is health care public or private?

Health care can be provided through public and private providers. Public healthcare is usually provided by the government through national health systems. For example, a private hospital is more likely to offer interventions such as scans (which involve radiation exposure) or procedures (such as colonoscopy) even if the patient does not need them, because it will increase its profit margin. Voluntary private health insurance is unrelated to the compulsory public system; it is mostly a type of duplicate insurance, offering coverage for the same goods and services offered by the public sector.

Understanding the tensions between global processes and local implementation is crucial for policy makers in addressing the consequences of recent health reforms and their influence on both efficiency and equity, two of the main challenges facing today's health systems. Noting that "free public healthcare is not free to the taxpayer, they compare the cost per patient in the two sectors and find that it is four times higher in the public sector. In the Sharan system, public hospitals sell services not covered by health funds to private insurers or individuals. However, these systems are often resisted by medical unions, not least because they threaten the income enjoyed by public doctors (such as those in Madhya Pradesh), whose remuneration is now independent even of their presence in the clinic.

Thus, the combination of structural similarities in economic development, welfare regimes and health systems with political and cultural differences makes the comparison very useful in understanding the varied avenues of privatisation. The Department of Health and Human Services has been designated as the Health Sector and Public Health Risk Management Agency. It was this mandate that kept healthcare costs low under the PPACA by promoting cost sharing across a wider group. In Israel, private groups are local and there is no significant foreign capital investment in the health sector.

Private sector healthcare facilities could also invest more in new equipment and workspaces. Research and development of medical devices and pharmaceuticals is supported by both public and private sources of funding. Like Spain, Israel has moved from a social security to a universal health care system. Private health organisations are established for profit and may be financed through self-employed professionals and non-governmental organisations.

Out-of-pocket payments account for about two-thirds of private expenditure (co-payments, dental care and oral treatment, private doctors and private insurance, prescription drugs not included in the shopping basket, private long-term care).

Samuel Krejsa
Samuel Krejsa

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