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National health insurance (NHI), sometimes called statutory health insurance (SHI), is a system of
health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among m ...
that insures a national population against the costs of
health care Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health pr ...
. It may be administered by the public sector, the private sector, or a combination of both. Funding mechanisms vary with the particular program and country. National or statutory health insurance does not equate to government-run or government-financed health care, but is usually established by national legislation. In some countries, such as Australia's Medicare system, the UK's
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
and South Korea’s National Health Insurance Service, contributions to the system are made via general taxation and therefore are not optional even though use of the health system it finances is. In practice, most people paying for NHI will join it. Where an NHI involves a choice of multiple insurance funds, the rates of contributions may vary and the person has to choose which insurance fund to belong to.


History

Germany has the world's oldest national social health insurance system,

with origins dating back to Otto von Bismarck's Sickness Insurance Law of 1883. In Britain, the
National Insurance Act 1911 The National Insurance Act 1911 created National Insurance, originally a system of health insurance for industrial workers in Great Britain based on contributions from employers, the government, and the workers themselves. It was one of the foun ...
included national social health insurance for primary care (not specialist or hospital care), initially for about one third of the population — employed working class wage earners, but not their dependents. This system of health insurance continued in force until the creation of the
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
in 1948 which created a universal service, funded out of general taxation rather than on an insurance basis, and providing health services to all legal residents.


Types of programs

National healthcare insurance programs differ both in how the contributions are collected, and in how the services are provided. In countries such as
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by to ...
, payment is made by the government directly from tax revenue and this is known as single-payer health care. The provision of services may be through either publicly or privately owned health care providers. In
France France (), officially the French Republic ( ), is a country primarily located in Western Europe. It also comprises of Overseas France, overseas regions and territories in the Americas and the Atlantic Ocean, Atlantic, Pacific Ocean, Pac ...
, a similar system of compulsory contributions is made, but the collection is administered by non-profit organisations set up for the purpose. An alternative funding approach is where countries implement national health insurance by legislation requiring compulsory contributions to competing insurance funds. These funds (which may be run by public bodies, private for-profit companies, or private non-profit companies), must provide a minimum standard of coverage and are not allowed to discriminate between patients by charging different rates according to age, occupation, or previous health status (
pre-existing medical conditions In the context of healthcare in the United States, a pre-existing condition is a medical condition that started before a person's health insurance went into effect. Before 2014, some insurance policies would not cover expenses due to pre-existin ...
). To protect the interest of both patients and insurance companies, the government establishes an equalization pool to spread risks between the various funds. The government may also contribute to the equalization pool as a form of health care subsidy. This is the model used in the
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. Other countries are largely funded by contributions by employers and employees to sickness funds. With these programs, funds come from neither the government nor direct private payments. This system operates in countries such as Germany and Belgium. These funds are usually non-profit institutions run solely for the benefit of their members. These systems are characterized by a mixture of three sources of funds in varying degrees: private, employer-employee contributions, and national/subnational taxes. In addition to direct medical costs, some national insurance plans also provide compensation for loss of work due to ill-health, or may be part of wider social insurance plans covering things such as pensions, unemployment, occupational retraining, and financial support for students. National schemes have the advantage that the pool or pools of contributors tend to be vast and reflective of the national population. Health care costs tend to be high at the extremes of age and other specific events in life, such as during pregnancy and childbirth. In a national healthcare scheme, these costs are covered by contributions made to the pool over an individual's lifetime (i.e., higher when earning capacity is greatest to meet costs incurred at times when earning capacity is low or non-existent). This differs from the private insurance schemes with contribution rates that vary year by year, according to health risks such as age, family history, previous illnesses, and height/weight ratios. Consequently, some people tend to have to pay more for their health insurance when they are sick or are least able to afford it. These problems do not exist in national health insurance schemes.


Programs

* Aasandha – Maldives *
Health care in Argentina Argentina's health care system is composed of a universal health care system and a private system. The government maintains a system of public medical facilities that are universally accessible to everyone in the country, but formal sector worker ...
* Health care in AustraliaMedicare (Australia) * Healthcare in Belgium – Sickness and Invalidity Insurance * Health care in Canada * Health care in Colombia – Law 100 – National Health Insurance Scheme: Contributory Vs. Subsidized coverage (NHIS) * Health care in France * Healthcare in Germany * Health care in Ghana – National Health Insurance Scheme (NHIS) * Health care in Israel * Health care in Italy – National Health Service (SSN) * Healthcare in India - Employees' State Insurance, Ayushman Bharat Yojana, others are provided insurance through their employer. *
Health care in Japan The health care system in Japan provides healthcare services, including screening examinations, prenatal care and infectious disease control, with the patient accepting responsibility for 30% of these costs while the government pays the remain ...
– People without insurance through employers can participate in a national health insurance program administered by local governments. *
Healthcare in Nigeria Health care, Healthcare in Nigeria is a concurrent responsibility of the three tiers of government in the country. Private providers of healthcare have a visible role to play in health care delivery. The use of traditional medicine (TM) and Comple ...
– National Health Insurance Scheme (NHIS) *
Health care in the Netherlands Healthcare in the Netherlands is differentiated into several main categories. Firstly in three different echelons; secondly in physical (somatic) versus mental healthcare; and thirdly in "cure" (short term) versus "care" (long term). ''"Huisarts ...
* Healthcare in the Philippines – Social Health Insurance Program, a resource pooling, risk sharing health care program that provides quality health care financing not only to the employed but to the sick, elderly, and indigents, as well * Health care in Poland *
Healthcare in South Korea Healthcare in South Korea is universal, although a significant portion of healthcare is privately funded. South Korea's healthcare system is based on the National Health Insurance Service, a public health insurance program run by the Ministry of H ...
* Healthcare in Switzerland – A compulsory health insurance covers a range of treatments which are set out in detail in the Federal Act. * Healthcare in Taiwan – National Health Insurance (NHI) * Health care in the United Kingdom – National Insurance


See also

*
Health care compared Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiz ...
*
Health care politics Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society".World Health Organization''Health Policy'' accessed 22 March 2011(Web archive)/ref> According to the ...
* Publicly funded health care * Single-payer health care * Universal health care


References


Further reading

*Nicholas Laham: ''Why the United States lacks a national health insurance program'', Westport, Conn. .a.: Greenwood Press, 1993 *Barona, B., Plaza, B., and Hearst, N. (2001) Managed Competition for the poor or poorly managed: Lessons from the Colombian health reform experience. Oxford University Pres

*Ronald L. Numbers (ed.): ''Compulsory Health Insurance: The Continuing American Debate'', Westport, Conn. : Greenwood Press, 1982. *Saltman, R.B., Busse, R. and Figueras, J. (2004) ''Social health insurance systems in western Europe'', Berkshire/New York: Open University Press/McGraw-Hill. *Saltman, R.B. and Dubois, H.F.W. (2004) Individual incentive schemes in social health insurance systems, 10(2): 21-25
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*Van de Ven, W.P.M.M., Beck, K., Buchner, F. et al. (2003) Risk adjustment and risk selection on the sickness fund market in five European countries, Health Policy, 65(1=: 75-98. *Saltman, R.B. and Dubois, H.F.W. (2005) Current reform proposals in social health insurance countries, Eurohealth, 11(1): 10-14
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External links


Health Care for America NOW!
An advocacy group that supports a public health insurance option for universal health care.
Health Care Issues & Resources
Barack Obama Website

Family Doctor Magazine Website {{Authority control Health economics Social programs Health policy