Medicine is practiced within the medical system, which is a legal, credentialing
and financing framework, established by a particular culture or government.
The characteristics of a health care system have significant effect on the way medical
care is delivered.
Most industrialized countries and many developing countries deliver health care though
a system of universal health care which guarantees health care for all through a system
of compulsory private or co-operative health insurance funds or via government backed
social insurance. This insurance, (in effect, a form of taxation) ensures the entire
population has access to medical care on the basis of need rather than ability to pay.
The delivery systems may be provided by private medical practices or by state owned
hospitals and clinics, or by charities.
Most tribal societies but also some communist countries (e.g. China) and at least one
industrialized capitalist country (the United States) provide no guarantee of health care
for the population as a whole. In such societies, health care 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.
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 US health care system has come under
fire for lack of openness, 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.