In most Western countries, a large share of health insurance is supported by the state. This is also a fundamental component of social security, and a duty of the State under the Universal Declaration of Human Rights of 1948.
A public health insurance system can be managed by a state agency, delegated to private organizations, or be mixed.
Operation, like all insurance is based on risk-sharing: each person contributes, in exchange for which it is paid according to a fixed scale.
For a system of public health insurance, the insurance premium paid by the insured does not necessarily follow the rules of pure insurance, that is to say, it is not based solely on risk. Indeed, the public system fulfills both a function and a pure insurance distribution function in which the wealthier pay insurance for the poor.
History
Until the eighteenth century, the protections against the risks of life are provided by personal wealth, local solidarity (family, village) or professional ( guilds, guilds ), and charity. The nineteenth century, the Industrial Revolution concentrated populations in cities where local solidarity cannot play while the number of accident's increases. In addition, it develops intellectual and scientific movement that promotes individual pension (the origin of private insurance), the mutual insurance companies that provide the collective welfare and the notion of "sacred debt" introduced by the Revolution which Article 21 of the Declaration of the Rights of Man and of the Citizen of 1793 recognizes the right for every citizen to support and social protection, giving rise to social security.
These new concepts are applied in Prussia where Otto's von Bismarck, who want a strong state, develops the first system of compulsory social insurance with bills concerning insurance against accidents at work and social health insurance in 1883 adopted and 1884.