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It deals mainly with the poor and rural populations, who cannot afford private healthcare.
In addition, there is a non-profit health sector operated by the National Social Security Fund which covers 16% of the population.
In others tax revenues are used either to fund insurance for the very poor or for those needing long term chronic care.
In some cases, government involvement also includes directly managing the health care system, but many countries use mixed public-private systems to deliver universal health care.
The UN has adopted a resolution on universal health care.
It may be the next stage after the Millennium Development Goals.
Tunisia operates a public healthcare system under the National Health Insurance Fund (Caisse Nationale d'Assurance Maladie).
The common denominator for all such programs is some form of government action aimed at extending access to health care as widely as possible and setting minimum standards.Usually some costs are borne by the patient at the time of consumption but the bulk of costs come from a combination of compulsory insurance and tax revenues.Some programs are paid for entirely out of tax revenues.There is also a private sector for those who can afford it.
Rwanda operates a system of universal health insurance through the Ministry of Health called Mutuelle de Santé (Mutual Health), a system of community-based insurance where people pay premiums based on their income level into local health insurance funds, with the wealthiest paying the highest premiums and required to cover a small percentage of their medical expenses, while those at the lowest income levels are exempt from paying premiums and can still utilize the services of their local health fund.
Such referral treatment is also carried out at the cost of the Royal Government.