Comparative of Health Care Policies Readings: Harrop: Chapter 7 "Health Policy" (pp. 150-173) Fallows: "A Triumph of Misinformation" (pp. 9-17 or pp. 13-21) I. Care in Comparative Perspective A. Definition of Health Care Policy. 1. What is health? a) Dealing with illness by ensuring the provision of treatment for the sick. b) Health defined as the state of optimal physical, social and mental well-being. 2. What is the role of the State? a) In Japan and France, the constitutions specifically refer to health. b) In Britain, the Beveridge Report of 1942 established a basic government authority for health care. c) The American constitution does not mention health. B. Funding Health Care 1. France operates a system of national health insurance (NHI) begun in 1936 as part of the Social Insurance Act and covered nearly all by 1979. a) The French government provides about 25% of the total revenue. b) People pay premiums to insurers who reimburse patients (or care providers) for the cost of treatment. c) It is an employment-based scheme. (1) Employers' contribute 13.5% of employees' taxable salary to the plan. (2) Employees add 6.5%. d) Health care for the unemployed is provided through Social Aid. 2. Japan provides health care through the Employer Health Insurance (EHI) program established in 1922 and expanded in 1939. a) EHI covers larger employment-based groups (about half of the population) (1) Funded with a 4% payroll tax on both employers and workers. (2) Covers 90% of insured workers' medical costs and 70% to 80% of dependents' costs with a cap on patient payments. b) NaHI (National Health Insurance) in 1961 made the system comprehensive and compulsory. (1) NaHI is organized by local governments, funded by taxes on households and supplemented with a government subsidy.
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