Bismarck Model

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Bismarck Model

The Bismarck Model is a health care system model that uses an insurance system — the insurers are called "sickness funds" — which must cover every citizen (universal health coverage). Named after the Prussian Chancellor Otto von Bismarck, who invented the welfare state as part of the unification of Germany in the 19th century, this system is used in Germany, Belgium, and the Netherlands. It is also used to some extent in Switzerland and Japan.

Overview[edit | edit source]

The Bismarck Model is characterized by a dual system of private and statutory health insurance. The statutory health insurance, also known as "sickness funds", is compulsory for all citizens earning less than a certain income. Those earning more than this income threshold can choose to remain in the statutory system or opt for private health insurance.

Features[edit | edit source]

The Bismarck Model has several key features:

  • Compulsory Insurance: All residents are required to have health insurance, either through the statutory system or through a private insurer.
  • Funded by Employers and Employees: The system is funded through payroll deductions, with employers and employees contributing equally.
  • Non-Profit Insurers: The sickness funds are usually operated as non-profit organizations.
  • Tight Regulation: The system is tightly regulated by the government, which sets the benefit packages and regulates the cost of services.

Comparison with Other Models[edit | edit source]

Compared to the Beveridge Model, another common health care system model, the Bismarck Model tends to have higher costs due to the need for multiple insurers. However, it also tends to have shorter waiting times for procedures and appointments.

Criticisms[edit | edit source]

Critics of the Bismarck Model argue that it can lead to a two-tier health care system, where those with private insurance receive better care. They also point out that the system can be complex and difficult to navigate.

See Also[edit | edit source]

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Contributors: Prab R. Tumpati, MD