Public hospital

A public hospital or government hospital is a hospital which is owned by a government and receives government funding. In some countries, this type of hospital provides medical care free of charge, the cost of which is covered by government reimbursement.

Australia

In Australia, public hospitals are operated and funded by each individual state's health department. The federal government also contributes funding. Services in public hospitals for all Australian citizens and permanent residents are fully subsidized by the federal government's Medicare Universal Healthcare program. Hospitals in Australia treat all Australian citizens and permanent residents regardless of their age, income, or social status.

Emergency Departments are almost exclusively found in public hospitals. Private hospitals rarely operate emergency departments, and patients treated at these private facilities are billed for care. Some costs, however (pathology, X-ray) may qualify for billing under Medicare.

Where patients hold private health insurance, after initial treatment by a public hospital's emergency department, the patient has the option of being transferred to a private hospital.

Brazil

The Brazilian health system is a mix composed by public hospitals, non-profit philanthropic hospitals, and private hospitals. The majority of low- and-medium income population uses services provided by a public hospitals run by either State or by the municipality. Since the inception of 1988 Federal Constitution, health care is a universal right for everyone living in Brazil: citizens, permanent residents, and foreigner. For that reason, Brazilian government created a national public health insurance system called SUS (Sistema Unico de Saude, Unified Health System) where all public funded hospitals (public and philanthropic entities)receive payments based on number of patients and procedures performed. Also, hospitals and health clinics are built by government in all three levels.

In general, all patients are supposed to have a global coverage including emergency care, preventive medicine, complex procedures, diagnostic procedures (blood exams, x-rays, CT-scan, etc.), surgeries (excluding cosmetic procedures), and medicines need to treat their condition. Because of the limitation in the budget, those services are often unavailable in most part of the country, in exception in large metropolis like São Paulo, Rio de Janeiro, and Belo Horizonte. Even in those metropolis, the access to some complex health care may take months if not completely ignored. However, patients that sued the government were able to get their treatment covered by the SUS, even with experimental therapeutics.

Recently, new legislation mandate that no private hospitals should refuse accept poor or uninsured patients in case of life threat emergencies. Cost of emergency care in this case is also paid by SUS.

Canada

In Canada all hospitals are funded through Medicare, Canada's publicly funded universal health insurance system.^[1] Hospitals in Canada treat all Canadian citizens and permanent residents regardless of their age, income, or social status.

Norway

In Norway, all public hospitals are funded from the national budget^[2] and run by four Regional Health Authorities (RHA) owned by the Ministry of Health and Care Services. In addition to the public hospitals, a few privately owned health clinics are operating. The four Regional Health Authorities are: Northern Norway Regional Health Authority, Central Norway Regional Health Authority, Western Norway Regional Health Authority, and South-eastern Norway Regional Health Authority.^[3][4] All citizens are eligible for treatment free of charge in the public hospital system. According to The Patients' Rights Act,^[5] all citizens have the right to Free Hospital Choices.^[6]

South Africa

South Africa has private and public hospitals. Public hospitals are funded by the Department of Health. The majority of the patients use public hospitals in which patients pay a nominal fee, roughly $3–5. The patients point of entry usually is through primary health care (Clinics) usually run by nurses. The next level of care would be district hospitals which have General Practitioners and basic radiographs. The next level of care would be Regional hospitals which have general practitioners, specialists and ICU's, and CT SCANS. The highest level of care is Tertiary which includes super specialists, MRI scans, and nuclear medicine scans.

Private patients either have healthcare insurance, known as medical aid, or have to pay the full amount privately if uninsured.

United Kingdom

In the UK public hospitals provide health care free at the point of use for the patient. Private health care is used by less than 8 percent of the population. The UK system is known as the National Health Service (NHS) and has been funded from general taxation since 1948.

United States

Ben Taub General Hospital in Houston, Texas

In the United States, two thirds of all urban hospitals are non-profit. The remaining third is split between for-profit and public. The urban public hospitals are often associated with medical schools.^[7] The largest public hospital system in America is the New York City Health and Hospitals Corporation, which is associated with the New York University School of Medicine.

In the U.S., public hospitals receive significant funding from local, state, and/or federal governments. In addition, they may charge Medicaid, Medicare, and private insurers for the care of patients. Public hospitals, especially in urban areas, have a high concentration of uncompensated care and graduate medical education as compared to all other American hospitals. Public hospitals in America are closing at a much faster rate than hospitals overall. The number of public hospitals in major suburbs declined 27% (134 to 98) from 1996 to 2002. It is thought that the increase in uninsured has drained public hospitals to near bankruptcy.^[8] Non-profit rural hospitals were disproportionately represented with high numbers of patients with uncompensated care. Public and non-profit rural hospitals form a large part of the health care safety net for the uninsured and poor underinsured in the U.S.^[9]

For-profit hospitals were more likely to provide profitable medical services and less likely to provide medical services that were relatively unprofitable. Government or public hospitals were more likely to offer relatively unprofitable medical services. Not-for-profit hospitals often fell in the middle between public and for-profit hospitals in the types of medical services they provided. For-profit hospitals were quicker to respond to changes in profitability of medical services than the other two types of hospitals.^[10]

In 2009, at non-profit hospitals, the average CEO made $600,000 annually. The range was from $100,000 to $3 million.^[11]

India

In India, public hospitals (called Government Hospitals) provide health care free at the point of use for any Indian citizen. These are usually individual state funded. However, hospitals funded by the central (federal) government also exist. State hospitals are run by the state (local) government and may be dispensaries, peripheral health centers, rural hospital, district hospitals or medical college hospitals (hospitals with affiliated medical college). In many states (like Tamil Nadu) the hospital bill is entirely funded by the state government with patient not having to pay anything for treatment. However, other hospitals will charge nominal amounts for admission to special rooms and for medical and surgical consumables. The fees in public hospitals for these rooms is up to 900 rupees.

See also

• The Waiting Room (documentary)
• Private hospital

References