Also referred to as a health system, a healthcare system has as its core objective the delivery of goods and services as well as the allocation of limited resources to meet the health needs of a population. Additional objectives of healthcare systems may include, for example, preventing and controlling communicable diseases, treating illnesses, and promoting healthy behaviours.
Although healthcare systems around the world may share similar objectives, each system differs from others in how it is funded, who can access its goods and services, and the types of goods and services that it provides (Table 1).
These systems make use of different funding strategies to protect individuals from the uncertainty of healthcare needs. Public funding, for example, means that the healthcare system is financed through taxation; this also means that any increase in funding requires reallocation of public revenues away from other public goods and services. In the United Kingdom, for example, the Parliament decides the NHS expenditure along with the financing of other sectors. Private funding means that individuals must contribute to an insurance plan or pay out-of-pocket. In the UK voluntary private insurance can be purchased to cover certain healthcare needs or reduce waiting times for certain goods and services.
Universal health coverage is one of the sustainable development goals set by the World Health Organization. This goal means providing adequate access to healthcare of all populations without creating financial hardship for them.
Table 1. Examples of different types of healthcare system*
|Type||Example countries||Financing source(s)||Coverage extension|
|National health service||United Kingdom, Denmark, Finland, Iceland, Norway, Sweden, Portugal, Spain||Public||Universal|
|National health insurance||Canada, Australia, Ireland, New Zealand, Italy||Public||Universal|
|“Etatist” social health insurance||Belgium, France, Czech Republic, Netherlands, Poland||Public and private||Universal|
|Private health system||United States||Private||Not universal**|
*The healthcare systems in this table are representative of most countries in the Organisation for Economic Co-operation and Development, which are considered to be high-income, developed countries.
**8.5% of the population uninsured in 2018 as reported in Bohm et al. (2013).
Table sources: Bohm et al. (2013) and Commonwealth Fund (2020)