FINANCING AND INSURANCE OF MEDICAL SECTOR

If we analyze the different types of financing we can think of four large systems models:

Welfare status system (Beverige and Shemasko model):

Services financed by taxes.

State control.

Social Security (Bismarck model):

Quotes.

Mandatory participation of workers.

Voluntary insurance (private):

Participation depends on the individual decision.

Direct payment of services.

In the first model, which includes the Spanish health system, are the systems encompassed in what is known as SNS, which are financed through taxes, where no one can avoid being exempt from funding and, therefore, can not be excluded in its use which provides universal and usually free access, although there may be benefits that require an additional payment for the use of certain benefits (co-payment). They are under state control, which determines the volume of taxes that will go to the system, the financing of the various benefits and to regulate the management processes of health centers and the access of citizens. They are known under the Beveridge model in Western society and also the Shemasko model in the former Soviet countries.

One of its strengths is the relatively easy administration of the system, and the universality that facilitates both social cohesion and effectiveness in health care by reducing barriers to accessibility. The healthcare system also focuses on medical device development projects. Within its weaknesses is the sensitivity to political interference and the competition of economic funds, with the financing of other public services. The second type of insurance is associated with the retention of part of the income of workers, these quotas constitute a specific fund only for the benefit of care of those groups that are listed - workers and their families. Therefore, it has a concrete link between contribution and profits and is independent of other government revenues. They are systems implemented in many countries of Central Europe and Latin America and are known as the Bismarck or Social Security model. Usually, it allows the choice of insurer or healthcare provider, which incorporates variables of competitiveness among them and, indirectly, facilitates the satisfaction of users with services. Logically, it does not enjoy the universal nature of the NHS, it has higher administrative costs and is more complicated to manage and, as part of labor costs, it can limit or reduce the competitiveness of companies. It is more regressive than the contribution by tax, since the quotations are usually subject to maximum retention ceilings in the upper reaches of labor income, so they have a lower relation between the level of income and the economic contribution to the maintenance of the system.

The last two systems of financing fall on the individual will of the people exclusively, either by voluntary insurance or by direct payment of the services, and in close relation with the capacity of payment at their disposal. Both have a strong relationship between payment and use and a high capacity in the election. In the case of voluntary insurance, it is subject to the risk of adverse selection, so that those who require health care because they have a greater degree of need may be excluded from insurance because they do not find the person who covers their risk or do not have sufficient economic level to support the cost of the policy. In most countries, financing and assurance systems are not pure and there are different models within each one, although the fundamental characteristic is usually defined as defining 6, this side of the North Atlantic being characterized by the SNS and the Security Social and the other side is decanted by a private insurance model, although according to the work of Health Cast 2010 7, there is a convergence between the insurance systems of the United States and Europe. In Europe, where healthcare is a right for all citizens, private insurance covers about 10% of healthcare costs and grows between 5% and 7% every year. In the United States, where health care is a benefit for workers for which businesses pay, public spending has increased in 10 years from 40 percent to almost 50 percent, and debate continues on the extent of public benefits to all citizens. The study suggests that basic and compulsory insurance systems, and additional or optional insurance, borne by the consumer or by companies will eventually be imposed.