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What do other countries do about health care?

By Paqui Toscano, Academics/Administration Editor

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As the debate about health care rages within the U.S., some people suggest that lawmakers look to the health care plans of other countries in order to create a new outline for our own.

But what do some of the health care packages in other countries offer? And how different are they from the current health care system in the U.S.? As U.S. citizens learn more about the universal health care systems in other countries, they can gain greater insight into how the health care proposals on Capitol Hill might affect them.   

France

In 2000, the World Health Organization concluded that France provided its citizens with the “best overall health care” in the world.

Much like other countries in Europe, France has a form of socialized, universal health care. Assurance Maladie, the French state health insurer, covers approximately 77 percent of health care costs. However, as a person gets increasingly sicker, Assurance Maladie covers more of the cost. For chronic illnesses, citizens eventually get reimbursed 100 percent.

Taxpayers are taxed proportionally to their income, but no one is turned away from getting health coverage even if they can’t pay. If people have the money to spend, they can also buy supplemental coverage from private insurers. Much like the U.S., there are public hospitals, non-profit independent hospitals and for-profit private hospitals.

When French citizens go to the doctor or dentist’s office, they pay the full fee. However, they then can claim back a portion of the fee. This portion is usually around 75 to 80 percent, but the number can vary. The balance serves as a co-payment, although in some instances even the co-payment can be recovered. Because of this system, patients have the freedom to go the practitioner of their choice.

Although this system has a high popularity rating among its recipients, Assurance Maladie has been in the red since 1989. At the end of this year alone, the shortfall is projected to reach $13.5 billion.

United Kingdom

Much like France, the United Kingdom has a universal health care system of its own, which is provided by the National Health Service. Coverage, which is funded by general taxation, extends to all permanent residents of the United Kingdom. While most people use the public health service, those who are willing to pay may also buy supplemental private insurance. However, today in the U.K., private health insurance is used by less than 8 percent of the population.

Although the NHS covers the majority of health services free at the point of use for the patient, eye tests, prescriptions and dental care may require further costs.

The United Kingdom, like France, spends a smaller percentage of its GDP on health care than the United States, spending 8.4 percent compared to the U.S., which spent 16 percent in 2007. While 85.3 percent of the population in the U.S. and 99.9 percent of the population in France has health insurance, 100 percent of the population in the United Kingdom are insured.

 Canada

Finally, no comprehensive review of foreign health care systems would be complete without an overview of the Canadian health care system. Much like France and England, Canada’s health care system is largely free of charge at the point of use and is paid for by income tax (along with a monthly premium in three provinces).

The Canadian government mandates a high quality of care by passing laws regulating the system; however, in general the government does not micromanage the health care system. It doesn’t actively involve itself in the patients’ daily care, and information exchanged between doctor and patient is kept confidential.

The Canada Health Act requires publicly funded insurance plans to cover the cost of all medically necessary care delivered by a physician or in a hospital. Various provinces and territories have drawn the line regarding the amount of money that the government will cover for prescription drugs, home care, dental care, physical therapy, and even ambulance services. Each province and territory may also choose to opt out of the Canadian health care system, but none do currently.

Basic health care is offered to patients by a private doctor, and the doctor fees are then paid by the government. In this system, most family doctors gets paid a fee by the government per visit. The rate at which the government will pay the doctor is negotiated between the local governments and the medical associations of that particular territory or province. These rates are generally negotiated yearly. Physicians are not allowed to charge a patient for more money than the negotiated fee, unless they decide to not be a part of the federally funded system entirely.

Most people agree that the biggest problem with the Canadian system is the wait times. The average wait for a Canadian to see a specialist is four weeks. An MRI or CAT scan takes two weeks, while the wait time for surgery is three weeks. Some Canadian citizens contend they have been forced to come to the U.S. to get necessary health care. However, the Canadian government contends that if a person has a life-threatening medical condition, the case is dealt with immediately.

No health care system is perfect, and regardless of how hard the men and women on Capitol Hill try, the system they write into law will still have flaws. Of course, it doesn’t hurt to take a look at the health care systems of other countries to see what we can do to our own to make it the most beneficial system possible.

3 Comments

3 Responses to “What do other countries do about health care?”

  1. cynthia axiotes toscano on October 27th, 2009 9:53 pm

    Great article! Helps to have all the information. Thanks for the hard work!

    [Reply]

  2. Barb Carpenter on November 2nd, 2009 7:53 pm

    Love this story! Way to keep us informed on what else is going on in health care.

    [Reply]

  3. Rebecca Gentry on November 11th, 2009 12:14 pm

    Great article! As someone who has lived and worked in a foreign country (and has used their health care system), I know that it’s very important to get the facts about and experience different methods other than our own for health care. I did have to pay a lot in taxes when I lived abroad, but it was very reassuring to know that if I did get sick or injured, I would be able to choose which doctor I wanted to go to and I wouldn’t have to go into debt to pay for good health care!

    [Reply]

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What do other countries do about health care?