ABSTRACT
There are very few cases of ‘pure’ health systems that are neatly captured by these archetype descriptions. Wide and increasing
A health system is made up of users, payers, providers and regulators and can be defined by the relations between them. Governments can play a number of different roles as financers, regulators and/or providers of services. At one extreme, provision and financing can be completely public. Tax revenues pay for building and equipping facilities for service provision, for employment of the people who work within them, and the supply of all drugs and other non-durable inputs. Patients receive services free at the time they use them. Some countries have even outlawed all forms of private practice. There is no example of the other extreme, a country whose whole health care system is completely private. In all countries there is at least some government subsidy (or tax) on components of the health system, regulation of some service transaction (such as minimum standards for the qualification ‘medical doctor’ or for hospitals) or public ownership or employment of the resources used to produce health services. However, there are some fully private ‘sub-systems’ in many countries, for example unregulated pharmaceuticals markets.
