Health Care Systems: Differences Around the Globe

February 22, 2014

Gap Medics student during her hospital experience programme in ThailandThe primary concern of doctors who take the Hippocratic oath is to provide the best medical care possible to patients regardless of ability to pay for services provided.  Across the globe, the issue over a patient’s ability to pay for medical care is addressed through a variety of health care systems.  If you are considering a career in medicine, here’s what you need to know about the business side of the healthcare system – how patients services are covered and who pays for what.

If you are considering a career in medicine, here’s what you need to know about the business side of the healthcare system – how patients services are covered and who pays for what.

System #1: The Beveridge Model

Also known as nationalized health care, the Beveridge Model was first created and implemented in Britain.  Patients have access to any type of care that they require, and they will never see any medical bills as a result of their visits to doctors or hospitals.  Citizens of countries that utilize the Beveridge Model of health care services pay for their medical care through a higher tax rate than other countries.  They see doctors who are generally public employees in hospitals that are owned by the government.  No one is denied health care in this type of system, because the goal of the system is to provide high-quality medical care, rather than seek profits, as other models are known to do. Critics argue, however, that the Beveridge Model relies too heavily on the expertise and wisdom of the government, and that governments should not be involved in this type of personal business.

Countries that operate their health care systems using the Beveridge Model include Britain, Italy, Spain, Norway, Denmark, Finland, Sweden, and New Zealand.

System #2: The Bismarck Model

This system will seem familiar to those in the US, as it is funded by employers and employees who pay into “sickness funds” that subsequently cover medical care.  A key feature to this system, much like the Beveridge Model, is that it is strictly non-profit and government-run.  No one is denied coverage in the Bismarck Model. Most hospitals are privately run.

Countries that operate their health care systems using the Bismarck Model include Germany, Switzerland, the Netherlands, and Japan.

System #3: National Health Insurance Model

Canada, Taiwan, and South Korea are all examples of health care systems that employ the National Health Insurance Model.  This model combines the best of both the Beveridge and Bismarck Models; citizens pay for their health care services through a higher taxation rate, but they are free to seek medical services anywhere throughout the country without concern of being denied.  These countries are able to negotiate better prices from pharmaceutical and medical equipment companies to meet the needs of their citizens’ health care. There is no goal of profit, only providing excellent care to all citizens.

System #4: Private Insurance Model

The US is the only developed country that relies on this out-of-pocket health care model.  As such, not all citizens are covered, and a patient’s access to healthcare services are dependent upon how much money the patient has. Private insurance is obtained through one’s employer or through a private insurance company, and profit rules the game.

In the US, there are certain populations of people who qualify for medical assistance from the government, including the elderly (Medicare) and the poor (Medicaid).  For those who fall into neither category, paying out-of-pocket for medical services is a costly way to obtain needed care.

These are simplified descriptions of each of the common health care systems across the globe, but they reveal a country’s priorities and concerns.  If you are planning to become a doctor, it is valuable to know the kind of health care system you are likely to be working within.


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Gap Medics provides year-round hospital work experience for people aged 16 and over. Our shadowing placements offer a unique insight into the work of doctors, nurses, midwives and dentists – helping students to focus their career aspirations before embarking upon medical training.