Which of these four health care system models do you prefer and why?

[Redalgo]

Seeing as I look most favorably on the health care system of France, I voted the "Bismarck Model." Still, it's worth bearing in mind I am influenced by more than one model and tend to mix them a bit.

From what I understand (which may of course be flawed), there is public insurance for everyone but co-pays which reduce the detrimental impact of moral hazard. The state reimburses some of those costs (35%-100%) in some instances in an effort to encourage folks to take cost-effective medications, seek preventative care, and get treatment for chronic conditions that will otherwise worsen in their severity over time - which threatens to become more financially burdensome for both the system and afflicted individuals. The public plan is only basic, so folks get supplementary insurance privately (often through their employers). People who cannot afford it receive state aid. There are public and private hospitals and care providers alike from among which one may choose and individuals are given discretion in deciding whether to pay for higher qualities of health care.

Then again, it would be quite helpful for me if someone from France were to explain some of the pros and cons of their health care system, seeing as I have only read about it through American authors and am almost surely overlooking a few important considerations.

[Redalgo]

I went with Bismarck, but would someone mind listing the pros and cons of these?

This is a fantastic (and easily read) book if you're interested: http://www.amazon.com/The-Healing-America-Global-Cheaper/dp/1594202346

Alternatively, although I am sure this is far from being complete and is less authoritative, here are some basic points I picked up during health care debates in my time as an undergrad student:


Canada (National Health Insurance Model)

- Its method is arguably centre-left and typical of social liberalism
- Average waiting times don’t seem markedly longer than in the States
- State price bargaining lowers the cost of treatments but hinders R&D
- Physicians have more time for patients yet less for each, individually
- Administrative costs and complexity are much lower than in the U.S.
- Queues are not always first come, first serve
- One is basically stuck with using this system


France (Mixed / Bismarck Model)

See Antonio’s post for a basic breakdown of the system.


Germany (Bismarck Model)

- Its approach is more or less centrist and typical of ordoliberalism
- Numerous private, but non-profit health insurers / sickness funds dominate the market
- Insurers compete yet are regulated to avoid unjust discrimination
- Funds redistributed from sickness funds with the healthiest folk to those with the least
- Patients inefficiently use up hospital beds for almost twice as many days as in the U.S.
- Health care costs per capita are markedly higher than in the U.K.
- Opting out is a choice but very few people actually want to do so


United Kingdom (Beveridge/NHS/Whatever Model)

- Its method is arguably left-of-centre and typical of social democracy or socialism
- Health care costs per capita are 60% lower than in the U.S.
- New and/or expensive tests and treatments get rationed for budgetary reasons
- Physicians have more time for patients yet less for each, individually
- Use of resources benefits the young and those with minor ailments
- Yet olds and sufferers of dire ills often get the short end of the stick
- Quality of care can greatly vary by location (i.e. the NHS is a “postcode lottery”)


 United States (Mixed / Out-of-Pocket Model)

- Its method is right-of-centre and vaguely reminiscent of low-GDP countries
- Private insurers compete in a regulated market; patients buy what they want
- People have very low rates of mortality from many treatable diseases
- Physicians have less time for patients yet more for each, individually
- Administrative costs are high and interactions with insurers complex
- Costs are rising but at rates somewhat similar to in other high-GDP countries
- The VHA offers its best quality of care yet uses the Beveridge/NHS/Whatever Model