 What is a health system? Now if you go and take a look at the definition for a health system, you might not be very surprised at the answer that you read, because it's basically defined as an organization of people, institutions and resources to deliver health-related services to meet the needs of a target population. But what does that mean? What does that look like and how does it work? Obviously it works very different in different countries and I was doing some research for this and trying to find out ways that I could diagram this concept and it's almost impossible to find a simple diagram of this. So we're going to try it right now but I'm not sure if we're going to succeed. So we're going to start with kind of what is meant to be at the core of health care, which is prevention and care. So this is kind of the main function of that and what health care systems are often built to do is pay for this. So we're going to put payment over here and I'm going to include also the patient over here, the people, because patients are really important. And so the patient goes, gets the care and then somehow it's paid for. And how this works in a traditional sort of economic sense, like in the sort of liberal economic sense, is the patient goes to a hospital or a clinic, they get their care and then they pay for it. And most of the prevention, they do themselves. So it's kind of an agreement that would be done between a doctor. The prevention work would be the doctor saying, don't do this, patient doesn't do it. If they do, they pay for it. And that's just a very simple system. But in the modern era, health care has become obviously much more expensive and harder to manage. There's so many different kinds of diseases out there. There's so many things that need to be taken care of. And slowly over time, things have started popping up in order to sort of take care of this. One of the major sort of players is the government. And the government of different countries, the governments of different countries have taken different approaches to this. So if you look at the United States, they've never really taken a really strong leading role in prevention and care. They've tried to leave that to the private sector. Whereas countries like England, for example, and to name another Western example, has always taken sort of more of a heavy-handed role in prevention and care for patients and of diseases. Obviously, you have all these doctors and clinics and things like that. That's something that you've always had. So I'm just going to include those in there as well. So clinics and you can understand when I write clinics, also just understand hospitals as well. Doctors and nurses. So obviously very important people in that. In some societies, you also have healers who are now through lots of different programs being integrated into the health care systems as well, although that's a very touchy topic that we might talk about later. As a part of this whole prevention and care network, a lot of companies have come out and started selling services. So pharmaceutical, for example, pharmaceutical companies are a big one. So pharmaceutical companies. And you also, over time, have also gotten a lot of NGOs, non-governmental organizations. So something that those of these are organizations that aren't as affiliated with the government. A lot of them are sort of fundraising to solve some sort of problem, to pay for the solution to some kind of problem. So they've kind of come in and joined in this effort to do prevention campaigns or to provide care for people who are sick. You also have insurance companies, which came up at some point and who are a very strong in certain countries, a very strong component of the entire system. They are a very deciding factor in all of this. And they are sometimes related directly to the prevention and care, although that actually, I should maybe put that as a dotted line because that's not always the case. In some places they are, in some places they're not. And then they're always involved in payment because that's essentially what they were built to. Insurance companies were built to pay for these problems. And they are directly related obviously to the customer. So to the patient, their customer, the patient. And the patient pays the insurance company and the insurance pays for the care, although not completely and entirely. So you've got your payment, you've got your government over here, you've got your insurance company. Sometimes your government is paying for things. So sometimes the insurance company is not paying for it. Sometimes it's the government. Obviously the government has a direct link here. Sometimes the patient is paying the government and the government is in turn paying for their bills. Sometimes the patient is paying the insurance company and the insurance company is paying the bills. Or the equivalent because insurance companies, sometimes in certain societies there are certain sort of equivalent, like organic equivalents. You'll have spending clubs or saving clubs or insurance clubs where people will in sort of small groups and sort of cooperatives create their own sort of equivalent to an insurance company. You also have employers. So in some countries, in many countries actually, employers play a big role in the insurance paying for insurance. So obviously the employer has a connection to the patient because they work for them. And sometimes in some systems the employer is paying for a certain part of the care. Sometimes, and not as commonly, but sometimes the employer is actually providing the care. So large companies will sometimes have their own clinic and their own prevention programs and things like that. But this is not always necessarily, I should maybe make that also sort of a dotted line because that's not as common but it does happen. So these are all sort of members of a health care system. And they're all there basically to try to get this key goal here in the middle accomplished, which is prevention and care. And prevention is sort of really where we kind of come into the public health sort of sector. And where you can kind of take this prevention idea and when you kind of go out to the government you can kind of explode this government word out into tons and tons of services. So for example, you might not think about it this way, but trash collection or something like that is a prevention service that does relate back to health care or water purification or lots of things like lots of things that are maybe not necessarily something you would directly think of. You wouldn't think of health when you think of them, but these services are provided by the government and do sort of work towards public health goals that they've set and are all a part of this health care system. So this is kind of an overview of what a health care system can look like. It doesn't always look like this. In some countries, you're going to have all these things sort of integrated and in some places they're going to be little islands and they're not going to have very much to do with each other. Really what makes a health care system work is that is when all of these organizations can sort of align their goals and align their ideals and really decide on what their goals are in prevention and care and how to accomplish that. So we're going to talk more about this concept in pretty great detail in some future lessons. We're also going to especially concentrate on what health care systems are getting wrong.