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Since 1983, many of the health care reforms in Germany have been legislative interventions aimed at stabilizing statutory health insurance. 9 out of 10 citizens are legally insured, only 8% privately. Healthcare in Germany, including its industry and all services, is one of the largest sectors of the German economy. Total spending in the German health economy amounted to around €287.3 billion in 2010, which corresponds to 11.6% of gross domestic product (GDP) this year and around €3,510 per capita. Direct inpatient and outpatient care is projected to account for only about a quarter of total spending. [3] Drug spending is almost twice as high as that of the hospital sector as a whole. Drug spending increased by an average of 4.1% per year between 2004 and 2010. [Citation needed] Health care was reformed in 1948 after World War II, largely modelled on the Beveridge Report of 1942, with the creation of the National Health Service, or NHS. It was originally created as part of a broader reform of social services and financed by a social security system, although the provision of health care was never conditional on the payment of contributions to the National Insurance Fund. Private healthcare was not abolished, but had to compete with the NHS. Around 15% of all healthcare spending in the UK is still funded by the private sector, but this includes patient contributions to NHS prescription medicines, so private sector healthcare in the UK is quite low. As part of a broader reform of the social offer, it was originally thought that the focus would be on both the prevention and cure of diseases.

The NHS, for example, would distribute baby milk fortified with vitamins and minerals to improve the health of children born in the post-war years, as well as other supplements such as cod liver oil and malt. Many of the most common childhood diseases, such as measles, mumps and chickenpox, have been largely eradicated through a national immunization programme. A key element of health care reform is the reduction of fraud and abuse in health care. In the US and the EU, it is estimated that up to 10% of all healthcare transactions and expenses can be fraudulent. See Terry L. Leap, Phantom Billing, Fake Prescriptions, and the High Cost of Medicine: Health Care Fraud and What to Do About It (Cornell University Press, 2011). Employers and the self-employed are legally required to pay national health insurance (NHI) premiums equivalent to social security contributions in other countries. However, NHI is a pay-as-you-go system. The aim is for premium revenues to bear the costs. The system is also subsidized by a tobacco tax surtax and contributions from the national lottery. [16] [17] After the collapse of the Soviet Union, Russia launched a series of reforms aimed at ensuring better health care through compulsory health insurance with private providers in addition to state institutions.

According to the OECD[8], none of the 1991-93 reforms went as planned, and the reforms worsened the system in many ways. Russia has more doctors, hospitals, and health workers than almost any other country in the world per capita,[9][10] But since the collapse of the Soviet Union, the health of the Russian population has deteriorated significantly due to social, economic, and lifestyle changes. However, after Putin became president in 2000, public health spending increased significantly, surpassing pre-1991 levels in real terms in 2006. [11] Life expectancy also increased from 1991-93, with the infant mortality rate rising from 18.1 in 1995 to 8.4 in 2008. [12] Russian Prime Minister Vladimir Putin announced large-scale health care reform in 2011 and promised to allocate more than 300 billion rubles ($10 billion) over the next few years to improve health care in the country. [13] It is also interesting to note the world`s oldest healthcare system and its advantages and disadvantages, see Health in Germany. Taiwan changed its health care system in 1995 to a national health insurance model similar to the U.S. Medicare system for the elderly.

As a result, the 40% of Taiwanese who were not previously insured are now insured. [14] It is said to offer universal coverage with free choice of doctors and hospitals and no waiting list. Surveys conducted in 2005 reportedly showed that 72.5 per cent of Taiwanese were satisfied with the system and, if dissatisfied, with the cost of premiums (equivalent to less than $20 per month). [15] The proposed five control buttons represent the mechanisms and processes through which policymakers can shape effective health care reforms. These tax buttons are not only the most important elements of a health care system, but they also represent the aspect that can be consciously adapted by reforms to bring about change. The five control buttons are as follows:[19] As shown by the wide variety of different health systems around the world, there are different paths a country could take when considering reforms. Compared to the UK, doctors in Germany have more bargaining power through professional associations (i.e. medical associations); This negotiating capacity has an impact on reform efforts. [18] Germany uses health insurance companies, which citizens must join, but which can withdraw with a very high income (Belien 87). The Netherlands used a similar system, but the financial threshold for opt-out was lower (Belien 89). The Swiss, on the other hand, are more likely to use a private health insurance system in which citizens are at risk based on age and gender, among others (Belien 90). The U.S.

government provides health care to just over 25 percent of its citizens through various agencies, but does not otherwise use a system. Healthcare generally focuses on regulated private insurance methods. In „Getting Health Reform Right: A Guide to Improving Performance and Equity”[19], Marc Roberts, William Hsiao, Peter Berman and Michael Reich of Harvard T.H. The Chan School of Public Health aims to provide decision-makers with tools and framework conditions for health system reform. They propose five „control buttons” of health care reform: funding, payment, organization, regulation, and behavior. [19] These control buttons refer to „mechanisms and processes that reformers can adapt to improve system performance.” [19] The authors chose these control buttons as representative of the key factors on which a decision-maker can act to determine health system outcomes. In the United States, the debate on health care reform focuses on the issues of the right to health care, access, equity, sustainability, quality, and the amounts spent by government. The mixed public-private health care system in the United States is the most expensive in the world, with health care costing more per person than in any other country, and more of the gross domestic product (GDP) is spent on it than in any other United Nations member state except East Timor (Timor-Leste).

[1] The NHS has undergone many reforms since 1974. Conservative Thatcher governments have sought to compete with the NHS by developing a supplier/buyer role between hospitals as suppliers and health authorities as buyers. This required the detailed calculation of activities, which the NHS should never have done in such detail, and some felt it was unnecessary. Labour has generally rejected these changes, although the Blair government, after the party became New Labour, retained elements of competition and even expanded it so that private healthcare providers could apply for NHS work. Some treatment and diagnostic centres are now operated by private companies and financed under contract. However, the scale of this privatisation of NHS work is still small, but remains controversial. The administration has provided more money to the NHS, which has brought it almost the same level of funding as the European average, and as a result, there has been a major programme of expansion and modernisation and improved waiting times. A 2008 article in the journal Health Affairs suggested that the Dutch health system, which combines compulsory universal coverage with competing private health plans, could serve as a model for reform in the United States. [6] [7] These developments have led to many health care reforms since the 1980s. A recent example from 2010 and 2011: For the first time since 2004, spending on medicines increased from €30.2 billion in 2010 to €29.1 billion in 2011, or minus €1.1 billion or minus 3.6%. The reason for this was the restructuring of the Social Security Code: manufacturer`s discount of 16% instead of 6%, moratorium on prices, increase in discount contracts, increase in discount by wholesalers and pharmacies.

[4] Gordon Brown`s government has proposed new reforms for care in England. One is to steer the NHS towards health prevention by tackling problems known to cause long-term illness. The most important of these is obesity and related diseases such as diabetes and cardiovascular disease. The second reform is to make the NHS a more personalised service, and it negotiates with doctors to offer more services at more convenient times for the patient, such as evenings and weekends. This idea of personalized service would introduce regular health check-ups so that the population is checked more regularly. Doctors will give more advice on disease prevention (for example. B, encourage and support patients to control their weight, eat, exercise more, quit smoking, etc.) and thus solve problems before they become more serious. Wait times, which have decreased significantly under Blair (the average wait time is about 6 weeks for non-emergency non-urgent operations), are also the focus of attention. In December 2008, a goal was set to ensure that no one waits more than 18 weeks from the date a patient is referred to the hospital until the time of surgery or treatment. .