Health system

The health care system or health of a country includes all individuals, organizations, institutions, rules and processes, whose task is the promotion and maintenance of health and the prevention against and treatment of diseases and injuries. In Austria, the term for this medical service is being used. The term health is used to describe the highly complex health system for patient care and health maintenance, while the health industry as a whole in addition to the inpatient and outpatient care of the sick and prevent disease in healthy individuals, among other things, the production of pharmaceuticals and medical devices, health tourism, the spa - and includes the fitness industry.

Objectives

In the scientific literature, one finds the following objectives for the health sector:

• Responsiveness (the problem of influencing the demand by the provider)
• Equal opportunities ( access to health care regardless of income and status)
• Affordability ( pricing and utilization of services )
• Performance (fast and effective treatment )
• Efficiency (ratio of costs and benefits)

In 2000, the World Health Organization laid down objectives against which it measures national health systems:

• The response to needs of the population in general issues such as dignity, self-determination, privacy, and customer orientation,
• The equitable distribution of the financial burden as well as
• The health level of the population.

2001, the European Commission defined goals for health care and the elderly:

• Financial viability,
• High quality and
• Access for all.

The question of funding is linked to the question who get sick as quickly which treatment. In doctors' offices, the saving - long since led to a secret rationing - especially for physicians in private practice at the end of a quarter, when the ' points ' of the practice are depleted. Sweden practiced a system that can be incorporated cost-benefit considerations in the medical decisions.

Party

The participants in the health care system are

• The recipients of health care services (service recipient )
• Care providers: doctors, dentists, pharmacists, nurses, therapists. (The term " provider " is a legal term from the SGB V, which is perceived by the health professional members as pejorative ).
• The performance financiers: direct payer ( self-pay ), voluntarily insured, legally insured workers, employers, private health insurance
• Performance payer: direct payer, health insurance, the statutory accident insurance, long term care insurance and pension insurance, the statutory health insurance physicians, dentists' associations State aid agencies
• The state: its legislative bodies such as states and municipalities and its regulatory and monitoring bodies such as health authorities
• Other health professionals interest groups, for example, patients' associations, national associations and self-help organizations, professional associations
• Science: medicine, health sciences and health services research

Financing models

A characteristic feature of a health system is the way it is financed. Basically, there are three classes:

• National Health Service: tax-based funding (eg, Great Britain, Italy, Ireland, Denmark, Portugal)
• Private insurance model: financing through voluntary health insurance (eg USA )
• Social model: financing through legal insurance ( eg Germany, France, Benelux).

In addition, the Dutch model, consisting of health premium and einkommensentsprechendem contribution.

International Comparisons

Health expenditure

The right table shows the countries with the highest relative expenditure on health as a share of gross domestic product or the countries with the highest absolute expenditure as purchasing power -adjusted dollars per capita in 2008.

On average across OECD member countries, health spending increases faster than the economy force. The per capita spending increased from 1990 to 2005 over 80 %, while the gross domestic product ( GDP) per capita grew by only 37%. Documents, health spending in 1970 at an average of 5% of GDP, the proportion in 1990 was increased to 7% and increased up to 2005 further to 9%. In Germany, the health expenditure was in 2010 at 287.3 billion euros, equivalent to 11.6% of GDP.

* Fulfilling the WHO criteria compared to the resources used

The quality of health care systems is difficult to assess. For example, has a high proportion of patients in the population do not necessarily indicate a poor medical care. On the contrary, a diabetic will die in a country with poor medical care soon, and thus fall out of sick days. In a country with good medical care, however, he can still live a long time, but will appear in the statistics as a sick person. A high proportion of sick people in the population, however, is an indication that medical care is more concerned about the treatment of symptoms takes care as to eliminate the causes. The diabetic obtained, for example insulin to live with his illness can the specific causes of the disorder are not fixed and if appropriate. The situation is similar in a number of other, mainly caused by diet and lifestyle diseases, which are responsible for a large proportion of care cases.

The World Health Organization has established a ranking of the health systems of its 191 member countries. Was compared on the basis of the above objectives - health level, need guidance and financing justice - on the basis of data from the year 1997 The study revealed the following rankings in the table above. .

The German Medical Journal accuses the study, however, have an insufficient and frivolous selected data base and a political coloring. It also criticized the fact that the rankings differ greatly in the various categories of the study.