hmb203 Lec 5.docx

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Human Biology
Maria Papaconstantinou

HMB203 Lecture 5 (February 9, 2012) Health Systems& Culture and Health Cost effectiveness of Health interventions - Large percentage of GDP and family income spent on health care - Countries weigh costs and make decisions based on cost effective analysis - Health system by the WHO definition: o Functions – comprehensive range of services; protect individuals from financial ruin of health costs; improve the health of populations o Health does not jsut depend on a country’s health care system  Social, political, medical, economic factors  Act at region, individual, international and national levels  A country’s social and cultural values - Six building blocks of a GOOD health system o A good health system has a good information system o Ensure equitable access to everyone, safe and of high quality o Has to raise enough money to create small packages to provide for individuals that cannot afford. Categorizing Health Systems - Basic healthcare package should be a right rather than a privilege - In most high income countries, facilities are usually owned by the government or private sectors - Manner in which insurance in operated o Some countries operate and provide insurance o Doctors are in private practice in Canada and contract themselves to the government  Privately provided health care system o In the UK, funding the highly public—money comes from the income tax of individuals; some doctors are privately funded and most are public employees of the UK different that Canada o Germany was at the forefront of universal healthcare programs - Cuba is the only country in the world where the public sector finances and delivers all health services - Most low income countries have fragmented health systems o Includes both private and public providers - Many middle income have national health insurance - High income countries : private sectors deliver services but public services handle the finances Levels of Care - Primary Care – high income see physicians, low income sees everyone but a physician - Secondary – high income got to general hospital - Specialized hospitals only exist in very large cities Primary Health care - Different from primary LEVEL of healthcare - Regards health as a human right Public, private and NGOs - Public o Try to offer some type of insurance scheme o Can provide health services - Private for profit o Provide clinics and hospitals linked to insurance scheme o Many contract services to the government for a specific fee o Might involve private insurers - NGOs o Not for profit o Many contract their services to government organizations as well, because it is more cost effective for governments to do so . o Ex: VIRA in Bangladesh Health Expenditure - We must look at both formal and informal health care services that provide care to individuals o Ex: shamans, medicine men, herbal remedies Costa Rica – example of middle income - Similar to UK systems - Most services are free but some require co-payments India – low income example - Sub-centers, very tiered system of health care - One females and one male serve thousands of patients - Most primary healthcare is free in primary facilities - The private healthcare sectors –80% of all healthcare expenditures are out of pocket - Anout 90% of healthcare provided by the state government Health Sector Issues - High disparity in health care quality and accessibility between rural and urban areas because ngood health care providers are usually in the urban areas. - Do people have the capacity to pay for their healthcare? - Quality varies within health systems and between countries - percentage of he
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