Key traits of Bismarck health care systems Universal insurance Community rating Insurance is financed through taxes(based on income), not premiums(based on health status) This means the rich and healthy subsidize the poor and sick The insurance system operates under managed competition-to be discussed later Regulated,private health care provision Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Key traits of Bismarck health care systems Universal insurance Community rating Insurance is financed through taxes (based on income), not premiums (based on health status) This means the rich and healthy subsidize the poor and sick The insurance system operates under managed competition – to be discussed later Regulated, private health care provision
Key traits of Bismarck health care systems ▣Universal insurance Community rating Regulated,private health care provision Many hospitals are private Physicians operate privately,not public employees But,prices are set by the government in negotiation with providers Private providers do not have the option of offering services at higher(or lower)prices Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Key traits of Bismarck health care systems Universal insurance Community rating Regulated, private health care provision Many hospitals are private Physicians operate privately, not public employees But, prices are set by the government in negotiation with providers Private providers do not have the option of offering services at higher (or lower) prices
Bismarck:balancing solidarity and liberty 。 Solidarity/equity:the poorest and sickest members of society are supported by the system,which grants subsidized health insurance to those least able to afford it. This subsidy is borne by the wealthiest and healthiest, who pay high taxes and actuarially-unfair premiums to keep the system afloat. Liberty:patients and doctors are at liberty to make fundamental economic choices,like which hospital to visit,which insurance contract to take,or where to open a new clinic or hospital. Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Bismarck: balancing solidarity and liberty • Solidarity/equity: the poorest and sickest members of society are supported by the system, which grants subsidized health insurance to those least able to afford it. • This subsidy is borne by the wealthiest and healthiest, who pay high taxes and actuarially-unfair premiums to keep the system afloat. • Liberty: patients and doctors are at liberty to make fundamental economic choices, like which hospital to visit, which insurance contract to take, or where to open a new clinic or hospital
A BRIEF TOUR OF THE BISMARCK WORLD Ch 17 The Bismarck model:Social health insurance
Ch 17 | The Bismarck model: Social health insurance A BRIEF TOUR OF THE BISMARCK WORLD
Germany German patients have the option of choosing among all available health insurance plans,including plans run by other companies or faraway states. These plans are nominally private entities,they are extensively regulated (managed competition). Premiums to finance insurance are collected as payroll taxes,and vary only with income,not health. Patients and insurers are free to choose their health care providers,who can compete to attract them. Remember,providers must compete based on quality rather than price Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Germany German patients have the option of choosing among all available health insurance plans, including plans run by other companies or faraway states. These plans are nominally private entities, they are extensively regulated (managed competition). • Premiums to finance insurance are collected as payroll taxes, and vary only with income, not health. • Patients and insurers are free to choose their health care providers, who can compete to attract them. • Remember, providers must compete based on quality rather than price