RENASCENT IGBO RELIGION: DR KENEZ THEORY AND PRACTICE OF EXISTENTIAL FAMILY THERAPEUTICS FOR HIS CBO HAPPY FAMILY NETWORK INTERNATIONAL

Saturday, November 26, 2016

DR KENEZ THEORY AND PRACTICE OF EXISTENTIAL FAMILY THERAPEUTICS FOR HIS CBO HAPPY FAMILY NETWORK INTERNATIONAL

EXISTENTIAL FAMILY THERAPEUTICS

THIS IS HEALTH FOR ALL KENEZIANS; all you need to know ABOUT HEALTH CARE SYSTEMS WORLDWIDE

The Theory & Practice of Interdisciplinary Therapeutic Organisation

founded by Hafani Research Consortium

Compiled by the ANIMATOR INTERNATIONAL;

Dr J. K. Danmbaezue.

Prologue:

IN ENGLISH LANGUAGE

We are here to serve! We are here to save lives. We are poised to re-invent the pristine priniciples of “being our brothers and sisters keepers”. That is our motivation! It's our priority to work closely with the community we live in and earn our living so as to create a mutually beneficial local relationship while providing the necessary resources to expand essential healthcare services, professional care and technology. It has been the ultimate objective of this team of dedicated research scientists to have a holistic perspective of health both in theory and in practice. Thus we started off the first TRIPARTITE CONSULTATIONS in world history, whereby a patient is seen contemporaneously by three specialists in the triangular prism of health care delivery, viz: the PHYSICAL. SOCIAL and MENTAL dimensions or levels of optimum health that each person is entitled to. It may be difficult to attain, but we have been doing it for a decade now. All it costs us is HUMANITARIAN PRINCIPLES that ignore capitalist orientations. We are doctors without borders; no social class nor religious compartmentalisation is our motto!

A single voice can change the world. Whether the voice describes a new scientific theory, tells the stories of a culture or speaks for a previously voiceless group of people, it can reach across national borders and across time to influence a wider world and transform the world that follows. The 20th century is nearing an end. Great changes have occurred in the past 100 years, so that science, art, politics and society, as they approach the year 2000, are markedly different than they were in 1900. Powerful ideas, such as non-violent political protest and the theory of the unconscious—developed by unique thinkers such as Mohandas Gandhi of India and Sigmund Freud of Austria—have altered humanity, increased understanding between individuals and cultures and helped define our present world. 1]

The voices of all the patriotic health professionals and friends of Dr J. K. Danmbaezue who are the foundation members of this interdisciplinary team are being added in this millennium in the areas of Human/Social Medicine and Psychometrics in finding Alternative Management Strategies for Halting the pandemic of HIV-AIDS, by Re-education of the Youths through Pre-Marital counselling and Existential Family Therapeutics. We need your intellectual, moral and financial support to translate these objectives into meaningful and practicable programmes to benefit the less-informed masses that pro-create profusely in the hinterlands of our nations in Sub-Saharan Africa for now, and later to all the developing nations of the world!----Danmbaezue J. K. (11th March 2001)

IN GERMAN LANGUAGE

GESUNDHEIT FÜR KENEZIANS alles was Sie wissen müssen
ÜBER Gesundheitssysteme weltweit

Die Theorie & Praxis für interdisziplinäre therapeutische Organisation
gegründet von Hafani Research Consortium

Zusammengestellt vom Animator INTERNATIONAL, Dr. JK Danmbaezue.

Prolog:

Wir sind hier um zu dienen! Wir sind hier, um Leben zu retten. Wir sind bereit, neu zu erfinden, die unberührten priniciples des "Seins unsere Brüder und Schwestern Hüter". Das ist unsere Motivation! Es ist unsere Priorität, eng mit der Gemeinde in der wir leben und unseren Lebensunterhalt verdienen, um so eine für beide Seiten vorteilhafte Beziehung zu schaffen und gleichzeitig lokale Bereitstellung der notwendigen Ressourcen, um essentiellen Gesundheitsdiensten, professionelle Betreuung und Technik zu erweitern. Es war das Endziel dieses Team von engagierten Forschern, um eine ganzheitliche Sichtweise von Gesundheit sowohl in Theorie und Praxis haben. So brachen wir die ersten dreigliedrigen Konsultationen in der Weltgeschichte, wobei ein Patient gleichzeitig wird durch drei Fachleute sehen in dem dreieckigen Prisma der Erbringung von Gesundheitsleistungen, nämlich: die physische. Soziale und mentale Dimensionen oder Ebenen der optimalen Gesundheit, dass jeder Mensch das Recht hat,. Es kann schwierig sein zu erreichen, aber wir getan haben, es für ein Jahrzehnt. Alles was es kostet uns ist, die humanitären Prinzipien der kapitalistischen Orientierungen zu ignorieren. Wir sind Ärzte ohne Grenzen, keine soziale Klasse oder religiöse Abschottung ist unser Motto!

Eine einzige Stimme kann die Welt verändern. Ob die Stimme eine neue wissenschaftliche Theorie beschreibt, erzählt die Geschichten von einer Kultur oder spricht für eine zuvor Stimmlosen Gruppe von Menschen, kann es über nationale Grenzen hinweg und über die Zeit hinweg zu erreichen, eine größere Welt zu beeinflussen und verwandle die Welt, die folgt. Das 20. Jahrhundert nähert sich dem Ende. Große Veränderungen haben in den letzten 100 Jahren aufgetreten, so dass Wissenschaft, Kunst, Politik und Gesellschaft, da sie das Jahr 2000 nähern, deutlich anders, als sie im Jahr 1900 waren es.Leistungsstarke Ideen, wie gewaltfreien politischen Protests und der Theorie von der durch einzigartige Denker wie Mohandas Gandhi in Indien und Sigmund Freud von unbewussten entwickelte Österreich-verändert haben Menschlichkeit, mehr Verständnis zwischen Menschen und Kulturen und trug zur Definition unserer heutigen Welt. 1]
[1] "einflussreichsten Denker des 20. Jahrhunderts," Microsoft ® Encarta ® 98 Encyclopedia. © 1997.

Die Stimmen von allen patriotischen Gesundheitsberufe und Freunde von Dr. JK Danmbaezue, die die Gründungsmitglieder des interdisziplinären Teams sind werden in diesem Jahrtausend in den Bereichen Mensch / Sozialmedizin und Psychometrie bei der Suche nach alternativen Strategien zum Umgang Eindämmung der Pandemie von HIV hinzugefügt -AIDS, durch Umerziehung der Jugend durch voreheliche Beratung und Existenzanalyse Familie Therapeutics.Wir brauchen Ihre geistige, moralische und finanzielle Unterstützung, um diese Ziele in sinnvolle und praktikable Programme umzusetzen, die weniger informierten Massen reichlich, dass pro-schaffen sich im Hinterland von unseren Nationen in Afrika südlich der Sahara für jetzt und später auf alle Entwicklungsländer profitieren Völker der Welt! ---- Danmbaezue JK (11. März 2001)

IN FRENCH LANGUAGE

LA SANTÉ POUR KENEZIANS tout ce que vous devez savoir
A PROPOS DE SYSTÈMES DE SANTÉ DANS LE MONDE

La théorie et la pratique de l'Organisation thérapeutique interdisciplinaire
fondée par Hafani Consortium pour la recherche

Compilé par le INTERNATIONAL ANIMATOR, le Dr JK Danmbaezue.

Prologue:

Nous sommes ici pour servir! Nous sommes ici pour sauver des vies. Nous sommes prêts à ré-inventer les priniciples vierges d '"être nos frères et sœurs gardiens". C'est notre motivation! C'est notre priorité est de travailler en étroite collaboration avec la communauté où nous vivons et gagner notre vie de manière à créer une relation mutuellement bénéfique locale tout en fournissant les ressources nécessaires pour étendre les services de soins de santé essentiels, les soins professionnels et de la technologie. Il a été l'objectif ultime de cette équipe de chercheurs dédiés d'avoir une perspective holistique de la santé à la fois en théorie et en pratique. Ainsi nous avons commencé les premières consultations tripartites dans l'histoire du monde, par lequel un patient est vu simultanément par trois spécialistes dans le prisme triangulaire de la prestation des soins de santé, à savoir: le physique. Les dimensions sociales et mentale ou leur niveau de santé optimal que chaque personne a droit. Il peut être difficile à atteindre, mais nous avons fait pendant une décennie maintenant. Tout ce qu'il nous en coûte est principes humanitaires qui ne tiennent pas compte des orientations capitalistes. Nous sommes des médecins sans frontières, pas de classe sociale ni de cloisonnement religieux est notre devise!

Une seule voix peut changer le monde. Que ce soit la voix décrit une nouvelle théorie scientifique, raconte les histoires d'une culture ou parle pour un groupe déjà sans voix de personnes, il peut atteindre à travers les frontières nationales et dans le temps d'influencer un monde plus vaste et transformer le monde qui suit.Le 20ème siècle touche à sa fin. De grands changements ont eu lieu dans les 100 dernières années, de sorte que la science, l'art, la politique et la société, à mesure qu'ils approchent de l'année 2000, sont nettement différents de ce qu'ils étaient en 1900. Idées puissantes, telles que la non-violente de protestation politique et la théorie de l'humanité inconscient élaborée par des penseurs uniques tels que Mohandas Gandhi de l'Inde et Sigmund Freud de l'Autriche-ont modifié, une meilleure compréhension entre les individus et les cultures et a aidé à définir notre monde actuel. 1]
[1] «penseurs les plus influents du 20e siècle," Microsoft ® Encarta ® 98 Encyclopédie. © 1997.

Les voix de tous les professionnels de la santé patriotiques et les amis du Dr JK Danmbaezue qui sont les membres de la fondation de cette équipe interdisciplinaire sont ajoutés dans ce nouveau millénaire dans les domaines de la médecine humaine / sociale et de la psychométrie à trouver des stratégies de gestion alternatives pour mettre un terme à la pandémie du VIH -SIDA, par Re-éducation des jeunes par le biais consultation prénuptiale et de thérapeutique de famille existentiels. Nous avons besoin de votre soutien intellectuel, moral et financier de traduire ces objectifs dans les programmes significatifs et possible de bénéficier des masses moins informés que les pro-créer en abondance dans les arrière-pays de nos nations en Afrique sub-saharienne pour l'instant, et plus tard à tous les pays en développement nations du monde! ---- Danmbaezue JK (11 Mars 2001)

IN SPANISH LANGUAGE

SALUD PARA KENEZIANS todo lo que necesitas saber
ACERCA DE LA SALUD SISTEMAS DE TODO EL MUNDO

La Teoría y Práctica de la Organización Terapéutico Interdisciplinario
fundada por el Consorcio de Investigación Hafani

Compilado por el animador INTERNACIONAL, Dr. JK Danmbaezue.

Prólogo:

Estamos aquí para servirle! Estamos aquí para salvar vidas. Estamos a punto de volver a inventar las priniciples prístinas de nuestro ser "hermanos y hermanas" guardianes. Esa es nuestra motivación! Es nuestra prioridad trabajar en estrecha colaboración con la comunidad en que vivimos y nos ganamos la vida con el fin de crear una relación mutuamente beneficiosa, mientras que local, proporcionando los recursos necesarios para ampliar los servicios esenciales de salud, atención profesional y la tecnología. Ha sido el objetivo fundamental de este equipo de científicos de investigación dedicados a tener una perspectiva holística de la salud tanto en la teoría y en la práctica. Por lo tanto, estamos trabajando en las primeras consultas tripartitas en la historia del mundo, con lo que se ve a un paciente simultáneamente por tres especialistas en el prisma triangular de la asistencia sanitaria, a saber: el físico. Dimensiones Sociales y Mentales o del nivel de salud óptimo que cada persona tiene derecho. Puede ser difícil de lograr, pero hemos estado haciendo desde hace una década. Todo lo que nos cuesta es principios humanitarios que ignoran las orientaciones capitalistas. Somos médicos sin fronteras, no hay clase social ni religiosa compartimentación es nuestro lema!

Una sola voz puede cambiar el mundo. Ya sea que la voz describe una nueva teoría científica, cuenta la historia de una cultura o habla por un grupo hasta ahora sin voz de la gente, puede llegar a través de las fronteras nacionales ya través del tiempo para influir en un mundo más amplio y transformar el mundo que le sigue. El siglo 20 está llegando a su fin. Grandes cambios han ocurrido en los últimos 100 años, por lo que la ciencia, el arte, la política y la sociedad, cuando se acercan al año 2000, son notablemente diferentes de lo que eran en 1900.Ideas poderosas, como la no-violenta protesta política y la teoría de la humanidad inconsciente, desarrollada por pensadores únicos como Mohandas Gandhi de la India y Sigmund Freud de Austria-han alterado, el aumento de la comprensión entre los individuos y las culturas y ayudó a definir nuestro mundo actual. 1]
[1] "Los pensadores influyentes del siglo 20", Microsoft ® Encarta ® Encyclopedia 98. © 1997.

Las voces de todos los profesionales de la salud patrióticos y amigos del Dr. JK Danmbaezue que son los miembros de la fundación de este equipo interdisciplinario se están agregando en este milenio en las áreas de Medicina Humana / Social y Psicometría en la búsqueda de estrategias de tratamiento para detener la pandemia del VIH -sida, por Re-educación de los jóvenes a través de consejería pre-matrimonial y Terapéutica existenciales de Familia.Necesitamos su apoyo intelectual, moral y financiero para traducir estos objetivos en los programas de útiles y viables, para beneficiar a las masas menos informadas que los pro-crear con profusión en las zonas de influencia de nuestras naciones en el África subsahariana, por ahora, y más tarde a todos los países en desarrollo las naciones del mundo! ---- Danmbaezue JK (11 de marzo de 2001)

IN JAPANES LANGUAGE

KENEZIANSあなたが知っているために必要なすべての健康
Worldwideについて医療制度

学際的な治療機関の理論と実践
Hafani研究コンソーシアムによって設立された

ANIMATOR INTERNATIONALによってコンパイルされた。博士JK Danmbaezue。

プロローグ：

我々は、提供するためにここにいます！私たちは命を救うためにここにある。私たちは "である私たちの兄弟姉妹キーパー"の原始的なpriniciplesの再発明をする態勢を整えています。私たちの動機はそれです！それは我々が住んでいる地域と密接に連携し、必要不可欠な医療サービス、専門的ケアと技術を展開するために必要なリソースを提供しながら、相互に有益な地元の関係を作成するために、私たちの生活費を稼ぐために私たちの優先順位です。それは理論と実践の両方の健康の全体的な視点を持つように専用の研究者のこのチームの究極の目標であった。物理的：したがって、私たちは、患者が医療提供、すなわち三角プリズムの3つの専門家によって同時期に見られていることにより、世界史上初の三者協議を始めました。それぞれの人が受ける権利を有することが最適な健康の社会的および精神的な寸法やレベル。それは達成することは困難かもしれませんが、我々は今、十年のためにそれをやっている。それが我々のコストはすべて資本主義の方向を無視して人道原則である。我々は、国境なき医師団であり、社会階級や宗教的なコンパートメントには私たちのモットーではありません！

単一の声が世界を変えることができます。声は、新しい科学理論を説明する文化の物語を伝えたり、人々の以前に無声グループのために話すかどうか、それはより広い世界に影響を与えると、次の世界を変えるために国境を越えてと時間を越えて到達することができます。 20世紀は終わりに近づいています。大きな変化は、科学、芸術、政治や社会は、彼らが2000年に近づくにつれ、彼らは1900年にあったより著しく異なっているように、過去100年間に発生した。このような非暴力的な政治的な抗議と無意識の開発、インドのマハトマ·ガンジーとオーストリア持っている変更され、人類のジークムント·フロイトのようなユニークな思想家の理論のような強力なアイデアは、個人や文化間の理解を増加し、現在の我々の世界を定義しました。 1]
[1] "20世紀の影響力のある思想家は、" Microsoft®Encarta百科®98百科事典。©1997。

この学際的なチームの基礎のメンバーである博士JK Danmbaezueのすべての愛国的な医療専門家や友人の声は、HIVの流行を停止するための代替の経営戦略を見つけるために人間/社会医学と心理統計学の分野では、このミレニアムに追加されています-AIDS、婚前カウンセリングと実存家族の治療を通じて、青少年の再教育による。我々は、今のサハラ以南のアフリカにおける私たちの国の奥地にやたらとプロ作成することの少ない情報に大衆の利益のために有意義かつ実用的なプログラムにこれらの目標を変換するために、知的、道徳的及び財政的支援を必要とし、以降のすべての開発へ世界の国！---- Danmbaezue JK（2001年3月11日）

The voices of all the patriotic health professionals and friends of Dr J. K. Danmbaezue who are the foundation members of this interdisciplinary team are being added in this millennium in the areas of Human/Social Medicine and Psychometrics in finding Alternative Management Strategies for Halting the pandemic of HIV-AIDS, by Re-education of the Youths through Pre-Marital counselling and Existential Family Therapeutics. We need your intellectual, moral and financial support to translate these objectives into meaningful and practicable programme to benefit the less-informed masses that pro-create profusely in the hinterlands of our nations in Sub-Saharan Africa for now, and later to all the developing nations of the world!-----------------------------------------------------------------------------------------------------Danmbaezue J. K. (11^th March 2001)

HERE ARE THE TOPICS THAT FORM THE FOUNDATION STONES OF ALL OUR RESEARCH THEMES, READINGS & PROJECTS

Health For All

From Wikipedia, the free encyclopedia

(Redirected from Health for all)

Jump to: navigation, search

Health For All is a programming goal of the World Health Organization (WHO), which envisions securing the health and well being of people around the world that has been popularized since the 1970s. It is the basis for the World Health Organization's primary health care strategy to promote health, human dignity, and enhanced quality of life.

[edit] Definition

Halfdan Mahler, Director General (1973-1983) of the WHO, defined Health For All in 1981, as follows:^[1]

Health For All means that health is to be brought within reach of everyone in a given country. And by "health" is meant a personal state of well being, not just the availability of health services – a state of health that enables a person to lead a socially and economically productive life. Health For All implies the removal of the obstacles to health – that is to say, the elimination of malnutrition, ignorance, contaminated drinking water and unhygienic housing – quite as much as it does the solution of pus a lack of doctors, hospital beds, drugs and vaccines.

· Health For All means that health should be regarded as an objective of economic development and not merely as one of the means of attaining it.

· Health For All demands, ultimately, literacy for all. Until this becomes reality it demands at least the beginning of an understanding of what health means for every individual.

· Health For All depends on continued progress in medical care and public health. The health services must be accessible to all through primary health care, in which basic medical help is available in every village, backed up by referral services to more specialised care. Immunisation must similarly achieve universal coverage.

· Health For All is thus a holistic concept calling for efforts in agriculture, industry, education, housing, and communications, just as much as in medicine and public health. Medical care alone cannot bring health to in hovels. Health for such people requires a whole new way of life and fresh opportunities to provide themselves with a higher standard of living.

The adoption of Health For All by government, implies a commitment to promote the advancement of all citizens on a broad front of development and a resolution to encourage the individual citizen to achieve a higher quality of life. The rate of progress will depend on the political will. The World Health Assembly believes that, given a high degree of determination, Health For All could be attained by the year 2000. That target date is a challenge to all WHO's Member States. The basis of the Health For All strategy is primary health care.

Two decades later, WHO Director General Lee Jong-wook (2003–2006) reaffirmed the concept in the World Health Report 2003:^[2]

Health for all became the slogan for a movement. It was not just an ideal but an organizing principle: everybody needs and is entitled to the highest possible standard of health. The principles remain indispensable for a coherent vision of global health. Turning that vision into reality calls for clarity both on the possibilities and on the obstacles that have slowed and in some cases reversed progress towards meeting the health needs of all people. We have a real opportunity now to make progress that will mean longer, healthier lives for millions of people, turn despair into realistic hope, and lay the foundations for improved health for generations to come.

Health system

From Wikipedia, the free encyclopedia

(Redirected from Health care system)

Jump to: navigation, search

A health system, also sometimes referred to as health care system or healthcare system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations.

There is a wide variety of health systems around the world, with as many histories and organizational structures as there are nations. In some countries, health system planning is distributed among market participants. In others, there is a concerted effort among governments, trade unions, charities, religious, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve. However, health care planning has been described as often evolutionary rather than revolutionary.^[1][2]

Contents

[hide]

2.1 World Health Organization Definition

4.1 Payment models

[edit] Goals

The goals for health systems, according to the World Health Organization, are good health, responsiveness to the expectations of the population, and fair financial contribution. Progress towards them depends on how systems carry out four vital functions: provision of health care services, resource generation, financing, and stewardship.^[3] Other dimensions for the evaluation of health systems include quality, efficiency, acceptability, and equity.^[1] They have also been described in the United States as "the five C's": Cost, Coverage, Consistency, Complexity, and Chronic Illness.^[4] Also, continuity of health care is a major goal.^[5]

[edit] Definitions

Often health system has been defined with a reductionist perspective, for example reducing it to health care system. In many publications, for example, both expressions are used interchangeably. Some authors^[6] have developed arguments to expand the concept of health systems, indicating additional dimensions that should be considered:

Health systems should not be expressed in terms of their components only, but also of their interrelationships;
Health systems should include not only the institutional or supply side of the health system, but also the population;
Health systems must be seen in terms of their goals, which include not only health improvement, but also equity, responsiveness to legitimate expectations, respect of dignity, and fair financing, among others;
Health systems must also be defined in terms of their functions, including the direct provision of services, whether they are medical or public health services, but also "other enabling functions, such as stewardship, financing, and resource generation, including what is probably the most complex of all challenges, the health workforce."^[6]

[edit] World Health Organization Definition

The World Health Organization defines health system as follows: "A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities. A health system is therefore more than the pyramid of publicly owned facilities that deliver personal health services. It includes, for example, a mother caring for a sick child at home; private providers; behaviour change programmes; vector-control campaigns; health insurance organizations; occupational health and safety legislation. It includes inter-sectoral action by health staff, for example, encouraging the ministry of education to promote female education, a well known determinant of better health."^[7]

[edit] Providers

Main article: Health care provider

Health care providers are institutions or individuals providing health care services. Individuals including health professionals and allied health professions can be self-employed or working as an employee in a hospital, clinic, or other health care institution, whether government operated, private for-profit, or private not-for-profit (e.g. non-governmental organization). They may also work outside of direct patient care such as in a government health department or other agency, medical laboratory, or health training institution. Examples of health workers are doctors, nurses, midwives, paramedics, dentists, medical laboratory technologists, therapists, psychologists, pharmacists, chiropractors, optometrists, community health workers, traditional medicine practitioners, and others.

[edit] Financial resources

There are generally five primary methods of funding health systems:^[8]

general taxation to the state, county or municipality
social health insurance
voluntary or private health insurance
out-of-pocket payments
donations to charities

Most countries' systems feature a mix of all five models. One study ^[9] based on data from the OECD concluded that all types of health care finance "are compatible with" an efficient health system. The study also found no relationship between financing and cost control.

The term health insurance is generally used to describe a form of insurance that pays for medical expenses. It is sometimes used more broadly to include insurance covering disability or long-term nursing or custodial care needs. It may be provided through a social insurance program, or from private insurance companies. It may be obtained on a group basis (e.g., by a firm to cover its employees) or purchased by individual consumers. In each case premiums or taxes protect the insured from high or unexpected health care expenses.

By estimating the overall cost of health care expenses, a routine finance structure (such as a monthly premium or annual tax) can be developed, ensuring that money is available to pay for the health care benefits specified in the insurance agreement. The benefit is typically administered by a government agency, a non-profit health fund or a corporation operating seeking to make a profit.^[10]

Many forms of commercial health insurance control their costs by restricting the benefits that are paid by through deductibles, co-payments, coinsurance, policy exclusions, and total coverage limits and will severely restrict or refuse coverage of pre-existing conditions. Many government schemes also have co-payment schemes but exclusions are rare because of political pressure. The larger insurance schemes may also negotiate fees with providers.

Many forms of social insurance schemes control their costs by using the bargaining power of their community they represent to control costs in the health care delivery system. For example by negotiating drug prices directly with pharmaceutical companies, or negotiating standard fees with the medical profession. Social schemes sometimes feature contributions related to earnings as part of a scheme to deliver universal health care, which may or may not also involve the use of commercial and non-commercial insurers. Essentially the more wealthy pay proportionately more into the scheme to cover the needs of the relatively poor who therefore contribute proportionately less. There are usually caps on the contributions of the wealthy and minimum payments that must be made by the insured (often in the form of a minimum contribution, similar to a deductible in commercial insurance models).

In addition to these traditional health care financing methods, some lower income countries and development partners are also implementing non-traditional or innovative financing mechanisms for scaling up delivery and sustainability of health care, such as micro-contributions, public-private partnerships, and market-based financial transaction taxes. For example, as of June 2011, UNITAID had collected more than one billion dollars from 29 member countries, including several from Africa, through an air ticket solidarity levy to expand access to care and treatment for HIV/AIDS, tuberculosis and malaria in 94 countries.^[11]

[edit] Payment models

In most countries, wage costs for health care practitioners are estimated to represent between 65% and 80% of renewable health system expenditures.^[12][13] There are three ways to pay medical practitioners: fee for service, capitation, and salary. There has been growing interest in blending elements of these systems.^[14]

[edit] Fee-for-service

Fee-for-service arrangements pay general practitioners (GPs) based on the service.^[14] They are even more widely used for specialists working in ambulatory care.^[14]

There are two ways to set fee levels:^[14]

By individual practitioners.
Central negotiations (as in Japan, Germany, Canada and in France) or hybrid model (such as in Australia, France's sector 2, and New Zealand) where GPs can charge extra fees on top of standardized patient reimbursement rates.

[edit] Capitation

In capitation payment systems, GPs are paid for each patient on their "list", usually with adjustments for factors such as age and gender.^[14] According to OECD, "these systems are used in Italy (with some fees), in all four countries of the United Kingdom (with some fees and allowances for specific services), Austria (with fees for specific services), Denmark (one third of income with remainder fee for service), Ireland (since 1989), the Netherlands (fee-for-service for privately insured patients and public employees) and Sweden (from 1994). Capitation payments have become more frequent in “managed care” environments in the United States."^[14]

According to OECD, "Capitation systems allow funders to control the overall level of primary health expenditures, and the allocation of funding among GPs is determined by patient registrations. However, under this approach, GPs may register too many patients and under-serve them, select the better risks and refer on patients who could have been treated by the GP directly. Freedom of consumer choice over doctors, coupled with the principle of "money following the patient" may moderate some of these risks. Aside from selection, these problems are likely to be less marked than under salary-type arrangements."^[14]

[edit] Salary arrangements

In several OECD countries, general practitioners (GPs) are employed on salaries for the government.^[14] According to OECD, "Salary arrangements allow funders to control primary care costs directly; however, they may lead to under-provision of services (to ease workloads), excessive referrals to secondary providers and lack of attention to the preferences of patients."^[14] There has been movement away from this system.^[14]

[edit] Information resources

Main articles: Health care delivery, Health information management, Health informatics, and eHealth

Sound information plays an increasingly critical role in the delivery of modern health care and efficiency of health systems. Health informatics - the intersection of information science, medicine and health care - deals with the resources, devices, and methods required to optimize the acquisition and use of information in health and biomedicine. Necessary tools for proper health information coding and management include clinical guidelines, formal medical terminologies, and computers and other information and communication technologies. The kinds of data processed may include patients' medical records, hospital administration and clinical functions, and human resources information.

The use of health information lies at the root of evidence-based policy and evidence-based management in health care.

[edit] Management

Main articles: Health policy, Public health, Health administration, and Disease management (health)

The management of any health system is typically directed through a set of policies and plans adopted by government, private sector business and other groups in areas such as personal health care delivery and financing, pharmaceuticals, health human resources, and public health.

Public health is concerned with threats to the overall health of a community based on population health analysis. The population in question can be as small as a handful of people, or as large as all the inhabitants of several continents (for instance, in the case of a pandemic). Public health is typically divided into epidemiology, biostatistics and health services. Environmental, social, behavioral, and occupational health are also important subfields.

A child being immunized against polio.

Today, most governments recognize the importance of public health programs in reducing the incidence of disease, disability, the effects of ageing and health inequities, although public health generally receives significantly less government funding compared with medicine. For example, most countries have a vaccination policy, supporting public health programs in providing vaccinations to promote health. Vaccinations are voluntary in some countries and mandatory in some countries. Some governments pay all or part of the costs for vaccines in a national vaccination schedule.

The rapid emergence of many chronic diseases, which require costly long-term care and treatment, is making many health managers and policy makers re-examine their health care delivery practices. An important health issue facing the world currently is HIV/AIDS.^[15] Another major public health concern is diabetes.^[16] In 2006, according to the World Health Organization, at least 171 million people worldwide suffered from diabetes. Its incidence is increasing rapidly, and it is estimated that by the year 2030, this number will double. A controversial aspect of public health is the control of tobacco smoking, linked to cancer and other chronic illnesses.^[17]

Antibiotic resistance is another major concern, leading to the reemergence of diseases such as tuberculosis. The World Health Organization, for its World Health Day 2011 campaign, is calling for intensified global commitment to safeguard antibiotics and other antimicrobial medicines for future generations.

[edit] Health systems performance

Since 2000, more and more initiatives have been taken at the international and national levels in order to strengthen national health systems as the core components of the global health system. Having this scope in mind, it is essential to have a clear, and unrestricted, vision of national health systems that might generate further progresses in global health. The elaboration and the selection of performance indicators are indeed both highly dependent on the conceptual framework adopted for the evaluation of the health systems performances^[18].

An increasing number of tools and guidelines are being published by international agencies and development partners to assist health system decision-makers to monitor and assess health systems strengthening^[19] including human resources development^[20] using standard definitions, indicators and measures.

[edit] International comparisons

See also: Health care system

Universal health care systems vary according to the extent of government involvement in providing care and/or health insurance. In some countries, such as the UK, Spain, Italy and the Nordic countries, the government has a high degree of involvement in the commissioning or delivery of health care services and access is based on residence rights not on the purchase of insurance. Others have a much more pluralistic delivery system based on obligatory health with contributory insurance rates related to salaries or income, and usually funded by employers and beneficiaries jointly. Sometimes the health funds are derived from a mixture of insurance premiums, salary related mandatory contributions by employees and/or employers to regulated sickness funds, and by government taxes. These insurance based systems tend to reimburse private or public medical providers, often at heavily regulated rates, through mutual or publicly owned medical insurers. A few countries such as the Netherlands and Switzerland operate via privately owned but heavily regulated private insurers that are not allowed to make a profit from the mandatory element of insurance but can profit by selling supplemental insurance.

Universal health care is a broad concept that has been implemented in several ways. The common denominator for all such programs is some form of government action aimed at extending access to health care as widely as possible and setting minimum standards. Most implement universal health care through legislation, regulation and taxation. Legislation and regulation direct what care must be provided, to whom, and on what basis. Usually some costs are borne by the patient at the time of consumption but the bulk of costs come from a combination of compulsory insurance and tax revenues. Some programs are paid for entirely out of tax revenues. In others tax revenues are used either to fund insurance for the very poor or for those needing long term chronic care. The UK government's National Audit Office in 2003 published an international comparison of ten different health care systems in ten developed countries, nine universal systems against one non-universal system (the U.S.), and their relative costs and key health outcomes.^[3] A wider international comparison of 16 countries, each with universal health care, was published by the World Health Organization in 2004^[4] In some cases, government involvement also includes directly managing the health care system, but many countries use mixed public-private systems to deliver universal health care.

[edit] Americas

Argentina, Barbados, Brazil (see below), Canada (see below), Chile, Colombia (see below), Costa Rica, Cuba, Mexico (see below), Panama, Peru (see below), Uruguay, Trinidad and Tobago, and Venezuela all have public universal health care provided.

[edit] Argentina

Main article: Health care in Argentina

Health care is provided through a combination of employer and labor union-sponsored plans (Obras Sociales), government insurance plans, public hospitals and clinics and through private health insurance plans. It costs almost 10% of GDP and is available to anyone regardless of ideology, beliefs, race or nationality.

[edit] Brazil

Main article: Health care in Brazil

The universal health care system was adopted in Brazil in 1988 after the end of the military regime's rule. However, universalized/socialized health care was available many years before, in some cities, once the 27th amendment to the 1969 Constitution imposed the duty of applying 6% of their income in healthcare on the municipalities.^[5]

[edit] Canada

Main article: Health care in Canada

In 1984, the Canada Health Act was passed, which prohibited extra billing by doctors on patients while at the same time billing the public insurance system. In 1999, the prime minister and most premiers reaffirmed in the Social Union Framework Agreement that they are committed to health care that has "comprehensiveness, universality, portability, public administration and accessibility."^[6]

The system is for the most part publicly funded, yet most of the services are provided by private enterprises or private corporations, although most hospitals are public. Most doctors do not receive an annual salary, but receive a fee per visit or service.^[7] About 29% of Canadians' health care is paid for by the private sector or individuals.^[8] This mostly goes towards services not covered or only partially covered by Medicare such as prescription drugs, dentistry and vision care.^[9] Many Canadians have private health insurance, often through their employers, that cover these expenses.^[10]

The Canada Health Act of 1984 "does not directly bar private delivery or private insurance for publicly insured services," but provides financial disincentives for doing so. "Although there are laws prohibiting or curtailing private health care in some provinces, they can be changed," according to a report in the New England Journal of Medicine.^[11][12] The legality of the ban was considered in a decision of the Supreme Court of Canada which ruled in Chaoulli v. Quebec that "the prohibition on obtaining private health insurance, while it might be constitutional in circumstances where health care services are reasonable as to both quality and timeliness, is not constitutional where the public system fails to deliver reasonable services." The appellant contended that waiting times in Quebec violated a right to life and security in the Quebec Charter of Human Rights and Freedoms. The Court agreed, but acknowledged the importance and validity of the Canada Health Act, and at least four of the seven judges explicitly recognized the right of governments to enact laws and policies which favour the public over the private system and preserve the integrity of the public system.

[edit] Chile

Main article: Health care in Chile

Health care in Chile is provided by the government (via Fonasa) and by private insurers (via Isapre). All workers and pensioners are mandated to pay 7% of their income for health care insurance (the poorest pensioners are exempt from this payment). Workers who choose not to join an Isapre, are automatically covered by Fonasa. Fonasa also covers unemployed people receiving unemployment benefits, uninsured pregnant women, insured worker's dependant family, people with mental or physical disabilities and people who are considered poor or indigent.

Fonasa costs vary depending on income, disability or age. Attention at public health facilities via Fonasa is free for low-income earners, people with mental or physical disabilities and people over the age of 60. Others pay 10% or 20% of the costs, depending on income and number of dependants. Fonasa beneficiaries may also seek attention in the private sector, for a designated fee.

Additionally, there are a number of high-mortality illnesses (currently 69) that have special attention guarantees for both Isapre and Fonasa affiliates, in relation to access to treatment, waiting times, maximum costs and quality of service.

[edit] Colombia

Main article: Health in Colombia

In 1993 a reform transformed the health care system in Colombia, trying to provide a better, sustainable, health care system and to reach every Colombian citizen.

[edit] Mexico

Further information: Health care in Mexico

Public health care delivery is accomplished via an elaborate provisioning and delivery system instituted by the Mexican Federal Government. Public health care is provided to all Mexican citizens as guaranteed via Article 4 of the Constitution. Public care is either fully or partially subsidized by the federal government, depending on the person's (Spanish: derechohabiente's) employment status. All Mexican citizens are eligible for subsidized health care regardless of their work status via a system of health care facilities operating under the federal Secretariat of Health (formerly the Secretaria de Salubridad y Asistencia, or SSA) agency. Employed citizens and their dependents, however, are further eligible to use the health care program administered and operated by the Instituto Mexicano del Seguro Social (IMSS) (English: Mexican Social Security Institute). The IMSS health care program is a tripartite system funded equally by the employee, its private employer, and the federal government. The IMSS does not provide service to employees of the public sector. Employees in the public sector are serviced by the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) (English: Institute for Social Security and Services for State Workers), which attends to the health and social care needs of government employees. This includes local, state, and federal government employees. The government of the states in Mexico also provide health services independently of those services provided by the federal government programs. In most states, the state government has established free or subsidized healthcare to all their citizens.

On December 1, 2006 the Mexican government created the Health Insurance for a New Generation also known as "life insurance for babies".^[13][14][15]

On May 16, 2009 Mexico to Achieve Universal Health Coverage by 2011.^[16]

On May 28, 2009 Mexico announced Universal Care Coverage for Pregnant Women.^[17]

[edit] Peru

Further information: es:Aseguramiento Universal en Salud

On April 10, 2009 the Government of Peru published the Law on Health Insurance to enable all Peruvians to access quality health services, and contribute to regulate the financing and supervision of these services. The law enables all population to access diverse health services to prevent illnesses, and promote and rehabilitate people, under a Health Basic Plan (PEAS).^[18][19]

On April 2, 2010 President Alan Garcia Perez on Friday signed a supreme ordinance approving the regulations for the framework law on the Universal Health Insurance, which seeks to provide access to quality health care for all Peruvian citizens.

Peru’s Universal Health Insurance law aims to increase access to timely and quality health care services, emphasizes maternal and child health promotion, and provides the poor with protection from financial ruin due to illness.^[20]

The regulation states that membership of the Universal Health Insurance (AUS for its Spanish acronym) is compulsory for the entire population living in the country. To that end, the Ministry of Health will approve, by supreme ordinance, the mechanisms leading to compulsory membership, as well as escalation and implementation.^[21]

[edit] Trinidad and Tobago

Main article: Health care in Trinidad and Tobago

A universal health care system is used in Trinidad and Tobago and is the primary form of health-care available in the country. It is used by the majority of the population seeking medical assistance, as it is free for all citizens.

[edit] United States

Health care reform in the United States

Latest enacted legislation

Patient Protection and Affordable Care Act (Senate bill - H.R. 3590)
Health Care and Education Reconciliation Act of 2010 (H.R. 4872)

preceding legislation

[show]

More information

This box:

Main article: United States National Health Care Act

The United States does not have a universal health care system, however the Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care and Education Reconciliation Act of 2010, seeks to have expanded insurance coverage to legal residents by 2014. It provides for federally mandated health insurance to be implemented in the United States during the 2010–2019 decade with the Federal government subsidizing legal resident households with income up to 400% of the Federal poverty level.^[22] This threshold varies according to State and household size, but for an average family of four, subsidies would be available for families whose income was about $88,000 or lower.^[23] In June 2010 adults with pre-existing conditions became eligible to join a temporary high-risk pool.^[24] In 2014 applicants of the same age will obtain health insurance at the same published rate regardless of health status — the first time in U.S. history that insurers will lose the right to load the premium or deny coverage prior to contract, or cancel a policy after contract due to an adverse health condition, or test result indicating that one may be imminent. The law prohibits insurers from capping their liability for a person's health care needs, a move which is expected to rectify medically induced bankruptcy.

The Congressional Budget Office and related government agencies scored the cost of a universal health care system several times since 1991, and have uniformly predicted cost savings,^[25] partly from the elimination of insurance company overhead costs.^[26] In 2009, a universal health care proposal was pending in Congress, the United States National Health Care Act (H.R. 676, formerly the "Medicare for All Act").

The Congressional Budget Office estimated that the bill would reduce the number of nonelderly people who are uninsured by about 32 million, leaving about 23 million nonelderly residents uninsured (about one-third of whom would be illegal immigrants). Under the legislation, the share of legal nonelderly residents with insurance coverage would rise from about 83 percent in 2010 to about 94 percent by 2019.^[27]

In May of 2011, the state of Vermont became the first state to pass legislation establishing a Single-Payer health care system. The legislation, known as Act 48, establishes health care in the state as a "human right" and lays the responsibility on the state to provide a health care system which best meets the needs of the citizens of Vermont. The state is currently in the studying phase of how best to implement this system.

[edit] Asia

Azerbaijan,^[28] Bhutan (see below), Bahrain,^[29] Brunei, China, Hong Kong (see below), India (see below), Iran,^[30] Israel^[31] (see below), Japan, Jordan,^[32] Kazakhstan,^[33] Kuwait^{[citation
needed]}, Macau(see below), Malaysia^{[citation
needed]}, Mongolia,^[34] North Korea, Oman,^[35][36] Pakistan^{[citation
needed]}, Qatar^{[citation
needed]}, Saudi Arabia^{[citation
needed]}, Singapore (see below), South Korea, Sri Lanka,^[37]Syria,^[38] Taiwan (R.O.C.)^[39] (see below), Tajikistan,^[40] Thailand (see below), Turkey,^[41] Turkmenistan,^[42] and UAE^{[citation
needed]} have universal health care.

[edit] Bhutan

Main article: Health in Bhutan

The Royal Government of Bhutan maintains a policy of free and universal access to primary health care. As hospital facilities in the country are limited, patients with diseases that cannot be treated in Bhutan, such as cancer, are normally referred to hospitals in India for treatment. Such referral treatment is also carried out at the cost of the Royal Government.^[43]

[edit] Hong Kong

Main article: Healthcare in Hong Kong

Hong Kong is one of the healthiest places in the world.^{[citation
needed]} Because of its early health education, professional health services, and well-developed health care and medication system, Hongkongers enjoy a life expectancy of 84 for females and 78 for males,^[44] which is the second highest in the world, and 2.94 infant mortality rate, the fourth lowest in the world.^[45][46]

There are two medical schools in Hong Kong, and several schools offering courses in traditional Chinese medicine. The Hospital Authority is a statutory body that operates and manages all public hospitals. Hong Kong has high standards of medical practice. It has contributed to the development of liver transplantation, being the first in the world to carry out an adult to adult live donor liver transplant in 1993.^[47]

[edit] India

Main article: Healthcare in India

India has a universal health care system run by the local (state or territorial) governments. Government hospitals provide treatment at taxpayer expense. Some essential drugs are offered free of charge in these hospitals. However, the fact that the government sector is understaffed, underfinanced and that these hospitals maintain very poor standards of hygiene forces many people to visit private medical practitioners.^{[citation
needed]}

An outpatient card at AIIMS (one of the best hospitals in India) costs a one-time fee of 10 rupees (around 20 cents U.S.) and thereafter outpatient medical advice is free. In-hospital treatment costs depend on the financial condition of the patient and the facilities utilized, but are usually much less than the private sector. For instance, a patient is waived treatment costs if their income is below the poverty line. However, getting treatment at high quality government hospitals is very tough due to the high number of people needing healthcare and the lack of sufficient facilities.

Primary health care is provided by city and district hospitals and rural primary health centres (PHCs). These hospitals provide treatment free of cost, but only if they are functional. Primary care is focused on immunization, prevention of malnutrition, pregnancy, child birth, postnatal care, and treatment of common illnesses.^{[citation
needed]} Patients who receive specialized care or have complicated illnesses are referred to secondary (often located in district and taluk headquarters) and tertiary care hospitals (located in district and state headquarters or those that are teaching hospitals).^{[citation
needed]}

Now organizations like Hindustan Latex Family Planning Promotional Trust and other private organizations have started creating hospitals and clinics in India, which also provide free or subsidized health care and subsidized insurance plans.^{[citation
needed]}

The government-run healthcare suffers from a lack of hygiene; the rich avoid the government hospitals and go to developed countries for treatment. With the advent of privatized healthcare, this situation has changed. India now has medical tourism for people from other countries while its own poor find quality healthcare either inaccessible or unaffordable.

[edit] Israel

Health care in Israel as a percentage of GDP

Main article: Health care in Israel

This unreferenced section requires citations to ensure verifiability.

In Israel, the National Health Insurance Law (or National Health Insurance Act) is the legal framework which enables and facilitates basic, compulsory universal health care. The Law was put into effect by the Knesset on January 1, 1995, and was based on recommendations put forward by a National Committee of Inquiry headed by Shoshana Netanyahu which examined restructuring the health care system in Israel in the late 1980s. Prior to the law's passage over 90% of the population was already covered by voluntarily belonging to one of four nation-wide, not-for-profit sickness funds which operated some of their own medical facilities and were funded in part by employers and the government and in part by the insured by levies which varied according to income. However, there were three problems associated with this arrangement. First, membership in the largest fund, Clalit, required one to belong to the Histadrut labor organization, even if a person did not wish to (or could not) have such an affiliation while other funds restricted entry to new members based on age, pre-existing conditions or other factors. Second, different funds provided different levels of benefit coverage or services to their members and lastly was the issue mentioned above whereby a certain percentage of the population, albeit a small one, did not have health insurance coverage at all.

Before the law went into effect, all the funds collected premiums directly from members. However, upon passage of the law, a new progressive national health insurance tax was levied through Israel's social security agency which then re-distributes the proceeds to the sickness funds based on their membership and its demographic makeup. This ensured that all citizens would now have health coverage. While membership in one of the funds now became compulsory for all, free choice was introduced into movement of members between funds (a change is allowed once every six months), effectively making the various sickness funds compete equally for members among the populace. Annually, a committee appointed by the ministry of health publishes a "basket" or uniform package of medical services and prescription formulary which all funds must provide as a minimum service to all their members. Achieving this level of equality ensured that all citizens are guaranteed to receive basic healthcare regardless of their fund affiliation which was one of the principal aims of the law. An appeals process was put in place to handle rejection of treatments and procedures by the funds and evaluating cases falling outside the "basket" of services or prescription formulary.

While the law is generally considered a success and Israeli citizens enjoy a high standard of medical care comparatively, with more competition having been introduced into the field of health care in the country, and order having been brought into what was once a somewhat disorganized system, the law nevertheless does have its critics. First and foremost among the criticisms raised is that the "basket" may not provide enough coverage. To partly address this issue, the HMOs and insurance companies began offering additional "supplementary" insurance to cover certain additional services not included in the basket. However, since this insurance is optional (though usually very modestly priced, costing the equivalent of about US$10 to $20 a month), critics argue that it goes against the spirit of the new law which stressed equality among all citizens with respect to healthcare. Another criticism is that in order to provide universal coverage to all, the tax income base amount (the maximum amount of yearly earnings that are subject to the tax) was set rather high, causing many high-income taxpayers to see the amount they pay for their health premiums (now health tax) skyrocket. Finally, some complain about the constantly rising costs of copayments for certain services.

[edit] Macau

Main article: Healthcare in Macau

Macau offers universally accessible single-payer system funded by taxes. Health care is provided by the Bureau for Health.

[edit] People's Republic of China

Main article: Healthcare system reform in the People's Republic of China

Since the founding of the People's Republic of China, the goal of health care programs has been to provide care to every member of the population and to make maximum use of limited health-care personnel, equipment, and financial resources.^{[citation
needed]}

China is undertaking a reform on its health care system, which was largely privatized in the 1990s. The New Rural Co-operative Medical Care System (NRCMCS), is a new 2005 initiative to overhaul the healthcare system, particularly intended to make it more affordable for the rural poor. Under the NRCMCS, the annual cost of medical cover is 50 yuan (US$7) per person. Of that, 20 yuan is paid in by the central government, 20 yuan by the provincial government and a contribution of 10 yuan is made by the patient. As of September 2007, around 80% of the whole rural population of China had signed up (about 685 million people). The system is tiered, depending on the location. If patients go to a small hospital or clinic in their local town, the scheme will cover from 70–80% of their bill. If they go to a county one, the percentage of the cost being covered falls to about 60%. And if they need specialist help in a large modern city hospital, they have to bear most of the cost themselves, the scheme would cover about 30% of the bill.^[48]

On January 21, 2009, the Chinese government announced that a total of 850 billion yuan (US$ 127.5 billion) will be provided between 2009 and 2011 in order to improve the existing health care system.^[49]

[edit] Singapore

Main article: Health care in Singapore

Singapore has a universal health care system where government ensures affordability, largely through compulsory savings and price controls, while the private sector provides most care. Overall spending on health care amounts to only 3% of annual GDP. Of that, 66% comes from private sources.^[50] Singapore currently has the second lowest infant mortality rate in the world and among the highest life expectancies from birth, according to the World Health Organization.^[51] Singapore has "one of the most successful healthcare systems in the world, in terms of both efficiency in financing and the results achieved in community health outcomes," according to an analysis by global consulting firm Watson Wyatt.^[52] Singapore's system uses a combination of compulsory savings from payroll deductions (funded by both employers and workers) a nationalized health insurance plan, and government subsidies, as well as "actively regulating the supply and prices of healthcare services in the country" to keep costs in check; the specific features have been described as potentially a "very difficult system to replicate in many other countries." Many Singaporeans also have supplemental private health insurance (often provided by employers) for services not covered by the government's programs.^[52]

[edit] Republic of China (Taiwan)

Main article: Health care in Taiwan

The current health care system in Taiwan, known as National Health Insurance (NHI), was instituted in 1995. NHI is a single-payer compulsory social insurance plan which centralizes the disbursement of health care dollars. The system promises equal access to health care for all citizens, and the population coverage had reached 99% by the end of 2004.^[53] NHI is mainly financed through premiums, which are based on the payroll tax, and is supplemented with out-of-pocket payments and direct government funding. In the initial stage, fee-for-service predominated for both public and private providers.

NHI delivers universal coverage offered by a government-run insurer. The working population pays premiums split with their employers, others pay a flat rate with government help and the poor or veterans are fully subsidized. Taiwan’s citizens no longer have to worry about going bankrupt due to medical bills.^[54]

Under this model, citizens have free range to choose hospitals and physicians without using a gatekeeper and do not have to worry about waiting lists. NHI offers a comprehensive benefit package that covers preventive medical services, prescription drugs, dental services, Chinese medicine, home nurse visits and many more. Working people do not have to worry about losing their jobs or changing jobs because they will not lose their insurance. Since NHI, the previously uninsured have increased their usage of medical services. Most preventive services are free such as annual checkups and maternal and child care. Regular office visits have co-payments as low as US $5 per visit. Co-payments are fixed and unvaried by the person’s income.^[55]

[edit] Thailand

Main article: Health care in Thailand

Thailand introduced universal coverage reforms in 2001, becoming one of only a handful of lower-middle income countries to do so at the time. Means-tested health care for low income households was replaced by a new and more comprehensive insurance scheme, originally known as the 30 baht project, in line with the small co-payment charged for treatment. People joining the scheme receive a gold card which allows them to access services in their health district, and, if necessary, be referred for specialist treatment elsewhere. The bulk of finance comes from public revenues, with funding allocated to Contracting Units for Primary Care annually on a population basis. According to the WHO, 65% of Thailand's health care expenditure in 2004 came from the government, 35% was from private sources.^[50] Although the reforms have received a good deal of critical comment, they have proved popular with poorer Thais, especially in rural areas, and survived the change of government after the 2006 military coup. The then Public Health Minister, Mongkol Na Songkhla, abolished the 30 baht co-payment and made the UC scheme free. It is not yet clear whether the scheme will be modified further under the coalition government that came to power in January 2008.^[56][57][58]

[edit] Europe

Virtually all of Europe has either publicly sponsored and regulated universal health care or publicly provided universal healthcare. The public plans in some countries provide basic or "sick" coverage only; their citizens can purchase supplemental insurance for additional coverage. Countries with universal health care include Austria, Andorra, Belarus,^[59] Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, the Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Moldova,^[60] Monaco, the Netherlands, Norway, Poland, Portugal,^[61] Romania, Russia, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Ukraine,^[62] and the United Kingdom.^[63]

[edit] Austria

Main article: Health care in Austria

The nation of Austria has a two-tier health care system in which many individuals receive publicly-funded care, but they also have the option to purchase supplementary private health insurance.

[edit] Denmark

Main article: Health care in Denmark

Denmark has a universal public health system paid largely from taxation with local municipalities delivering health care services in the same way as other Scandinavian countries. Primary care is provided by a general practitioner service run by private doctors contracting with the local municipalities with payment on a mixed per capita and fee for service basis. Most hospitals are run by the municipalities (only 1% of hospital beds are in the private sector).

[edit] Finland

Main article: Healthcare in Finland

In Finland, public medical services at clinics and hospitals are run by the municipalities (local government) and are funded 76% by taxation, 20% by patients through access charges, and 4% by others. Private provision is mainly in the primary care sector. There are a few private hospitals.^[64] The main hospitals are either municipally owned (funded from local taxes) or run by the medical teaching universities (funded jointly by the municipalities and the national government). According to a survey published by the European Commission in 2000, Finland's is in the top 4 of EU countries in terms of satisfaction with their hospital care system: 88% of Finnish respondents were satisfied compared with the EU average of 41.3%.^[65] Finnish health care expenditures are below the European average.^{[citation
needed]} The private medical sector accounts for about 14 percent of total health care spending. Only 8% of doctors choose to work in private practice, and some of these also choose to do some work in the public sector.^{[citation
needed]}

Taxation funding is partly local and partly nationally based. The national social insurance institution KELA reimburses part of patients prescription costs and makes a contribution towards private medical costs (including dentistry) if they choose to be treated in the private sector rather than the public sector. Patient access charges are subject to annual caps. For example GP visits cost €11 per visit with annual €33 cap; hospital outpatient treatment €22 per visit; a hospital stay, including food, medical care and medicines €26 per 24 hours, or €12 if in a psychiatric hospital. After a patient has spent €590 per year on public medical services (including prescription drugs), all treatment and medications thereafter in that year are free.

[edit] France

Main article: Healthcare in France

France has a system of universal health care largely financed by government through a system of national health insurance. It is consistently ranked as one of the best in the world.

[edit] Germany

Main article: Health care in Germany

The Charité (Hospital) in Berlin

Germany has the world's oldest universal health care system, with origins dating back to Otto von Bismarck's Health Insurance Act of 1883.^[66] As mandatory health insurance, it originally applied only to low-income workers and certain government employees, but has gradually expanded to cover the great majority of the population.^[67] The system is decentralized with private practice physicians providing ambulatory care, and independent, mostly non-profit hospitals providing the majority of inpatient care. Approximately 92% of the population is covered by a 'Statutory Health Insurance' plan, which provides a standardized level of coverage through any one of approximately 1100 public or private sickness funds. Standard insurance is funded by a combination of employee contributions, employer contributions and government subsidies on a scale determined by income level. Higher income workers sometimes choose to pay a tax and opt out of the standard plan, in favor of 'private' insurance. The latter's premiums are not linked to income level but instead to health status.^[68]

Historically, the level of provider reimbursement for specific services is determined through negotiations between regional physician's associations and sickness funds. Since 1976 the government has convened an annual commission, composed of representatives of business, labor, physicians, hospitals, and insurance and pharmaceutical industries.^[69] The commission takes into account government policies and makes recommendations to regional associations with respect to overall expenditure targets. In 1986 expenditure caps were implemented and were tied to the age of the local population as well as the overall wage increases. Although reimbursement of providers is on a fee-for-service basis the amount to be reimbursed for each service is determined retrospectively to ensure that spending targets are not exceeded. Capitated care, such as that provided by U.S. health maintenance organizations, has been considered as a cost containment mechanism but would require consent of regional medical associations, and has not materialized.^[70] Copayments were introduced in the 1980s in an attempt to prevent overutilization and control costs. The average length of hospital stay in Germany has decreased in recent years from 14 days to 9 days, still considerably longer than average stays in the U.S. (5 to 6 days).^[71][72] The difference is partly driven by the fact that hospital reimbursement is chiefly a function of the number of hospital days as opposed to procedures or the patient's diagnosis. Drug costs have increased substantially, rising nearly 60% from 1991 through 2005. Despite attempts to contain costs, overall health care expenditures rose to 10.7% of GDP in 2005, comparable to other western European nations, but substantially less than that spent in the U.S. (nearly 16% of GDP).^[73]

[edit] Greece

Main article: Health care in Greece

The Greek healthcare system provides high quality medical services to insured citizens and is coordinated by the Ministry for Health and Social Solidarity. Public health services are provided by the National Healthcare Service, or ESY (Greek: Εθνικό Σύστημα Υγείας, ΕΣΥ). In 2010 there were 35,000 hospital beds and 131 hospitals in the country.

The Greek healthcare system has received high rankings by the World Health Organization, ranked 14th in the overall assessment and 11th in quality of service in a 2000 report by the WHO.

[edit] Guernsey / Jersey

The medical care system in the Channel Islands is very similar to that of the UK in that many of the doctors and nurses have been trained from the UK health perspective. There is universal health care for residents of the island.^[74]

[edit] Ireland

Main article: Health care in Ireland

The public health care system of the Republic of Ireland is governed by the Health Act 2004,^[75] which established a new body to be responsible for providing health and personal social services to everyone living in Ireland – the Health Service Executive. The new national health service came into being officially on January 1, 2005; however the new structures are currently in the process of being established as the reform programe continues. In addition to the public-sector, there is also a large private health care market.

[edit] Isle of Man

The Isle of Man provides universal public health coverage to its residents.^[76]

[edit] Italy

Main article: Health care in Italy

Italy has a public health care service for all the residents called "Servizio Sanitario Nazionale" or SSN (National Health Service) which is similar to the UK National Health Service. It is publicly run and funded mostly from taxation: some services requires small co-pays, while other services (like the emergency medicine and the general doctor) are completely free of charge. Like the UK, there is a small parallel private health care system, especially in the field of Dental Medicine.

[edit] Luxembourg

Luxembourg has universal coverage of population by health insurance and mandatory dependence insurance.^[77]

[edit] Netherlands

Main article: Health care in the Netherlands

The Netherlands has a dual-level system. All primary and curative care (i.e. the family doctor service and hospitals and clinics) is financed from private compulsory insurance. Long term care for the elderly, the dying, the long term mentally ill etc. is covered by social insurance funded from taxation. According to the WHO, the health care system in the Netherlands was 62% government funded and 38% privately funded as of 2004.^[50]

Insurance companies must offer a core universal insurance package for the universal primary, curative care which includes the cost of all prescription medicines. They must do this at a fixed price for all. The same premium is paid whether young or old, healthy or sick. It is illegal in The Netherlands for insurers to refuse an application for health insurance, to impose special conditions (e.g. exclusions, deductibles, co-pays etc., or refuse to fund treatments which a doctor has determined to be medically necessary). The system is 50% financed from payroll taxes paid by employers to a fund controlled by the Health regulator. The government contributes an additional 5% to the regulator's fund. The remaining 45% is collected as premiums paid by the insured directly to the insurance company. Some employers negotiate bulk deals with health insurers and some even pay the employees' premiums as an employment benefit). All insurance companies receive additional funding from the regulator's fund. The regulator has sight of the claims made by policyholders and therefore can redistribute the funds its holds on the basis of relative claims made by policy holders. Thus insurers with high payouts will receive more from the regulator than those with low payouts. Thus insurance companies have no incentive to deter high cost individuals from taking insurance and are compensated if they have to pay out more than might be expected. Insurance companies compete with each other on price for the 45% direct premium part of the funding and try to negotiate deals with hospitals to keep costs low and quality high. The competition regulator is charged with checking for abuse of dominant market positions and the creation of cartels that act against the consumer interests. An insurance regulator ensures that all basic policies have identical coverage rules so that no person is medically disadvantaged by his or her choice of insurer.

Hospitals in the Netherlands are also regulated and inspected but are mostly privately run and not for profit, as are many of the insurance companies. Patients can choose where they want to be treated and have access to information on the internet about the performance and waiting times at each hospital. Patients dissatisfied with their insurer and choice of hospital can cancel at any time but must make a new agreement with another insurer.

Insurance companies can offer additional services at extra cost over and above the universal system laid down by the regulator, e.g. for dental care. The standard monthly premium for health care paid by individual adults is about €100 per month. Persons on low incomes can get assistance from the government if they cannot afford these payments. Children under 18 are insured by the system at no additional cost to them or their families because the insurance company receives the cost of this from the regulator's fund. There is a fixed yearly threshold of €165 for each person, excluding some health categories (like diagnosis and acute care), as incentive against excessive claims.

[edit] Norway

Norway has a universal public health system paid largely from taxation in the same way as other Scandinavian countries. Norway’s entire population has equal access to health care services. The Norwegian health care system is government-funded and heavily decentralized. The health care system in Norway is financed primarily through taxes levied by county councils and municipalities. There is no dental coverage within the Norwegian health care plan.

Norway regularly comes top or close to the top of worldwide healthcare rankings.

[edit] Romania

Main article: Healthcare in Romania

According to Article 34 from the Constitution of Romania, the state is obliged "to guarantee the sheltering of healthcare". Romania has, theoretically, a fully universal health care system, which covers up medical check-ups, any surgical interventions, and any post-operator medical care, as well as free or subsidized medicine for a range of diseases. The state is also obliged to fund public hospitals and clinics. Dental care is not funded by the state, although there are public dental clinics in some hospitals, which treat patients free of charge. However, due to the budget cuts and bribing, it is estimated that a third of the medical expenses are, in some cases, supported by the patient ^[78] Furthermore, Romania spends, per capita, less than any other EU state on medical care. ^[79]

[edit] Russia

Main article: Healthcare in Russia

Article 41 of the Constitution of the Russian Federation confirms a citizen's right to state healthcare and medical assistance free of charge.^[80] This is achieved through state compulsory medical insurance (OMS) which is free to Russian citizens, funded by obligatory medical insurance payments made by companies and government subsidies.^[81][82] Introduction in 1993 reform of new free market providers in addition to the state-run institutions intended to promote both efficiency and patient choice. A purchaser-provider split help facilitate the restructuring of care, as resources would migrate to where there was greatest demand, reduce the excess capacity in the hospital sector and stimulate the development of primary care. Russian Prime Minister Vladimir Putin announced a new large large-scale health care reform in 2011 and pledged to allocate more than 300 billion rubles ($10 billion) in the next few years to improve health care in the country.^[83] He also said that obligatory medical insurance tax paid by companies will increase from current 3.1% to 5.1% starting from 2011.^[83]

[edit] Serbia

Main article: Serbian healthcare system

The Constitution of the Republic of Serbia states that it is a right of every citizen to seek medical assistance free of charge.^[84] This is achieved by mutual contribution to the so called Compulsory Social Healthcare Fund of RZZO (Republički Zavod za Zdravstveno Osiguranje or National Health Insurance Institution). The amount of contribution depends on the amount of money the person is making. During the 1990s, Serbia's healthcare system has been of a poor quality due to severe underfunding. In the recent years, however, that has changed and the Serbian government has invested heavily in new medical infrastructure, completely remodeling existing hospitals and building two new hospitals in Novi Sad and Kragujevac.

[edit] Sweden

Main article: Healthcare in Sweden

Sweden has a universal public health system paid largely from taxation in the same way as other Scandinavian countries. Sweden’s entire population has equal access to health care services. The Swedish health care system is government-funded and heavily decentralized. The health care system in Sweden is financed primarily through taxes levied by county councils and municipalities.

Sweden regularly comes top or close to the top of worldwide healthcare rankings.^[85]

[edit] Switzerland

Main article: Healthcare in Switzerland

Healthcare in Switzerland is universal and is regulated by the Federal Health Insurance Act of 1994. Basic health insurance is mandatory for all persons residing in Switzerland (within three months of taking up residence or being born in the country). Insurers are required to offer insurance to everyone, regardless of age or medical condition. They are not allowed to make a profit off this basic insurance, but can on supplemental plans.^[86]

[edit] United Kingdom

Main article: Healthcare in the United Kingdom

Each of the Countries of the United Kingdom has a National Health Service that provides public healthcare to all UK permanent residents that is free at the point of need and paid for from general taxation. However private healthcare companies are free to operate alongside the public one. Since Health is a devolved matter, considerable differences are developing between the systems in each of the countries.^[87]

[edit] England

Main article: Healthcare in England

Norfolk and Norwich University Hospital, a National Health Service hospital.

The National Health Service (NHS), created by the National Health Service Act 1946, has provided the majority of healthcare in England since its launch on July 5, 1948.

The NHS Constitution for England documents, at high level, the objectives of the NHS, the legal rights and responsibilities of the various parties (patients, staff, NHS trust boards), and the guiding principles which govern the service.^[88] The NHS constitution makes it clear that it provides a comprehensive service, available to all irrespective of age, gender, disability, race, sexual orientation, religion or belief; that access to NHS services is based on clinical need and not an individual’s ability to pay; and that care is never refused on unreasonable grounds. Patient choice in terms of doctor, care, treatments and place of treatment is an important aspect of the NHS's ambition, and in some cases patients can elect for treatment in other European countries at the NHS's expense. Waiting times are low, with most people able to see their primary care doctor on the same day or the following day^[89] and only 36.1% of hospital admissions are from a waiting list, with the remainder being either emergencies admitted immediately or else pre-booked admissions or similar (e.g. child birth).^[90] No patient should experience a delay of more than 18 weeks from initial hospital referral to final treatment.^[91] This includes the time for all investigative tests and consultations, and two thirds of patients are currently treated in under 12 weeks.^[92]

Although centrally funded there is no large central bureaucracy to manage it. Responsibility is highly devolved to geographical areas through Strategic Health Authorities and even more locally through NHS primary care trusts, NHS hospital trusts and increasingly to NHS foundation trusts which are providing even more decentralized services within the NHS framework, with more decision making taken by local people, patients and staff. The central government office, the Department of Health, is not involved in day to day decision making in either the Strategic Health Authorities or the individual local trusts (primarily health, hospital or ambulance) or the national specialist trusts such as NHS Blood and Transplant, but it does lay down general guidelines for them to follow. Local trusts are accountable to their local populations, whilst government ministers are accountable to Parliament for the service overall.

The NHS provides, among other things, primary care, in-patient care, long-term healthcare, psychiatric care and treatments, ophthalmology, and dentistry. All treatment is free with the exception of certain charges for prescriptions, dentistry and ophthalmology (which themselves are free to children, certain students in full-time education, the elderly, the unemployed and those on low incomes). Eighty-nine percent of NHS prescriptions are obtained free of charge, mostly children, pensioners and pregnant women. Others pay a flat rate of £7.20,^[93] and others may cap their annual charges. Private health care has continued parallel to the NHS, paid for largely by private insurance. Private insurance accounts for only 4 percent of health expenditure and covers little more than a tenth of the population.^[94] Private insurers in the UK only cover acute care from specialists. They do not cover generalist consultations, pre-existing conditions, medical emergencies, organ transplants, chronic conditions such as diabetes, or conditions such as pregnancy or HIV.^[95] Most NHS general practitioners are private doctors who contract to provide NHS services, but most hospitals are publicly owned and run through NHS Trusts. A few NHS medical services (such as "surgicentres") are sub-contracted to private providers^[96] as are some non-medical services (such as catering). Some capital projects such as new hospitals have been funded through the Private Finance Initiative, enabling investment without (in the short term) increasing the public sector borrowing requirement, because long-term contractually-obligated PFI spending commitments are not counted as government liabilities.

[edit] Northern Ireland

Main article: Health and Social Care in Northern Ireland

Health and Social Care in Northern Ireland is the designation of the national public health service in Northern Ireland.

[edit] Scotland

The Royal Aberdeen Children's Hospital is a specialist children's hospital within NHS Scotland.

Main article: Healthcare in Scotland

NHS Scotland, created by the National Health Service (Scotland) Act 1947, was also launched on July 5, 1948 though it has always been a separate organization. Since devolution, NHS Scotland follows the policies and priorities of the Scottish Government, including the phasing out of all prescription charges by 2011.

[edit] Wales

Main article: Healthcare in Wales

NHS Wales was originally formed as part of the same NHS structure created by the National Health Service Act 1946 but powers over the NHS in Wales came under the Secretary of State for Wales in 1969,^[97] in turn being transferred under devolution to what is now the Welsh Government.

[edit] Oceania

[edit] Australia

Main article: Medicare (Australia)

Medicare logo

In Australia, Medibank — as it was then known — was introduced, by the Whitlam Labor government on July 1, 1975, through the Health Insurance Act 1973. The Australian Senate rejected the changes multiple times and they were passed only after a joint sitting after the 1974 double dissolution election. However, Medibank was supported by the subsequent Fraser Coalition (Australia)government and became a key feature of Australia’s public policy landscape. The exact structure of Medibank/Medicare, in terms of the size of the rebate to doctors and hospitals and the way it has administered, has varied over the years. The original Medibank program proposed a 1.35% levy (with low income exemptions) but these bills were rejected by the Senate, and so Medibank was funded from general taxation. In 1976, the Fraser Government introduced a 2.5% levy and split Medibank in two: a universal scheme called Medibank Public and a government-owned private health insurance company, Medibank Private.

During the 1980s, Medibank Public was renamed Medicare by the Hawke Labor government, which also changed the funding model, to an income tax surcharge, known as the Medicare Levy, which was set at 1.5%, with exemptions for low income earners.^[98] The Howard Coalition government introduced an additional levy of 1.0%, known as the Medicare Levy Surcharge, for those on high annual incomes ($70,000) and do not have adequate levels of private hospital coverage.^[99] This was part of an effort by the Coalition to encourage take-up of private health insurance. According to WHO, government funding covered 67.5% of Australia's health care expenditures in 2004; private sources covered the remaining 32.5% of expenditures.^[50]

[edit] New Zealand

Main article: Health care in New Zealand

As with Australia, New Zealand's healthcare system is funded through general taxation. According to the WHO, government sources covered 77.4% of New Zealand's health care costs in 2004; private expenditures covered the remaining 22.6%.^[50]

[edit] Africa

Countries that provide public healthcare in Africa are Algeria,^[100] Egypt,^[101] Ghana,^[102] Libya,^[103] Mauritius,^[104] Morocco,^[105] Seychelles^{[citation
needed]}, South Africa,^[106] and Tunisia.^[107]

[edit] Economics

Main article: Health care economics

[edit] Funding models

Universal health care in most countries has been achieved by a mixed model of funding. General taxation revenue is the primary source of funding, but in many countries it is supplemented by specific levies (which may be charged to the individual and/or an employer) or with the option of private payments (either direct or via optional insurance) for services beyond that covered by the public system.

Almost all European systems are financed through a mix of public and private contributions.^[108] The majority of universal health care systems are funded primarily by tax revenue (e.g. Portugal^[108]Spain, Denmark and Sweden). Some nations, such as Germany, France^[63] and Japan^[109] employ a multi-payer system in which health care is funded by private and public contributions. However, much of the non-government funding is by defined contributions by employers and employees to regulated non-profit sickness funds. These contributions are compulsory and vary according to a person's salary, and are effectively a form of hypothecated taxation.

A distinction is also made between municipal and national healthcare funding. For example, one model is that the bulk of the healthcare is funded by the municipality, speciality healthcare is provided and possibly funded by a larger entity, such as a municipal co-operation board or the state, and the medications are paid by a state agency.

Universal health care systems are modestly redistributive. Progressivity of health care financing has limited implications for overall income inequality.^[110]

[edit] Single payer

Main article: Single-payer health care

The term single-payer health care is used in the United States to describe a funding mechanism meeting the costs of medical care from a single fund. Although the fund holder is usually the government, some forms of single-payer employ a public-private system.

[edit] Public

Some countries (notably the United Kingdom, Italy, Spain and the Nordic countries) choose to fund health care directly from taxation alone. Other countries with insurance-based systems effectively meet the cost of insuring those unable to insure themselves via social security arrangements funded from taxation, either by directly paying their medical bills or by paying for insurance premiums for those affected.

[edit] Compulsory insurance

This is usually enforced via legislation requiring residents to purchase insurance, though sometimes, in effect, the government provides the insurance. Sometimes there may be a choice of multiple public and private funds providing a standard service (e.g. as in Germany) or sometimes just a single public fund (as in Canada). The U.S. Patient Protection and Affordable Care Act is a law based on compulsory insurance.^[111]

In some European countries where there is private insurance and universal health care, such as Germany, Belgium, and The Netherlands, the problem of adverse selection (see Private insurance below) is overcome using a risk compensation pool to equalize, as far as possible, the risks between funds. Thus a fund with a predominantly healthy, younger population has to pay into a compensation pool and a fund with an older and predominantly less healthy population would receive funds from the pool. In this way, sickness funds compete on price and there is no advantage to eliminate people with higher risks because they are compensated for by means of risk-adjusted capitation payments. Funds are not allowed to pick and choose their policyholders or deny coverage, but then mainly compete on price and service. In some countries the basic coverage level is set by the government and cannot be modified.^[112]

Ireland at one time had a "community rating" system through VHI, effectively a single-payer or common risk pool. The government later opened VHI to competition but without a compensation pool. This resulted in foreign insurance companies entering the Irish market and offering cheap health insurance to relatively healthy segments of the market which then made higher profits at VHI's expense. The government later re-introduced community rating through a pooling arrangement and at least one main major insurance company, BUPA, then withdrew from the Irish market.

[edit] Private insurance

In some countries with universal coverage, private insurance often excludes many health conditions which are expensive and which the state health care system can provide. For example in the UK, one of the largest private health care providers is BUPA which has a long list of general exclusions even in its highest coverage policy.^[113] In the USA dialysis treatment for end stage renal failure is generally paid for by government and not by the insurance industry. Persons with privatized Medicare (Medicare Advantage) are the exception and must get their dialysis paid through their insurance company, but persons with end stage renal failure generally cannot buy Medicare Advantage plans.^[114]

Among the potential solutions posited by economists are single payer systems as well as other methods of ensuring that health insurance is universal, such as by requiring all citizens to purchase insurance and limiting the ability of insurance companies to deny insurance to individuals or vary price between individuals.^[115][116]

Alma Ata Declaration

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The Declaration of Alma-Ata was adopted at the International Conference on Primary Health Care (PHC), Almaty (formerly Alma-Ata), Kazakhstan (formerly Kazakh Soviet Socialist Republic), 6-12 September 1978.^[1] It expressed the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world. It was the first international declaration underlining the importance of primary health care. The primary health care approach has since then been accepted by member countries of the World Health Organization (WHO) as the key to achieving the goal of "Health For All".

Contents

[hide]

1 Description

[edit] Description

The Conference called for urgent and effective national and international action to develop and implement primary health care throughout the world and particularly in developing countries in a spirit of technical cooperation and in keeping with a New International Economic Order. It urged governments, WHO and UNICEF, and other international organizations, as well as multilateral and bilateral agencies, non-governmental organizations, funding agencies, all health workers and the whole world community to support national and international commitment to primary health care and to channel increased technical and financial support to it, particularly in developing countries. The Conference called on all the aforementioned to collaborate in introducing, developing and maintaining primary health care in accordance with the spirit and content of the Declaration. The Declaration has 10 points and is non-binding on member states.

[edit] Definition of health

The first section of the declaration reaffirms the WHO definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."^[2] The definition seeks to include social and economic sectors within the scope of attaining health and reaffirms health as a human right.

[edit] Equity

The declaration highlighted the inequity between the developed and the developing countries and termed it politically, socially and economically unacceptable.

[edit] Health as a socio-economic issue and as a human right

The third section called for economic and social development as a pre-requisite to the attainment of health for all. It also declared positive effects on economic and social development and on world peace through promotion and protection of health of the people.

Participation of people as a group or individually in planning and implementing their health care was declared as a human right and duty.

[edit] Role of the State

This section emphasized on the role of the State in providing adequate health and social measures. This section enunciated the call for Health for all which became a campaign of the WHO in the coming years. It defined Health for All as the attainment by all peoples of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. The declaration urged governments, international organizations and the whole world community to take this up as a main social target in the spirit of social justice.

[edit] Primary health care and components

This section defined primary health care and urged signatories to incorporate the concept of primary health care in their health systems. Primary health care has since been adopted by many member nations. More recently, Margaret Chan, the Director-General of the WHO has reaffirmed the primary health care approach as the most efficient and cost-effective way to organize a health system. She also pointed out that international evidence overwhelmingly demonstrates that health systems oriented towards primary health care produce better outcomes, at lower costs, and with higher user satisfaction.^[3]

The seventh section lists the components of primary health care. The next two sections called on all governments to incorporate primary health care approach in their health systems and urged international cooperation in better use of the world's resources.

WE BASED OUR RESEARCH ORIENTATIONS ON ALL THESE.

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THE KENEZIAN CREED

THE KENEZIAN CREED International Worship of the Almighty Creator by All Rational Human Beings 1. I am old enough to know my natural father and mother besides recognising the biological roles they played in my physical manifestation on this plane of existence. They were definitely instrumental in my earliest survival and reared me as best as they could. Now; I am I, you are you, we are us; therefore I affirm that I exist! 2. I am aware that I had a beginning as a living corporeal being and will naturally come to an end as other animate beings I have observed do come to a definitive end. I need food, water, air and sleep to survive as an individual entity and love, education and social interactions to grow, develop and mature properly in a human community, therefore I accept that all finite beings like myself are governed by certain Natural Laws. 3. The macrocosms that I observe; the sun, the moon, mountains, canyons, rivers, oceans, and seas obey these natural laws daily as well as whales, elephants, rhinoceros, hippopotamuses, giraffes, ostriches, and other huge reptiles. These laws existed before our arrival here, are enforced all the time and will continue after our individual deaths; therefore I am convinced that they are Eternal as well as Supernatural. 4. Every law has a lawgiver, so these natural, eternal and supernatural laws must equally have a Natural, an Eternal and a Supernatural Lawgiver or givers. If the latter, there must be a hierarchy and at the apex of these lawgivers must be one Supreme overseer that is the ultimate law itself and therefore I refer to it as the Ultimate Lawgiver whom all else must obey at all times. To IT/HIM/HER I owe my existence, my breath, my blood, my food and my life. IT/HE/SHE is my Greatest Being that must be obeyed and worshipped! 5. I have equally observed actions and reactions; motions produced by winds, time and space interactions and those immanent motions that are inherited by all living entities. They obey definite laws of gravity, temperature, time and space. Therefore I concede that these laws exact commensurate punishment for any and every violation of their dictates. Some punishments are immediate while some are delayed but definitely actions and reactions as I have realised are equal and opposite in nature. This Supernatural and Eternal Lawgiver rewards for obedience to these laws and so must be the Ultimate Cause of these motions for the daily enforcement of His Natural and Eternal Laws to ensure eternal harmony in the universe. 6. The force of gravity, the energy of light, the speed of sound, the velocity of wind, and the devastating fury of all the relentless elements in creation; thunders, fires, floods, storms, volcanoes, earthquakes and cyclones exhibit the magnitude and the energy of the One who initiates, maintains and controls them. The limitlessness of time, space, sound, light and darkness force me to concede that this Eternal Lawgiver is not only Infinite and Expansive but also All Powerful! 7. When I study the skies at night or the seasons and climates, the vegetation and the desert, the lagoons and the islands, the hills and the valleys, and most especially the beauty of sunrise and sunset, I marvel at the precision, regularity and complementary nature of these phenomena and therefore fully appreciate that whoever put them there, cares and caters for them on an hourly, daily, weekly, monthly, and yearly bases and must therefore be a Benevolent Custodian, and an Accurate Time Keeper! 8. Positivity and Negativity exist in all forms of life; microcosms, macrocosms, material and non-material beings thereby producing some real currents, emotions and instincts that are equally subservient to these ever-present natural and eternal laws. These make life worth living, for they constitute the basic motivations for the survival needs of every genus and species of life on planet earth, and so all pro-creative activities obey these Natural and Eternal Laws! 9. When I observe living beings; their beauty and ugliness, their variety and numbers, their shapes, sizes, modes of feeding, defending and surviving in hostile environments and most especially their innate abilities at reproducing themselves, sexually and/or asexually, I declare that this Eternal Lawgiver is All Creative, All Beautiful, and an Impartial Judge! I am fully convinced IT/HE/SHE created all the finite beings around me. Therefore, permit me to call IT/HE/SHE our commonwealth Supernatural and Eternal Creator/Father/Mother! 10. Among the living things that move about on their own, I do observe that we all have the same basic structure, protoplasm and energy source. We equally possess identical feelings, functions and comparable life spans! We all need to prostrate and worship this All Knowing, All Powerful, and Infinite Energy Source that sustains all beings in the entire universe! And because there are no accidents in Nature when all His Natural Laws are respected and obeyed, I attest to this creed most solemnly and voluntarily: • *-THE UNIVERSE IS OUR INHERITANCE, ALL MANKIND MY BLOOD RELATIVES! • **--DOING GOOD AT ALL TIMES AND OBEYING ALL NATURAL LAWS IS MY CODE! • ***---SEEKING THE TRUTH, LIVING THE TRUTH, PROPAGATING THE TRUTH AND DYING FOR THE TRUTH IF THE NEED ARISES, IS MY RELIGION! Postscript: My respect, obedience and loyalty belongs to this Almighty Eternal Being as I extend my hands of love and co-operation to all other beings that I meet during my short span of life on this planet, since I now recognise them as my brothers, sisters and co-heirs of this Our Eternal Lawgiver, Father and Mother who created us all! This is the Genesis of Kenezianism THE ENOCHIAN BEATITUDES 1. Blessed are those who obey all the Natural Laws in creation, For theirs is the Kingdom of God, personally guaranteed by The Almighty Creator of the universe. 2. Blessed are those who recognise that all human beings are their brothers and sisters, For their portion is the possession of the true Egalitarianism. 3. Blessed are those who know that we all share the same air, water, blood plasma, sun and moon, For this native insight shall reward them with filial love and care for others. 4. Blessed are those who realise that we all walk and plant on the same ground, For social justice and the joy of sharing shall be their everlasting benefits. 5. Blessed are those who wake up early each morning thanking and praising God, For this acknowledgement shall bring them divine blessings and peace of mind. 6. Blessed are all that recognise that equality at birth is the L.C.M. of human life, For theirs is the philosophic insight that eradicates apartheid and abrogates racism. 7. Blessed are the wise who know that we return to this human equality at death, For theirs are the social virtues and simple lifestyles it inculcates in all wise people. 8. Blessed are the genuine proponents and practitioners of true family life, For, through lovely children and happy homes, they shall inherit eternal life. 9. Blessed are all who train themselves to restrain their thoughts and guard their speech, For they will be respected by and confided in by those who interact with them anywhere. 10. Blessed are the few who have conquered their appetites for food, drinks and sex, For true happiness based on control of their will power shall be crowns on their heads. BLESSED ARE THE TRUE DISCIPLES OF PATRIARCH ENOCH FOR • SUCCESSFUL LONG LIVES, • GOOD HEALTH IN OLD AGE, & • PHYSICAL ASCENSION INTO HEAVEN SHALL BE THE ETERNAL PRIZES RESERVED FOR THEM BY GOD! Inspired by the Holy Spirit and written down at 3.30 a.m. on the 11th of March, later improved on and modified till 9.35 a.m. on 26th July, 2004 by Rev. Prof. J. J. Kenez D.Sc. I. S. M. UNIVERSAL PRAYER The Animator International’s Version Lord of the universe, the Almighty Creator God, I am your humble son, Jideofo Kenechukwu, born into the family of Sir Daniel Paul Mbaezue. In your Infinite Wisdom and Love you have created me for a purpose, Permit me to understand and fulfil the mission you have assigned me, May your Holy Spirit guide me to accomplish it in my short span of life. My Eternal Creator and Lord of the universe, I know that you exist, I observe also that all beings are interdependent, we need each other, Therefore, increase my loyalty and dependence on your benevolence. I love you as the Father of all that exists, I want to love other beings, As much as I love myself, permit me to truly achieve this increasingly! I worship you as my first beginning, I wish to do this as long as I live, I acknowledge your constant sustenance and care for me and all that is, Guide me by your divine wisdom, correct me with your eternal justice, Comfort me with your mercy and protect me with your limitless power, So that I may obey all the laws, you put in creation for our own good! I have a princely heritage in that I function at three levels of operations, In that tripartite functionality of thought, word and action I am like you. Grant me a large heart and mind to appreciate the universal knowledge That all humankind are blood relatives and co-heirs of this your ability, Therefore, we all are brothers and sisters, children of the same Father! Permit me to fix all my thoughts on you; my words to edify mankind, My actions to reflect my love for all humanity because I respect you, And all my trials and sufferings to be endured for your greater glory. I want to do whatever you ask of me, in the very way that pleases you, Thereby, obey all your natural laws for as long as you permit to live here. Lord, enlighten my understanding, strengthen my will, purify my heart And make me holy so as to resist temptations and repent of all my sins, Help me to rise above human weaknesses and to grow stronger in truth, So that with simplicity of heart and humane love I may care for others, And in caring for others may my worship and adoration be self-evident. Help me to conquer every anger with gentleness, greed by generosity, Apathy by true charity, selfishness by works of mercy and compassion, Help me to forget myself and thereby freely reach out towards others. Let my conscience be clear most of the time, my conduct without fault, My speech blameless, my thoughts edifying and my life well ordered. Make me very prudent in planning ahead for all, courageous in taking risks, Patient in adversity, honest at work and unassuming in times of prosperity. Keep me attentive at my prayers, temperate at table and sober in drinking, Firm in my holy resolutions, diligent in my good intentions/ labours of love. May my lifestyle be exemplary and reflect your infinite goodness for all to see. Put me on guard against mundane desires, protect me from every vanity And licentiousness, which can draw me away from obeying your dictates. Let me cherish your benevolence for all humanity and imitate your ways. Teach me to realise that the world is passing by and that nothing here lasts, That my true happiness is being a loyal citizen in your heavenly kingdom! At the dusk of my earthly life, help me to prepare for death with a proper focus On your fair judgement, for even guilty I still rely fully on your Infinite Mercy. Lead me safely thro’ the pangs of physical death to that endless place of peace, Where all those who have done your will on earth will be adequately rewarded, With the bliss of singing your praises in communion with your saints forever! Lord, search and find that I have kept the golden rules of the psalmist: Lord, who may enter your temple or worship at your sacred hill? • A person who obeys God in everything, especially the natural laws and as far as it is humanly possible, has always done what is right at all times and places. • Whose words are true and sincere, and therefore he does not slander others. • He does no wrong to his friends nor spreads rumours about his neighbours, • Rather he has compassion for the needy and always forgives his offenders. • He despises those whom God rejects, denouncing their hypocritical lifestyles. • Nevertheless, he honours those who respect and obey the eternal laws of the Lord. • He always does what he promises, no matter how much it may cost him, in terms of material or human resources. • He makes loans without charging interest and cannot be bribed to testify against the innocent. • Whoever does these things will always be happy and feel secure in your love.

Saturday, November 26, 2016

DR KENEZ THEORY AND PRACTICE OF EXISTENTIAL FAMILY THERAPEUTICS FOR HIS CBO HAPPY FAMILY NETWORK INTERNATIONAL

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