How healthy is the Canadian health system

Health systems

The access of all citizens to comprehensive health care regardless of their income or state of health is a principle of modern societies, which is laid down in the Social Charter of the European Union. This postulate can only be met with public funding (taxes, social security contributions) which, depending on the country, cover between 70 and 85 percent of health expenditure in the EU. Historically, two different types of public health care have emerged, also known as the "Beveridge" and "Bismarck" systems after their founding fathers:

  • The Beveridge systems are state, tax-funded networks of medical practices and hospitals to which all residents have access. They were first set up in Great Britain (United Kingdom) after World War II on the basis of the report of a parliamentary commission led by Lord Beveridge. Comparable health systems have, among other things. the Scandinavian countries, Canada, Italy and Spain.
  • The "Bismarck" systems are social health insurances that are financed from social contributions of the insured and their employers. They have their historical roots in the statutory health insurance introduced by Bismarck in Germany in 1883. There are three different basic directions: regional or centralized insurance (e.g. in France, Poland and the Czech Republic), company or occupational and regional compulsory insurance (e.g. in Belgium, Japan, Austria), structured system with free choice of insurance company and box office competition (in Germany, the Netherlands and Switzerland).

An exception among the highly developed countries is the largely privately organized health system in the USA. Social health insurance is only available there for citizens over 65 ("Medicare") and for welfare recipients ("Medicaid"). About 50 percent of US citizens have a health plan, which employers collectively take out for their workforce with private or non-profit insurance. The scope of this insurance cover varies widely. 15 percent of US citizens have no health insurance at all, and another 20 to 25 percent are underinsured.

In an international comparison, the German health system has the following characteristics:

  • The dual system of private (PKV) and statutory health insurance (GKV) is unique in Europe since it was replaced in the Netherlands in 2006 by a uniform health insurance system for all citizens. In all other countries, the business model of private health insurance is limited to supplementary or complementary insurance to the public supply systems.
  • A structured GKV system with free choice of health insurance provider is only known in the Netherlands and Switzerland.
  • The legislature has assigned important tasks to the joint self-administration (including the specification of the statutory health insurance benefits catalog), which are carried out by government authorities in other European countries.

Federal Joint Committee

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