Health Care Systems - Four Basic Models. An excerpt from correspondent T. R. Reid’s upcoming book on international health care, titled “We’re Number 3. U. S.’s ranking in the World Health Organization 2. World Health Report. The book is scheduled to be published by Penguin Press in early 2. There are about 2. WORKERS' COMPENSATION IN ANTIQUITY. The history of compensation for bodily injury begins shortly after the advent of written history itself 1. 3191 from ancient Sumeria in the fertile crescent outlines. A collection of comments and observations about politicians, the frailties of people who get into politics, the kinds of fools who put their trust in them, corruption, and power. This is a very RARE signed Knight’s Cross Document in Folder (Ritterkreuz Urkunde Und Mappe) presented to Generaloberst Wilhelm Ritter v. Leeb by Adolf Hitler on the occasion of his receipt of. Bismarck at age 21, 1836. Bismarck was born in Sch. His father, Karl Wilhelm Ferdinand von Bismarck (Sch The origins of national health insurance began with the very conservative government of Otto von Bismarck, Chancellor of Germany in the 19th century. Conservatives in both Britain and Germany supported laws that provided for. There are about 200 countries on our planet, and each country devises its own set of arrangements for meeting the three basic goals of a health care system: keeping people healthy, treating the sick, and protecting families. But we don’t have to study 2. For all the local variations, health care systems tend to follow general patterns. There are four basic systems: The Beveridge Model. Named after William Beveridge, the daring social reformer who designed Britain’s National Health Service. In this system, health care is provided and financed by the government through tax payments, just like the police force or the public library. Government Role and Involvement. In the German health care system, each level of government has specific responsibilities. The central government passes legislation on policy and jurisdiction.Many, but not all, hospitals and clinics are owned by the government; some doctors are government employees, but there are also private doctors who collect their fees from the government. In Britain, you never get a doctor bill. These systems tend to have low costs per capita, because the government, as the sole payer, controls what doctors can do and what they can charge. Countries using the Beveridge plan or variations on it include its birthplace Great Britain, Spain, most of Scandinavia and New Zealand. Hong Kong still has its own Beveridge- style health care, because the populace simply refused to give it up when the Chinese took over that former British colony in 1. Cuba represents the extreme application of the Beveridge approach; it is probably the world’s purest example of total government control. The Bismarck Model. Social security, any of the measures established by legislation to maintain individual or family income or to provide income when some or all sources of income are disrupted or terminated or when exceptionally heavy. Title: Bismarck Tribune. Collection Number: 00080. Abstract: Images used in the Bismarck Tribune newspapers from the 1930s-1970s. Provenance: The collection was donated to the. Named for the Prussian Chancellor Otto von Bismarck, who invented the welfare state as part of the unification of Germany in the 1. Despite its European heritage, this system of providing health care would look fairly familiar to Americans. It uses an insurance system — the insurers are called “sickness funds” — usually financed jointly by employers and employees through payroll deduction. Unlike the U. S. Doctors and hospitals tend to be private in Bismarck countries; Japan has more private hospitals than the U. S. Although this is a multi- payer model — Germany has about 2. Beveridge Model provides. The Bismarck model is found in Germany, of course, and France, Belgium, the Netherlands, Japan, Switzerland, and, to a degree, in Latin America. The National Health Insurance Model. This system has elements of both Beveridge and Bismarck. It uses private- sector providers, but payment comes from a government- run insurance program that every citizen pays into. Since there’s no need for marketing, no financial motive to deny claims and no profit, these universal insurance programs tend to be cheaper and much simpler administratively than American- style for- profit insurance. The single payer tends to have considerable market power to negotiate for lower prices; Canada’s system, for example, has negotiated such low prices from pharmaceutical companies that Americans have spurned their own drug stores to buy pills north of the border. National Health Insurance plans also control costs by limiting the medical services they will pay for, or by making patients wait to be treated. The classic NHI system is found in Canada, but some newly industrialized countries — Taiwan and South Korea, for example — have also adopted the NHI model. The Out- of- Pocket Model. Only the developed, industrialized countries — perhaps 4. Most of the nations on the planet are too poor and too disorganized to provide any kind of mass medical care. The basic rule in such countries is that the rich get medical care; the poor stay sick or die. In rural regions of Africa, India, China and South America, hundreds of millions of people go their whole lives without ever seeing a doctor. They may have access, though, to a village healer using home- brewed remedies that may or not be effective against disease. In the poor world, patients can sometimes scratch together enough money to pay a doctor bill; otherwise, they pay in potatoes or goat’s milk or child care or whatever else they may have to give. If they have nothing, they don’t get medical care. These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus. When it comes to treating veterans, we’re Britain or Cuba. For Americans over the age of 6. Medicare, we’re Canada. For working Americans who get insurance on the job, we’re Germany. For the 1. 5 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out- of- pocket at the time of treatment or if you’re sick enough to be admitted to the emergency ward at the public hospital. The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody. This is much simpler than the U. S. Sweden has some features of a national health service such as hospitals run by county government; but other features of national health insurance such as physicians being paid on a FFS basis). Otto von Bismarck (1. Familypedia. Otto Eduard Leopold, Prince of Bismarck, Duke of Lauenburg (1 April 1. July 1. 89. 8), simply known as Otto von Bismarck, was a conservative German statesman who dominated European affairs from the 1. In 1. 87. 1, after a series of short victorious wars, he unified most of the German states (whilst excluding some, most notably Austria) into a powerful German Empire under Prussian leadership. His diplomacy of Realpolitik and powerful rule gained him the nickname the . As Henry Kissinger has noted, . He created a new nation- state and led the way to the welfare state. He disliked colonialism but reluctantly built an overseas empire when it was demanded by both elite and mass opinion. Bismarck (a devout Lutheran) was loyal to his king, who in turn gave Bismarck his full support. While his new German Empire had universal male suffrage, the elected officials did not have real control of the government. Bismarck distrusted democracy and ruled through a strong, well- trained bureaucracy with power in the hands of a Junker elite representing the landed aristocracy in the east. He possessed not only a long- term national and international vision, but also the short- term ability to juggle many complex developments simultaneously. As the leader of what historians call . Historians generally praise him as a statesman of moderation and balance who kept the peace in Europe and was primarily responsible for the unification of modern Germany. His father, Karl Wilhelm Ferdinand von Bismarck (Sch. The world saw Bismarck as a typical Prussian Junker — an image which he encouraged by wearing military uniforms. Bismarck was well educated and cosmopolitan, with a gift for conversation. He was fluent in English, French, Italian, Polish, and Russian. From 1. 83. 2 to 1. University of G. Motley later became an eminent historian and diplomat, and one of Bismarck's closest friends. Motley in 1. 83. 9 wrote a novel, Morton's Hope, or the Memoirs of a Provincial about life in a German university in which he described Bismarck as a reckless and dashing eccentric, but also as an extremely gifted and charming young man. Although Bismarck hoped to become a diplomat, he started his practical training as a lawyer in Aachen and Potsdam, and soon resigned, having first placed his career in jeopardy by taking unauthorized leave to pursue two English girls, first Laura Russell, niece of the Duke of Cleveland, and then Isabella Loraine- Smith, daughter of a wealthy clergyman. Under her influence, he became a Pietist Lutheran, and later recorded that at Marie's deathbed (from typhoid) he prayed for the first time since his childhood. Bismarck married Marie's cousin, the noblewoman Johanna von Puttkamer (Reinfeld, 1. April 1. 82. 4 – Varzin, 2. November 1. 89. 4) at Alt- Kolziglow (modern Ko. Their long and happy marriage produced three children, Herbert (b. Johanna was a shy, retiring and deeply religious woman—although famed for her sharp tongue in later life—and in his public life Bismarck was sometimes accompanied by his sister Malwine (. There, he gained a reputation as a royalist and reactionary politician with a gift for stinging rhetoric; he openly advocated the idea that the monarch had a divine right to rule. His selection was arranged by the Gerlach brothers, who were also Pietist Lutherans and whose ultra- conservative faction was known as the . The monarch, though initially inclined to use armed forces to suppress the rebellion, ultimately declined to leave Berlin for the safety of military headquarters at Potsdam (Bismarck later recorded that there had been a . He traveled to Berlin in disguise to offer his services, but was instead told to make himself useful by arranging food supplies for the Army from his estates in case they were needed. The King's brother Prince William (the future King and Emperor William I) had fled to England, and Bismarck intrigued with William's wife Augusta to place their teenage son (the future Frederick III) on the Prussian throne in King Frederick William IV's place—Augusta would have none of it, and detested Bismarck thereafter, although Bismarck did later help to restore a working relationship between the King and his brother, who were on poor terms. Bismarck was not yet a member of the Landtag—the lower house of the new Prussian legislature. The liberal victory perished by the end of 1. Gerlach brothers—known as the . Although a constitution was granted, its provisions fell far short of the demands of the revolutionaries. In 1. 84. 9, Bismarck was elected to the Landtag. At this stage in his career, he opposed the unification of Germany, arguing that Prussia would lose its independence in the process. He accepted his appointment as one of Prussia's representatives at the Erfurt Parliament, an assembly of German states that met to discuss plans for union, but only in order to oppose that body's proposals more effectively. The Parliament failed to bring about unification, for it lacked the support of the two most important German states, Prussia and Austria. In 1. 85. 0, after a dispute over Hesse, Prussia was humiliated and forced to back down by Austria (supported by Russia) in the so- called Punctation of Olm. Bismarck gave up his elected seat in the Landtag, but was appointed to the Prussian House of Lords a few years later. In Frankfurt he engaged in a battle of wills with the Austrian representative Count Friedrich von Thun und Hohenstein, insisting on being treated as an equal by petty tactics such as insisting on doing the same when Thun claimed the privileges of smoking and removing his jacket in meetings. No longer under the influence of his ultraconservative Prussian friends, Bismarck became less reactionary and more pragmatic. He became convinced that in order to countervail Austria's newly restored influence, Prussia would have to ally herself with other German states. As a result, he grew to be more accepting of the notion of a united German nation. Bismarck also worked to maintain the friendship of Russia and a working relationship with Napoleon III's France—the latter being anathema to his conservative friends the Gerlachs, but necessary both to threaten Austria and to prevent France allying herself to Russia. In a famous letter to Leopold von Gerlach, Bismarck wrote that it was foolish to play chess having first put 1. This observation was ironic as after 1. France would indeed become Germany's permanent enemy and would indeed eventually ally with Russia against Germany in the 1. Bismarck was also horrified by Prussia's isolation during the Crimean War of the mid- 1. Austria sided with Britain and France against Russia; Prussia was almost not invited to the peace talks in Paris). In the Eastern crisis of the 1. Bismarck's signing the Dual Alliance with Austria- Hungary in 1. However, in the 1. Bismarck correctly foresaw that by failing to support Russia (after Russian help in crushing the Hungarian Revolt in 1. Olm. His brother, William, took over the government of Prussia as regent. At first William was seen as a moderate ruler, whose friendship with liberal Britain was symbolised by the recent marriage of his son (the future Frederick III) to Queen Victoria's eldest daughter; their son (the future William II) was born in 1. As part of William's . In theory this was a promotion as Russia was one of the two most powerful neighbors of Prussia (the other was Austria). In reality Bismarck was sidelined from events in Germany, watching impotently as France drove Austria out of Lombardy during the Italian War of 1. Bismarck proposed that Prussia should exploit Austria's weakness to move her frontiers . As a further snub, the Regent, who scorned Bismarck as a . Bismarck stayed in Saint Petersburg for four years, during which he almost lost his leg to botched medical treatment and once again met his future adversary, the Russian Prince Gorchakov, who had been the Russian representative in Frankfurt in the early 1. Bismarck later referred to this period as . He also visited England that summer. A crisis arose in 1. Diet refused to authorize funding for a proposed re- organization of the army. However, Wilhelm was ambivalent about appointing a person who demanded unfettered control over foreign affairs. When, in September 1. Abgeordnetenhaus (House of Deputies) overwhelmingly rejected the proposed budget, Wilhelm was persuaded to recall Bismarck to Prussia on the advice of Roon. On 2. 3 September 1. Wilhelm appointed Bismarck Minister- President and Foreign Minister. Bismarck, Roon and Moltke took charge at a time when relations among the Great Powers—Great Britain, France, Austria and Russia—had been shattered by the Crimean War of 1. Italian War of 1. In the midst of this disarray, the European balance of power was restructured with the creation of the German Empire as the dominant power in Europe. This was achieved by Bismarck's diplomacy, by Roon's reorganization of the army, and by Moltke's military strategy. Despite the initial distrust of the King and Crown Prince, and the loathing of Queen Augusta, Bismarck soon acquired a powerful hold over the King by force of personality and powers of persuasion. Bismarck was intent on maintaining royal supremacy by ending the budget deadlock in the King's favour, even if he had to use extralegal means to do so. He contended that, since the Constitution did not provide for cases in which legislators failed to approve a budget, he could merely apply the previous year's budget. Thus, on the basis of the budget of 1. Bismarck's conflict with the legislators grew more heated during the following years. Bismarck then issued an edict restricting the freedom of the press; this policy even gained the public opposition of the Crown Prince, Friedrich Wilhelm (the future Emperor Friedrich III). Despite attempts to silence critics, Bismarck remained a largely unpopular politician. His supporters fared poorly in the elections of October 1. Progress Party) won over two- thirds of the seats in the House.
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