BISMARCK model- Can be salvager for health system of developing countries…!!!

There are four basic models of health system in the world which includes-

  1. Beveridge model
  2. Bismarck model
  3. National health insurance model
  4. Out of pocket model


Most of the developing countries [Around 150] falls under out of pocket model in which patients can sometimes scratch together enough money to pay a doctor bill, otherwise, most of the time they pay in potatoes or goat’s milk or child care or whatever else they may have to give. If they have nothing, they don’t get medical care. Thus poor becomes poorer and overall health keeps on deteriorating.

I believe a nation should have a proper and well organized health system to achieve optimum state of health. Today some of the European countries like Germany, France, Switzerland, Belgium, Netherland as Well as Japan have a very successful health system with affordable health expenditure per capita and this system in BISMARCK MODEL named after German chancellor Otto von Bismarck which comprises of following traits-

  1. Insurance system (called sickness funds) funded jointly by employers and employees through payroll deduction.
  2. Privatization– Private health care sector, private doctors, private hospitals and private health insurance plans.
  3. Equal health care facilities for all– Insurance plans must cover everyone. Tight regulation of insurance which is often (but not always) sold on a non-profit basis.
  4. Decentralization– Prices for most procedures fixed by the district and state with tight government cost‐control.

Why Bismarck healthcare model for developing countries?-

  • Decentralization i.e. Localization helps to break the monopoly of power at the national level by bringing decision making closer to people. Localization strengthens government accountability to citizens by involving citizens in monitoring government performance and demanding corrective actions. Localization as a means to make government responsive and accountable to people can help reduce corruption and improve service delivery.
  • As “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…” (Declaration of Human Rights (UDHR), article 25). Through insurance plans which cover everyone’s health in Bismarck model, equal health facilities can be achieved for poor’s as well as rich without any inequality.

Thus as BISMARCK which was one of the most powerful warships of world war 2, similarly Bismarck model of health care system will definitely be helpful to strengthen the health system of developing countries if implemented.




by | October 9, 2013 · 4:13 pm

2 responses to “BISMARCK model- Can be salvager for health system of developing countries…!!!

  1. Chandramouli Swami

    Wow ! Wonderfully said . It should be like that . Congrats .

  2. mita

    I also agree to what you have mentioned. well done good thinking

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