In order to describe the provision, management and effectiveness of health care systems in England, one must first define healthcare. Health care in nature is a universal requirement and is essentially (in economic terms) a derived demand from health. Health care is provided by personnel in a multidisciplinary team who work to advance and sustain a state of physical, mental and social wellbeing for all. A health care system can therefore be defined as a medium through which health care is provided to the population. The varying types of health care systems have arisen from each health service having their own different health objectives. Fundamentally there are two models of systems that health care seems to be based around (Culyyer et. al, 1981). The first is a market system where health care is selective and based on disposition to pay; this authority is attained by the purchase of private medical insurance. The main significance of this is that government has little control, and price and reward is determined by the market. The second system is a state run system funded by taxation to ensure that care is provided based on need and is free at the point-of-use. The two systems described are prototypes; the reality is that health care provision can be at either end of the extremes described or a mixture of the two. The health care systems that have been applied are commonly known as multi payer and single payer health care (single payer following closely to the latter system described by Culyer, Maynard and Williams (1981), multi payer tends to follow the former systems but can be a mixture of both). A multi payer health care system is typically financed more regressively, with private insurance companies (which can be profit or non-profit) providing the main funding with the government usually being the other source. The government and non-profit insurance companies tend to regulate the market to ensure fair pricing. Benefits of this system are that patients can select from a variety of coverage getting only the services that they require. Also there are usually shorter waiting times for non-emergency health services. Some of the main disadvantages are based around equity of the provision of treatment. It is seen as unfair that some are excluded from provision of treatment based upon their ability (or inability) to purchase the necessary insurance (btoema, 2011). Also in most countries much of the health coverage is provided (or at least matched) by a person’s place of work, meaning that health care is influenced greatly by employer sponsorship. The United States is an example of a multi payer health care system. A single payer health care system is whereby a public body covers all health care costs (not private insurers). The public body can employ health care staff and resources or can incorporate the single payer health care into a wider mixed payer system. This type of system ensures that health care is wealth dependent and is typically free at the point-of-use (as mentioned above). A single payer system promotes universal coverage ensuring fairness in society (Rice, 2002). Government systems also push preventative medicine more and increase awareness, something a multi payer health care system may not do. The nature of a single payer market is that it is publically funded and run through taxation. Theoretically a government run market tends to be more inefficient (in economic terms) than that of a free one due to poor cost minimization. Furthermore budgets and other constraints can lead to gaps in the health care system and longer waiting times. The National Health Service is an example of a socialized single payer health care system in England. N.B. As the British NHS is in fact devolved (England, Wales and Scotland each have their own separate funding), use of the term NHS should be associated with the NHS in England unless otherwise stated. Although a monopoly, the publically funded NHS has existed alongside...
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