Private healthcare
Encyclopedia
Private healthcare or private medicine is healthcare and medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

 provided by entities other than the government. The term is generally used more in Europe and other countries which have publicly-funded health care
Publicly-funded health care
Publicly funded health care is a form of health care financing designed to meet the cost of all or most health care needs from a publicly managed fund. Usually this is under some form of democratic accountability, the right of access to which are set down in rules applying to the whole population...

, to differentiate the arrangement from the usual system.

Ethical issues relating to private healthcare primarily concern the argument that the seriously ill be entitled to spend money on saving their lives. On the other hand, private healthcare can sometimes be more efficient than public sector provision. Private operators may be more innovative in areas such as telemedicine. Due to the profit motive, they can be more productive. Public healthcare tends to be limited by the amount of tax that individuals are willing to pay.

Some would argue that private healthcare needs to be more carefully regulated to ensure that it achieves standards set by the state, predominantly regarding safety, value, and efficiency.

Fulfilling work paid for by the state (outsourcing) or by social insurers

In Sweden, Finland and the UK, increasingly, the private sector is fulfilling work for the state owned national healthsystem. In Sweden, for instance, it is estimated that 30%-50% of primary care (family doctors) will be private and typically owned by large privately held groups within 5 years, interview with Ralph Riber, head of Ambea . Care homes in all three countries are increasingly owned by the private sector and paid for by the public sector.

In Germany and France almost all private healthcare operators are fulfilling work which is paid for by compulsory social insurance funds. Every employed individual and their employer is mandated to pay a certain percentage of their salary into a regulated insurance fund. In Germany, for instance, private hospitals are paid exactly the same per procedure as public (not-for-profit) hospitals. Many patients will never know that they are actually in a private facility, rather than one which is owned by the state.

Charging patients or private insurers for work

Europeans in all countries are willing to pay a charge for some private healthcare, whether to avoid long queues, to access cosmetic surgery, or to avoid the perceived risk of infection in public-sector hospitals. This is not a small market. In Finland it is estimated that it is worth some €700m a year. In Greece, half the income of private hospitals is from one-off payments from patients. Maternity is a particularly large private market. Healthcare tourism is also thriving within the EU, in which patients (mainly from the UK) travel to Eastern Europe for low-cost dental work. The particularly wealthy Russians and Saudi Arabians tend to go to private hospitals in Switzerland or Germany.

As most Europeans have access to public sector provision either through their mandatory social insurance fund or through taxes, private healthcare insurance remains a relatively small market, with levels typically in the range of 2%-8% of the population. Many consumers prefer to pay single fees as and when necessary. In addition, any occupational healthcare paid for by employers renders private healthcare insurance unnecessary. Nonetheless, around 10% of Germans have some form of private healthcare insurance which enables them to experience a slightly higher level of comfort during hospital stays. The most notable development in this area has been the Netherlands, which in 2005 moved to a system whereby all citizens are forced to take out private healthcare insurance rather than social insurance. This is being closely monitored by many European countries.

Occupational healthcare

In many European countries with a state-run national health service, employers are obliged to pay for some level of healthcare for their employees. This is the case in Romania, Poland and Finland, for instance, and one can find networks of small clinics in large cities in these countries. In other countries, such as the UK and Sweden, many employers are willing to pay for occupational healthcare for their workforce so that key workers can avoid delays in seeing a doctor when they are unwell. Naturally though, the occupational health department of a publicly-funded hospital will provide a similar standard of healthcare to that provided for patients.

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