By: Juan Viedma Martinez
Health laws are used to formalize commitment to goals, such as the goal of universal health coverage, creating a drive for action. To enable cooperation and achieve health goals, people use law to create different organizations (such as hospitals) and relationships (such as contracts for providing health services). In turn, organizations (whether health ministries, the private sector or civil society) have mandates, policies, and strategies based on legal rules that guide their work.
There are also many rules that structure what health organizations and individuals should do and what they may not do. This interaction between different health laws results in health system functions being carried out and health products and services being delivered. Organizations such as World Health Organization (WHO), Food and Drug Administration (FDA), National Agency for Food and Drug Administration and Control (NAFDAC), and The National Drug Law Enforcement Agency (NDLEA) help to implement health laws on a national level and global level, to ensure that the healthcare industry is performing effectively.
Below are some basic Rights and Laws that every citizen in any country should be aware of and make use of their provisions for better healthcare services –
No. 1: RIGHT TO NATIONAL INSURANCE
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As a Citizen of any country, you have the right to national insurance, which should be covered by the tax paid by the citizens. Although, that has not been the case in most developed countries.
The Bismarck Model
Like in the National Health Insurance model, most health care facilities are private. But citizens are required to buy health insurance, which is heavily regulated by the government and must provide certain benefits. Usually, health insurance is non-profit and paid for through payroll deductions or payroll taxes. Low-income people may receive subsidies for health insurance from the government. This is the system Germany, France, the Netherlands, Japan, and other countries use to deliver universal health care.
The Beveridge Model
This is the other system that provides what people think of as free healthcare. Like in the National Health Insurance model, the government uses taxation to pay for health care. Unlike the National Health Insurance or Bismarck models, most medical facilities are owned and run by the government. The most famous Beveridge health care system is the NHS in the U.K., which was designed by William Beveridge himself. New Zealand, Cuba, Hong Kong, and Spain are also among the many countries that use this system.
No.2: RIGHT TO PRIVATE INSURANCE
The USA does not have a universal, free healthcare program, unlike most other developed countries. Instead, in line with the free-market-virtue mindset, most Americans are served by a mix of publicly and privately funded programs and healthcare systems.
Most hospitals and clinics are privately owned, with about 60% being non-profits, and another fifth being for-profit facilities. Coverage by federal and state programs is partial, and most insured Americans have employment-based private insurance.
Group plans funded by the employer cover about 150 million Americans.
These include health maintenance organizations (HMOs), which are networks of providers. Insured patients see a primary care physician (PCP), whose refers them to a specialist if necessary.
A more popular option is to use preferred provider organizations (PPOs), which allow patients to see external providers, choose their PCPs, and see a specialist without a PCP referral, provided the former is willing.
These are now used by over 55% of insured employees, compared to 25% in HMOs or point-of-service (POS) plans.
With POS plans, patients must have a PCP in the provider network but can go out of the network for a fee.
No. 3: ARTICLE 35 – RIGHT TO PREVENTIVE CARE
Everyone has the right access to preventive health care and the right to benefit from medical treatment under the conditions established by national laws and practices. A high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities.
No. 4: ARTICLE 25 – THE RIGHT TO ADEQUATE HEALTH
The Declaration of Human Rights (UDHR) articulates this right to adequate health in Article 25: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care…”
No. 5: THE ANTI-KICKBACK LAW
This law prohibits any healthcare worker from accepting a bribe in exchange for a referral for an item or service paid for by Medicare or Medicaid. A similar law, known as the Stark Law, prohibits physicians from accepting bribes for referrals to medical services such as lab testing, hospital services, or even prescription drugs.
No. 6: THE FALSE CLAIMS ACT
This act prohibits anyone from making a false medical claim or a false record of services billed to a federally funded medical program. This includes billing for services not provided, or billing multiple times for a single service. The act also protects whistle-blowers who report these false claims. A similar act has been passed that specifically covers false claims to the Medicaid program.
No. 7: LAW FOR UNIVERSAL HEALTH COVERAGE (UHC)
For all aspects of health, there are binding rules that govern the rights and responsibilities of governments, health workers, companies, civil society and a country’s population. Together these rules make up the legal framework, or legal architecture for health. They take many forms including: statutory laws, regulatory and administrative laws, contracts, case law, and customary laws. Who is involved in making these rules, and the form they take, differs from country to country.
No. 8: The Health Information Technology for Economic and Clinical Health Act (HITECH):
No. 9: The most commonly known healthcare law is the Health Insurance Portability and Accountability Act, or HIPAA:
This law prevents healthcare professionals from discussing patients’ medical records with anyone but the patient or authorized personnel. That might be other team members treating the patient, insurance providers, or maybe a healthcare proxy. The important takeaway is that if you’re a patient, you get to decide who sees—and doesn’t see—your private medical records.
To determine the status, and ranking of global healthcare system such as in Europe, Africa, and North America, we need to look at some parameters including: implementation of healthcare laws for the benefit of the masses, affordability, efficiency, availability, Country Attainment of goals, Level (DALE) Performance and Overall health system performance
What Country Has the Best Healthcare System in Europe?
Europe has 5 of the top 10 countries ranked by their healthcare systems. The best healthcare systems in Europe are offered by France, Italy, Malta, Spain, and Austria. Most other countries in Europe have excellent health care for their citizens. The biggest factors in driving their top rankings are affordability and access. The systems are typically heavily subsidized by the government and, as a result, are very affordable. At the same time, there are often long wait times and restrictions limiting choice in these countries – so none of these systems are perfect.
The healthcare system in Spain is ranked the first best in the world, just ahead of Italy (2nd), Iceland (3rd) and Japan (4th).
Further Ranking include: Estonia 69 77, Ethiopia 182 180, Federated States of Micronesia 104 123 and Fiji 106 96 and Republic of Macedonia 68 72.
Macedonia Healthcare: The Score & Rank by Category for Republic of Macedonia was based on, Prevent Health which had an Index Score 35.7 38.3, Change from 2019 -4.2 +9.5 and the Overall Rank is 68 72.
The research on health protection possibilities shows major differences among citizens in all 30 towns in Macedonia. As regards availability of health care facilities for citizens across Macedonia, it is not the same whether one lives in the capital Skopje, marked by the highest level of health protection, or in Demir Hisar, Berovo, Sveti Nikole, Resen and Vinica, where citizens enjoy the poorest health protection possibilities. Differences are so great that, for example, Skopje has 1 M.D. specialist per 339 citizens, but Krusevo has 1 M.D. specialist per 3,182 citizens.
Ethiopia Healthcare: Ethiopia’s health service is structured into a three-tier system: primary, secondary, and tertiary levels of care. The primary level of care includes primary hospitals, health centres, and health posts. You can read in detail in article on Healthcare in Ethiopia – Health and welfare, Progress in health among regions, Ministry of Health contributions and International Trade Administrations and U.N., USAID partnerships with the Government for Strengthening the Healthcare system in Ethiopia by Chidiebere Moses Ogbodo – Titled: Current Performance of Hospitals & Healthcare System in Ethiopia and What To Do Better In which
Which Country’s Healthcare System Need’s Urgent Attention and Investments?
According to the World Health Organization, the following country’s healthcare systems need to be revitalized, upgraded and investments are needed to achieve the best healthcare services to their citizens:
- The Democratic Republic of the Congo
- Central African Republic
According to a 2017 publication from the Commonwealth Fund, The USA is ranked last out of 11 Countries with adequate healthcare system.
“Among the 11 nations studied in this report – Australia, Canada, the Netherlands, Germany, Switzerland, France, New Zealand, Norway, Sweden, the United Kingdom, and the United States—the U.S. ranks last, as it did in 2010, 2007, 2006, and 2014”
“Most troubling, the U.S. Healthcare System fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last or near last on dimensions of access, efficiency, and equity.”
Issue: No two countries are alike when it comes to organizing and delivering health care for their people, creating an opportunity to learn about alternative approaches.
Goal: To compare the performance of health care systems of 11 high-income countries.
Methods: Analysis of 71 performance measures across five domains — access to care, care process, administrative efficiency, equity, and health care outcomes — drawn from Commonwealth Fund international surveys conducted in each country and administrative data from the Organisation for Economic Co-operation and Development and the World Health Organization.
Key Findings: The top-performing countries overall are Norway, the Netherlands, and Australia. The United States ranks last overall, despite spending far more of its gross domestic product on health care. The U.S. ranks last on access to care, administrative efficiency, equity, and health care outcomes, but second on measures of care process.
Conclusion: Four features distinguish top performing countries from the United States: 1) they provide for universal coverage and remove cost barriers; 2) they invest in primary care systems to ensure that high-value services are equitably available in all communities to all people; 3) they reduce administrative burdens that divert time, efforts, and spending from health improvement efforts; and 4) they invest in social services, especially for children and working-age adults.
About The Author:
Name: Juan Viedma Martinez (Dr.)
Profession: Doctor at Law and MBA in Economy
My name is Juan Viedma Martínez, Doctor at law and MBA in economy. I am Spanish citizen, birthplace Madrid. I’m 67 years old. Divorced with three independents children. I was working in many areas of law, especially in international issues and in macroeconomics affairs. Also, I love to support the Macedonia question and its legitimate claim for the rights of the country and its people.
I wrote some books in my professional career and I have a very special feeling about Africa. I have traveled to many countries in the five continents and on defence of human rights. My clients are confident to fully recommend Juan Viedma Martinez – it is rare to see someone who brings such enthusiasm and initiative to any project. I have contributed to boost team performances and benefit greatly from my dedicated work ethic, creative skills, and flexibility of thinking.
Skills: Professional Liability · Business Law · Mergers and Acquisitions · Contractual Agreements · International Law · Economic Criminal Law · Criminal Law · Litigation.