Institutions
The Hospital
of Santa Maria della
Scala, fresco by Domenico di Bartolo,
1441–1442
Contemporary
medicine is in general conducted within health care systems. Legal, credentialing and
financing frameworks are established by individual governments, augmented on
occasion by international organizations, such as churches. The characteristics
of any given health care system have significant impact on the way medical care
is provided.
From ancient
times, Christian emphasis on practical charity gave rise to the development of
systematic nursing and hospitals and the Catholic
Church today remains the largest non-government provider of medical
services in the world.[15] Advanced
industrial countries (with the exception of the United
States)[16][17] and
many developing countries provide medical
services through a system of universal health care that aims to
guarantee care for all through a single-payer health care system, or
compulsory private or co-operative health
insurance. This is intended to ensure that the entire population has access
to medical care on the basis of need rather than ability to pay. Delivery may
be via private medical practices or by state-owned hospitals and clinics, or by
charities, most commonly by a combination of all three.
Most tribal societies
provide no guarantee of healthcare for the population as a whole. In such
societies, healthcare is available to those that can afford to pay for it or
have self-insured it (either directly or as part of an employment contract) or
who may be covered by care financed by the government or tribe directly.
Modern
drug ampoules
Transparency
of information is another factor defining a delivery system. Access to
information on conditions, treatments, quality, and pricing greatly affects the
choice by patients/consumers and, therefore, the incentives of medical
professionals. While the US healthcare system has come under fire for lack of
openness,[18] new
legislation may encourage greater openness. There is a perceived tension
between the need for transparency on the one hand and such issues as patient
confidentiality and the possible exploitation of information for commercial
gain on the other.
