Publicly funded medicine

Publicly funded medicine is a healthcare system that is financed entirely or in majority part by government funds (taxes or quasi-taxes). Publicly funded medicine is often referred to as "socialized medicine" or "nationalized medicine" by its opponents, whereas supporters of this approach tend to use the terms "universal healthcare", "single payer healthcare", or National Health Services. It is seen as a key part of a welfare state (see Welfare State for an interpretation in UK terms).

Parallel public/private systems

Almost every country that has a publicly funded health care system also has a parallel private system, generally catering to private insurance holders.

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From the inception of the NHS model (1948), public hospitals in the United Kingdom have included "amenity beds" which would typically be siderooms fitted more comfortably, and private wards in some hospitals where for a fee more amenities are provided. These are predominantly used for surgical treatment, and operations are generally carried out in the same operating theatres as NHS work and by the same personnel. These amenity beds do not exist in other socialized healthcare systems, like the Spanish one, among others. From time to time, the NHS pays for private hospitals (arranged hospitals) to take on surgical cases for which NHS facilities do not have sufficient capacity. This work is usually, but not always, done by the same doctors in private hospitals.

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In the United States, Medicare and Medicaid coverage is financed from taxation, but care is generally provided by privately owned hospitals or physicians in private practice. Another example is France, where Social Security is a public entity which refunds patients for care in both private and public facilities; the majority of French doctors are in private practice. In some systems, patients can also take private health insurance, but choose to receive care at public hospitals, if allowed by the private insurer.

Related Topics:
France - Social Security - Insurer

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While one goal of public systems is to provide equal service to all, this egalitarianism is often partial. Every nation either has parallel private providers or its citizens are free to travel to a nation that does, so there is effectively a two-tier healthcare system that reduces the equality of service. Private hospitals often get newer and better equipment and facilities, and since private providers are typically better paid, some medical professionals motivated by remunerative concerns migrate to the private sector. A number of countries such as Australia attempt to solve the problem of unequal care by requiring that doctors divide their time between the public and private systems.

Related Topics:
Egalitarianism - Two-tier healthcare - Equality - Australia

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Proponents of public/private systems argue that they are necessary to provide flexibility to the system, and are a way to reduce strain on the health care system as the wealthy continue to support it through taxation without consuming its services. Opponents believe that they are allowed to exist mainly because politicians and their friends are wealthy and would prefer better care. They also argue that all citizens should have access to uniformly high quality healthcare. Even though Canada pays all private health care providers at the same rate, some wealthy Canadians go to the United States for treatment, and some expert Canadian doctors go to the United States in order to charge higher rates.

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In some cases, doctors are so well paid in both systems that prestige is often more important to them than remuneration. This is very much the case in the United Kingdom where private medicine is seen as less prestigious than public medicine by much of the population. As a result, the best doctors tend to spend the majority of their time working for the public system, even though they may also do some work for private healthcare providers. The British in particular tend to use private healthcare to avoid waiting lists rather than because they believe that they will receive better care from it.

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