How Are Health Care Systems Funded?

Health care systems refer to a particular system that involves different people from different organizations and institutions that only have one goal. This goal is to cater the health needs or to provide health care services to a certain number of people in a particular place. These services are provided by several health care providers which include nurses, doctors, dentists, optometrists and other health professionals out there. These people may be a part of for profit organizations/ non-profit organizations, government-owned organizations or charitable institutions.

So where do these organizations and institutions get their funds to perform their tasks? Basically, there are five ways in which health care systems are funded – taxation, social insurance, private health insurance, out-of-pocket expenses and donations.

Most of the time, individuals and people who own different types of properties are known to be taxpayers. Unlike other types of payments and donations, tax is actually not something that you can decide not to pay because is it has to be paid. Whether you like it or not, you have to pay a certain amount of tax to support the government and its programs. It is something that the government demands to be paid in a certain period of time. A portion or a small part of the collected taxes will then be given to health care organizations run by the government as their funds.

Social insurance on the other hand is another method of funding health care systems. Basically, this is a program that is completely supported by the government. It can be funded by taxes but it can also be funded by premiums which are either paid by the people involved or by other people on behalf of the people involved.

Private health insurance is similar to social insurance in some ways but they also have their differences. The participation in private health insurance is not compulsory but purchasing an insurance hence, you will have a chance to decide on which insurer you want to go with. Your benefits will also based on a contract while in social insurance, it is based on a statute.

Out-of-pocket expenses refer to the money that is spent which can either be refunded or not. It is basically the amount that the patient has to pay to the health care provider for the medical service provided without anybody else involved like an insurer or the government.

And last not the least funding method, donations.This is considered to a gift given by anyone without expecting anything in return. Most of the time, donations are given for charitable purposes and help other people. Donations can be in any form like money, food, service, toys and other items as long as they are voluntarily given.Health care systems are not only ones that are funded by donations but there are more than you know.

With these five methods, health care systems are able to serve their purpose very well. Different countries actually use a combination of any of the five methods in order to get their funds and provide health care services for their community.

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You Need Patient Advocacy

Healthcare in the U.S. is broken and only getting worse. Here are just a few examples of why:

-Of the $3 trillion spent on healthcare annually, $1 trillion is wasted;

-Many doctors are providing too much unnecessary treatment;

-Providers are paid for quantity of care vs. quality of care;

-Healthcare costs are through the roof for everyone; and

-Many patients are not aware of their rights and responsibilities within their healthcare.

Many people settle for the care they get from their healthcare providers when they should not. If you ordered a cheeseburger and got a hamburger, wouldn’t you take it back? Do you use that same tactic in your healthcare? Maybe not. You’re not alone, most don’t.

Have you ever had an experience at a doctor or hospital that was uncomfortable or frustrating? Had errors on your bills? Left a doctor’s appointment feeling puzzled? Many experience this every day. I’m here to tell you that you don’t have to deal with poor treatment.

Advocacy is a patient-centered method that can address many of the ills of America’s healthcare delivery, spending waste and inefficiencies.

Being a social worker for 20 years in many areas of healthcare, I’ve seen plenty happen to people who were uninformed or didn’t know what to say, do, or ask. Many times, negative outcomes were preventable.

What is patient advocacy?

This means championing the cause of meeting a patient’s needs and desires during their healthcare journey. This could mean speaking with doctors on a patient’s behalf, facilitating communication between healthcare providers, supporting a patient’s end-of-life wishes, correcting an erroneous bill, helping with insurance claims and so many other things.

Advocates also have focuses such as billing, insurance claims and appeals, specific diseases (cancer, Alzheimer’s, stroke), or getting and keeping good care (like me). There are professionals such as hospital advocates, patient navigators and nurse navigators in healthcare facilities to assist patients with their needs while they are in the hospital.

If you hire a private advocate (one with no corporate/non-profit interests) and pay them directly, their job is to go to the mat for your best interests. If you want to know where the loyalty of any advocate is, find out where their paycheck comes from, and you will have your answer. It’s not always with the patient, unfortunately.

Insurance does not cover advocacy (so private advocates must be paid out-of-pocket), as the government has not regulated our profession. Anyone can say they are an advocate because of this, even my sixth-grader, no matter what their level of experience is. Make sure to check their education, skills and experience before hiring them. Ensure that they are the right fit for your specific needs.

In advocacy, intelligence is not a substitute for experience. Many very sharp people have called on my services because they didn’t know how to handle their healthcare situations, some after making matters worse. They alienated the healthcare providers or they were labeled as “troublemakers.” Communication shuts down between families and providers – which is an awful scenario that does not help the patient’s interests. Advocates can assist you in a situation such as this, and many others depending on their specialty.

Healthcare is a business and you are a consumer. Further, you are responsible for your own healthcare. Patients have to take care of themselves and yield to a provider’s orders, as they are the experts on healthcare. Yet, patients have the right to question any medication, test or procedure proposed to them. Patients must do their part to have good health, as they are the experts on themselves. One cannot drink and smoke heavily and expect a miracle cure for their body after abusing it.

Healthcare spending can decrease once patients learn to use the healthcare system correctly, and a good private advocate can show you how to do that while saving you time, money and frustration.

Not only individuals and families can benefit, but corporations and non-profits can save by enlisting an advocate’s services. It will show their employees (especially those that are caregivers or have chronic illnesses) that there is a more efficient way to experience healthcare treatment, and possibly solve problems which can increase productivity!

The benefits of hiring an advocate can be priceless. Let one assist you in handling the business of healthcare, while you concentrate on the most important role – being a patient.

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