Develop a 4–5 page examination of your chosen healthcare issue within the context or your chosen country.
Introduction
Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in sequence.
The manner in which policymakers allocate and promote resources has a strong relationship to access to healthcare, positive health outcomes, and life expectancy.
The past century has been marked by the second industrial revolution, economic development, human development, and the green revolution. These developments have contributed to improved standards of living but often created new threats to low-income countries through environmental degradation. Improved nutrition and basic infrastructure have helped many societies to experience an epidemiological transition, a decrease in infectious diseases, and increased life expectancy.
Global health organizations are trying to address healthcare issues of all kinds throughout the world. Guiding principles are set by the World Health Organization (WHO), and goals for improving global health policy have been defined by its millennium development goals. Other major worldwide organizations such as the United Nations, the International Monetary Fund, and others will continue to shape and mold global health policy.
From an international perspective, money and wealth do not necessarily buy positive health outcomes. The manner in which policymakers allocate and promote resources bears a strong relationship to access to healthcare, positive health outcomes, and life expectancy. China and Kerala, India, are prime examples of growth-mediated and support-led models. Service delivery, healthcare funding, prevention, and life expectancy are impacted by resource allocation. Elements and best practices can be extrapolated from the growth-mediated models and support-led models to compare with specific low, middle, and high income countries.
As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
Which type of healthcare system (entrepreneurial, mandated health insurance, or national health service) is most closely aligned to WHO principles?
What are the strengths and weaknesses of each type of healthcare system?
How would you measure an organization's success against other organizations that are trying to address the same issues? Consider qualitative and quantitative measures.
National Health Service (NHS) Model
A National Health Service (NHS) is a publicly funded and managed system where the government acts as the primary payer and provider of healthcare. Services are funded through general taxation and are free at the point of use. The UK's NHS is a prime example.
Strengths:
High Alignment with WHO Principles: This model is most closely aligned with WHO's core principles. It aims to provide universal access to care and promotes equity by removing financial barriers. Everyone, regardless of income, has the same access to a broad range of services.
Cost-Effectiveness: With a single-payer system, the government can control costs through negotiation with pharmaceutical companies and bulk purchasing of medical equipment. Administrative costs are also significantly lower than in multi-payer systems.
Focus on Public Health: A centralized system is better equipped to implement large-scale public health initiatives, such as vaccination campaigns or chronic disease prevention programs.
Weaknesses:
Funding Challenges and Long Wait Times: The reliance on tax-based funding can lead to political and economic pressures, resulting in underfunding and resource shortages. This often leads to long waiting times for non-emergency procedures and elective surgeries.
Lack of Patient Choice: Patients have limited choice of doctors or hospitals, and there is less competition among providers, which can sometimes stifle innovation.
Bureaucracy: Being a large government-run organization, it can be slow and bureaucratic, which can lead to inefficiencies.
2. Mandated Health Insurance (Bismarck) Model
In a mandated health insurance system, also known as the Bismarck model, healthcare is funded by a combination of employer and employee contributions to a non-profit "sickness fund" or insurance plan. While private providers deliver the care, the government regulates pricing and ensures that everyone is covered. Germany, France, and Japan use this model.
Strengths:
Universal Coverage and Choice: This model achieves near-universal health coverage and provides patients with a wide choice of doctors and specialists. There is a strong sense of personal responsibility and patient autonomy.
Good Responsiveness: The competitive nature of the private insurance market and multiple providers often leads to shorter wait times and better access to specialized services.
Innovation and Quality: Competition among providers can drive innovation and higher quality of care.
Sample Answer
Types of Healthcare Systems and Their Alignment with WHO Principles
The World Health Organization (WHO) promotes key principles for health systems, emphasizing universal health coverage (UHC), equity, efficiency, and responsiveness. UHC, in particular, is a core goal, meaning that all people receive the health services they need without suffering financial hardship. WHO's framework for health systems is based on six "building blocks": service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance.
The three main types of healthcare systems—entrepreneurial, mandated health insurance, and national health service—each align differently with these WHO principles.