The provision of health as we know now has come a long way. There have been changes in the concept and definition of health as well as the practice of medicine. Health concept and health systems differs in different parts of the world and this is influence by the political ideology of the nation [1]. This informs the health policies and practices [2]. The growth and development of health care services, systems and who benefits form it has come from many contributions: individuals, military services, missionary hospitals and the major player in health care, the government [1]. These agencies along with professional associations, various ministries in the federal and state governments with international agencies will continue to shape health care and bring reforms in the future [1].

The cost of health care services has grown and the insurance companies now play a major role as well as being driven by market forces and international corporations [1]. The future of the types of care available, who can access this care and who bears the cost is gradually being determined by the insurance companies and other nongovernmental agencies such as pharmaceutical companies and makers of medical supplies. Countries with socialist ideology who see health as a right of the citizens make effort to make health care available to all and the government paying for it. Example of this is the United Kingdom with its National Health scheme and Brazil [3]. The tax payers pay the bill. Canada on the other hand has mixed system with private/public partnership but all citizens are covered and have insurance. The United States of America has a great proportion of citizens’ uninsured, some are insured through their employers and others are self-insured. Any changes needed in the health system will take into consideration the financial cost of the innovation. The purchase of new medical equipment is not just a medical and administrative decision but the financial burden determines what the next purchase will be. Treatment regimens which was the prerogatives of doctors and health team is now determined by what the insurance companies are ready to pay for, or approve as a needed protocol.

The final cost is on the patient who cannot get what is the optimum care in the best system from the best care givers. Health reform will come from the active role of government, her policies, international bodies and associations of professional as well as other agencies in the health industry who will see a need for reform and guarantee that needed reforms are carried out without the interference and dictates of health insurance companies even when these are state owned [4].


1.            Reich, M.R., Reshaping the state from above, from within, from below: implications for public health. Social Science & Medicine, 2002. 54(11): p. 1669-1675.

2.            Lakin, J.M., The end of insurance? Mexico’s Seguro Popular, 2001–2007. Journal of Health Politics, Policy and Law, 2010. 35(3): p. 313-352.

3.            Arnquist, S., A. Ellner, and R. Weintraub, HIV/AIDS in Brazil: Delivering Prevention in a Decentralized Health System. Cases in Global Health Delivery, 2011. 018: p. 1-31.

4.            Glassman, A., et al., Political analysis of health reform in the Dominican Republic. Health Policy and Planning, 1999. 14(2): p. 115-126.



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