Question

scenario：You have been asked to serve on a committee that advises the World Bank about how to fund a healthcare system in the developing world. As part of this role you need to design a healthcare system for the country described below costing no more than $500 million that keeps the largest possible number of people healthy:
This country is about the size of Texas—250,000 square miles. A mountain range separates the country into two regions.
Ten million people live in the coastal region, while five million live in the inland region.
Half the people live in urban areas, and the other half are evenly distributed through the country.
The coastal region has a hot, moist, tropical climate that supports lush jungles and fertile farmland.
The inland region is dry and cool and is predominantly grassland and forest.
The coastal region is well serviced by roads, but only about half the people in the inland region have convenient access to roads.
Only the largest cities and towns have modern sanitation.
Malnutrition and malaria are problems, few people are vaccinated, and there is little health care currently available.
Most people grow their own food and have little extra money to spend. Few children attend school.
Challenge: Think of health care options for this country in terms of:
1. What are some options which should be included?
2. What are some options which should not be included ?

Answer 1

Solution

When we analyze the different healthcare systems around the world,they can classified into 4 different models:

1.TheBeveridge Model - Under this system,the entire healthcare costs f=of every citizen of the country is taken care by the Govt which is a big positive.Since it involves huge costs only the wealthiest countries(ex: Britain) mostly will be able to afford.

2.The Bismarck Model - In the countries that followthis model,the insurance companies are not allowed to function under for profit motive and every individual is insured by paying his / her own premium.The hospitals are run by individuals.Here,since the individuals are paying for their own medical expenses,they have freedom to opt for the services in the manner they wish to.So,there is more efficiency invloved.

3.The National Health Insurance Model - In these countries,the hospitals are owned by private parties.The govt chooses the kind of services for which it is going to pay for.In other words the premium will be paid by govt for the healthcare insurance policy that includes treatment for only specific ailments prescribed by the Govt.If someone wants to get covered to some different ailments they need to pay on their own.So,less freedom.So,generally the govt's choose the treatments according to their specific priorities like common diseases prevalent,economic cost involved,number of people to be covered etc.,

4.The Out of the pocket Model - Here the govt's do not partcipate at all in the healthcare system.All the medical expenses to be beared by the individuals themselves.So,while the rich can manage to get, th poor will suffer for treatment.

So,according to the background described above about the country,it is better to oprt for National Health Care System for this country:

- This country has huge population and it is not financially developed (majority has no proper sanitation,malnutrition,no proper infrastructure,etc.,)

- It is suffering more specially with the problems of malnutrition and Malaria and for vaccination

So the country can include the options for treatment of malnutrition,Malaria and vaccinationin the universal health polic that they roll out out across their country to all its citizens.In other words,Govt. bears the entire healthcare costs for a list of diseases,problems which also include malnutrition, Malaria and Vaccination.In this manner they would atleast be able to reach the maximum number of people but limiting the govt.'s scope primarily to the above mentioned ailments.

- Since the costal areas are fertile (due to which the agriculture icome is good) and also sanitation facilities are good,so the number of people who might suffer with Malaria,Malnutrition and not vaccinatedwill be less.So,the govt can exclude the people living in coastal regions regions from offering them free treatments for these.In this manner the govt. would be able to utilize their limited funds in a effcient manner (spending only on those who might need)

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