Mechanisms for financing health care systems: international experience

Abstract

Healthcare is an important component of a comprehensive social security system in every country and is an important priority for sustainable development. The purpose of the article is to systematize international experience in forming a financial mechanism for healthcare management, identify key factors in the effectiveness of various models, and determine the possibilities for adapting them to the socio-economic conditions of Ukraine. Methods: To achieve the goal and solve the tasks set, a set of methods was used: theoretical and methodological analysis of literature using PubMed/Medline, Google Scholar, and PakMediNet databases; content analysis method; comparative analysis method; and analytical method of systematization and synthesis. Results: It has been determined that the financing of healthcare systems can be divided into three groups: budgetary, social insurance, and private. The budgetary healthcare financing system is based on general tax revenues. Budget financing mainly takes the form of a single payment from the national budget to the national health service. This system of healthcare financing has been implemented in the United Kingdom, Sweden, Ireland, Spain, Italy, Norway, Montenegro, New Zealand, Cuba, and some other countries. The social insurance system of healthcare financing is implemented through systems based either on targeted contributions or on a single social insurance contribution. The mechanism for financing the healthcare system when introducing compulsory health insurance has certain features in each country and can be implemented either through a system of medical funds or through national health insurance companies. The social insurance system of healthcare financing has been introduced in Luxembourg, the Netherlands, the Czech Republic, Germany, Slovakia, France, Japan, and Canada. The private healthcare system is most prevalent in the United States and is characterized by decentralization, lack of state regulation, and highly developed infrastructure of insurance organizations. Conclusions Currently, none of the national healthcare systems are financed from a single source, as each financing system has its advantages and disadvantages and caters to specific segments of the population with different income levels. In reforming its healthcare system, Ukraine has based its approach on the implementation of state policy in the area of state financial guarantees for medical care through the National Health Service of Ukraine. Such a financing system can have both advantages and disadvantages, which can be observed in the organization of the healthcare system in the United Kingdom.