical service system, it accounts for about 75% of the NHS total budget, including comprehensive service institutions including medical care and social care. Secondary medical institutions are regional hospitals. The regional hospital is usually the medical center in this area, which is a comprehensive general hospital, responsible for emergency, serious illness and surgical treatment. The third level is the teaching hospital. Teaching hospitals are mainly hospitals for emergency treatment and major and difficult diseases.
The NHS implements a system of separation of medicines. Except for a small amount of dental treatment fee, the outpatient service of hospitals under the national medical service system is basically free of charge, and about 85% of prescription drugs are free. In this system, up to 82% of the funds come from taxpayers, the rest 12.2% comes from national insurance tax, a small part comes from medical expenses, and 1% comes from other income and funds donated by charities. Some public hospitals also accept patients from private hospitals on the basis of full fees.
Although NHS is regarded as one of the greatest social achievements in the 20th century, with the increase of population and the improvement of people's health awareness in Britain, the disadvantages of NHS as a medical service system have gradually emerged. When former British Prime Minister Tony Blair was in power, the NHS system was criticized as the worst medical system in Europe because of its outdated facilities and long waiting time for surgery. In July, 2000, Blair government issued a five-year plan for the modernization of the national medical service system. The main measures taken are to increase financial input and introduce competition mechanism to improve efficiency. The financial investment in NHS is increasing at an annual rate of nearly 7.4%, and Britain will rise from the country with the lowest investment among EU countries to the country with the highest investment. In addition, the plan will also reform medical institutions, increase the number of fast-track medical centers and shorten the time for medical treatment. It is reported that in a report released in early 2007, the British government stated that according to the goal set by the government, by the end of 2008, the longest waiting time for British patients to see a doctor should not exceed 18 weeks.
Germany: social insurance system
Germany's medical security system adopts social insurance, which provides expenses and services for the insured and his family when the insured falls ill or takes preventive measures to protect and restore the health of the insured and his family. Germany is the first country in the world to implement social security system through social legislation. Its source of funds is the insurance premium paid by the insured and the employer, and the state generally does not give direct subsidies. Citizens pay insurance premiums according to a certain proportion of their income, but no matter how much they pay, they can cure diseases. For workers whose monthly income is less than a certain amount, all the insurance premiums are borne by the employer, while most of the medical insurance for the unemployed is borne by the labor department. Besides the employees themselves, dependent family members can also enjoy sickness insurance as long as their monthly income does not exceed DM 430.
In Germany, all medical insurance institutions are not subordinate to government departments, but self-managed social self-governing institutions. Residents also implement a graded medical system.
The current medical insurance system in Germany consists of two major systems, with statutory medical insurance as the main and private medical insurance as the supplement. Residents must choose one of the statutory medical insurance institutions to participate in the insurance under a certain income; When the income exceeds this standard, you can choose to join legal or private medical insurance. Almost all residents in Germany are included in the medical insurance system, of which about 90% are covered by national medical insurance, about 8% by private medical insurance, and 2% of the population (such as soldiers and police) enjoy free medical care.
Germany's medical insurance system also has some problems that are difficult to solve. Due to the continuous progress of medical technology, aging population and other factors, the annual growth rate of medical insurance premiums obtained by major medical insurance foundations is obviously lower than the growth rate of medical insurance expenses, and the statutory medical insurance system is gradually making ends meet. Germany has become one of the countries with the highest medical expenses in the world.
In order to control the increasing medical insurance expenditure, Germany began to implement the modernization law of statutory medical insurance in 2004, and carried out drastic reforms on the medical insurance system. First, the payment base has expanded. When the insured pays the legal medical insurance premium, not only the wage income is included in the payment base, but also other non-wage income is included. The second is to cancel items that should not be paid by medical insurance, such as funeral expenses and wearing contact lenses. Third, the hospitalization expenses increased from 9 euros to 10 euros. At the same time, this reform also hopes to establish an economic interest restraint mechanism among medical units, disease insurance institutions and medical policyholders.
After the reform, the proportion of German statutory medical insurance in total health expenditure decreased from 60% in 2003 to 56% in 2004, while the proportion of private insurance expenditure increased, and the medical insurance reform has achieved initial results.
United States: Medical Insurance Management System
The medical insurance system in the United States is composed of private medical insurance and social medical insurance, which has the characteristics of high marketization.
American government medical insurance is a special social insurance system. In 1965, the US Congress passed the Medical Security Act, which established two kinds of social medical insurance, namely, medical care insurance for the elderly and medical assistance insurance for the poor. It is reported that medical care insurance is mainly funded and managed by the federal government. Applicants must be American citizens, and must be elderly people over 65 years old, and have paid taxes to the state for more than 65,438+00 years. People with lifelong disabilities and their families or patients with advanced kidney disease can also apply. Medical assistance insurance is mainly funded by the state government. The insurance is mainly provided to low-income American citizens or legal immigrants, whose personal or family annual income must be lower than the poverty line standard published by each state, and their personal or family assets cannot exceed a certain standard.
Because there is no national medical insurance system, most people in the United States see a doctor through their employers or buy medical insurance themselves. In the United States, many people participate in both private medical insurance and social insurance. According to the statistics of the Census Bureau of the United States Department of Commerce, in 2005, 247 million people in the United States participated in various forms of medical insurance, accounting for 84. 1% of the total population.
However, there are still many problems in the American medical system. The annual consumption of medical expenses in the United States ranks first in the world, accounting for 40% of the world's medical expenses, of which the total medical expenditure per capita is twice that of other developed countries; Secondly, although the cost of medical insurance in the United States has greatly increased in the past century, there are still 46 million Americans who do not have medical insurance; The lack of a unified security system also leads to an increase in total expenses and management costs, which affects fairness. These problems have plagued American society for many years.
Although the American medical and health system has the most advanced medical technology in the world, patients enjoy the freedom to choose medical service institutions, which is called the "best" in the world; However, due to the lack of national health care system, high input and low output of health care, they think they are the "worst" in the world.
"At present, in terms of public welfare in the United States, the most urgent concern is the medical insurance system of the whole society. At present, medical expenses are growing at a double-digit rate, which makes most people feel far behind, and their income can't keep up with the speed and range of medical insurance and medical expenses. " Max, an expert at the American Institute of Economic Policy? Sovic said. In order to solve this problem, seven states in the United States have put forward the solution of implementing universal health insurance system. (8F 1) Mace is afraid of harm.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.