The document outlines different models of health care systems: 1) The Beveridge model is government-run healthcare financed through taxes where healthcare is free at the point of service. Examples include the UK. 2) The Bismarck model is jointly financed by employers and employees through payroll deductions and provides universal coverage through non-profit insurers. Examples include Germany and France. 3) The National Health Insurance model uses a government-run universal insurance program paid for by citizens with private providers. Examples are Canada and South Korea. 4) The out-of-pocket model exists in underdeveloped countries where the poor cannot afford care and basic healthcare is not universally accessible.

1. Shiva Ram Khatiwoda
Health System Models
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2. Goals of Health System
• There are about 200 nations on our planet,
and each nation devises its own set of
arrangements for meeting the three basic
goals of Health care system:
– I. Keeping people healthy
– II. Treating the sick
– III. Protecting families against financial ruin from
medical bills.

3. Health System Models
Healthcare delivery (Health System) models :
1. The Beveridge model
2. Bismarck model
3. National Health Insurance model
4. The out-of-pocket model
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4. The Beveridge (NHS) Model
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5. The Beveridge (NHS) Model
• Named after William Beveridge, the daring social reformer
who designed Britain’s National Health Service (NHS).
• In this system, health care is provided and financed by the
government through tax payments,
• Many, but not all, hospitals and clinics are owned by the
government; some doctors are government employees,
but there are also private doctors who collect their fees
from the government.
• In Britain, you never get a doctor’s bill.
• These systems tend to have low costs per capita, because
the government, as the sole payer, controls what doctors
can do and what they can charge.
• Example – UK, Spain, New Zealand
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The Bismarck Model

7. The Bismarck Model
• Named after the Prussian Chancellor Otto von
Bismarck, who invented the welfare state as part of the
unification of Germany in the 19th century.
• Usually financed jointly by employers and employees
through payroll deduction.
• Bismarck-type health insurance plans have to cover
everybody
• Non-profit making insurance
• Doctors and hospitals tend to be private in Bismarck
countries.
• Examples –Germany, France, Belgium, Netherlands,
Switzerland, Japan
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The National Health Insurance
Model

9. The National Health Insurance Model
• Has elements of both Beveridge and Bismarck.
• It uses private-sector providers, but payment comes
from a government-run insurance program that every
citizen pays into.
• Since there’s no need for marketing, no financial
motive to deny claims and no profit, these universal
insurance programs tend to be cheaper and much
simpler administratively
• The classic NHI system is found in Canada, but some
newly industrialized countries - Taiwan and South
Korea, for example - have also adopted the NHI model.
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10. The Out-of-Pocket Model
• Only the developed, industrialized countries - perhaps
40 of the world’s 200 countries - have established
health care systems.
• In other countries they have out of pocket model.
• The basic rule in such countries is that the rich get
medical care; the poor stay sick or die.
• Most of the nations on the planet are too poor and
too disorganized to provide any kind of mass medical
care.
• Hospitals and doctors are mostly private 10

11. The Out-of-Pocket Model
• Example – Many underdeveloped countries
of Africa, South America and Asia including -
Nepal, India, and China
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12. Mixed models
• Some elements of different models may be
included in some countries.
• This may also be a in transitional phase.
• For example – some services provided free,
some with subsidies, some social/national
insurance, and some out-of-pocket.
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13. Another way of categorization of
Health system model
1. Free market –
2. Welfare state –
3. Socialist state -
4. Underdeveloped -
5. Transitional –

14. Thank You
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