Countries with free healthcare: How does it work?
Countries with free healthcare is a broad topic, as healthcare varies significantly from country to country. For instance, some of these countries have a ‘free’ system, some have private insurance systems, and others have a mix of the two.
When you think of free healthcare, it will likely conjure an image of the NHS, which is often the closest system to what we consider free healthcare.
There are many descriptions of healthcare systems that can make it confusing to understand, universal healthcare is the most generally used term, however, this does not actually mean the same as free healthcare.
In other words, a universal healthcare means a system is in place to cover the majority of citizens, but not all elements are free or free to everyone.
Types of healthcare
As countries are so diverse and different from one another, there is no one suitable healthcare system. To understand why healthcare differs so much, we need to take a look at the variations of healthcare across the globe.
The following map gives us an overview of universal healthcare nations across the world. It is important to note that not each of these countries is the same, and not all universal healthcare is ‘free’.
Countries with universal healthcare 2021
Countries with free healthcare
The map below shows 35 examples of countries with varying types of healthcare, each different type has different systems, conditions, and funding in place. Population is one of the largest factors in healthcare systems. As it is more difficult for larger countries to provide state-run medical care than it is for a small island, for example.
The conditions which influence healthcare provision include access to qualified staff, educational resources, the financial state of the country, political stability and climate conditions.
Finally, funding has a huge impact on healthcare. The economic wealth of a country and the leader of the country can determine how much, if any, money is spent on healthcare. For example, proposed NHS funding for 2020/21 was £199.2bn for a population of around 68 million.
The United States estimated a 2020 healthcare spend of US $4 trillion, which is around £2.8 trillion for a population of 328 million, just under 5 times the population of the UK.
Even wealthy countries can have limited access to healthcare. A combination of all these factors influence the healthcare system of a country, with the way budgets are spent being a primary factor.
Universal healthcare
Universal healthcare means different things to different countries, take a look to see the different variations of healthcare that currently exist.
Govt-funded or Single-payer
The term single-payer can be confusing; however, it quite simply means one ‘person’ is paying for the healthcare. In this case, the ‘single-payer’ is the government.
The government are responsible and involved in the nation’s healthcare. In these cases, the healthcare system is typically funded entirely by taxes.
This type of healthcare also means that everyone receives coverage despite their personal financial or employment circumstances. An easy example of this would be the United Kingdom.
Universal public insurance system
Like other countries, places with this type of system are typically required to have insurance. However, it can differ slightly.
For example, in Belgium, citizens must register for social security and make health insurance payments to have access to subsidized healthcare. But this is often cheaper than traditionally private insurance companies such as in the US.
In some of these countries, the unemployed, pensioners, students and disabled citizens are entitled to the same subsidies as those who make health insurance payments.
These public health insurance payments are like paying healthcare tax contributions. However, in the UK for example, it is not required to sign up for health insurance. The contribution is made automatically from your pay slip when you begin employment.
Universal public-private insurance system
In these systems, the primary form of healthcare is via private insurance, such as for people over a certain income threshold and those in employment. Those who are unemployed or cannot work due to disability, receive healthcare from their government.
However, using Mexico as an example, there is an option to make contributions through their salary for healthcare if private insurance is not affordable and they do not quality for free healthcare.
In conclusion, this system is true mixture of both public and private, and the healthcare you receive is largely influenced by your income.
Universal private health insurance system
While this system sounds like straight forward private healthcare, it does differ slightly. As an example, Switzerland requires all citizens to take out health insurance.
However, they also require insurers to offer basic coverage to everyone, regardless of age or medical history.
Private insurers are strictly regulated to ensure they do not exploit or profit from the mandatory health insurance policies.
Non-universal insurance system
The most common example of this system is the United States. In this type of system, there is aid available for healthcare costs, private insurance, and non-insured citizens.
Not having insurance is common in systems such as this for its high monthly cost and excess fees, and in most states, not having insurance is not illegal. As a result, many people in these systems struggle to receive the care they need.
The primary source of healthcare in these systems are private, the coverage of these insurances will depend largely on the individual’s income or employment status. There is little consistency within this system.
Types of healthcare in different countries
Now we know what different types of healthcare exist, lets take a look at some countries as examples of these systems.
GOVT FUNDED SINGLE-PAYER ‘FREE’
Country Population
Brazil 213.8m
United Kingdom 68.2m
Italy 60.4m
South Africa* 59.9m
Spain 46.8m
Canada 38.0m
Australia 25.8m
Cuba 11.3m
Greece 10.4m
Sweden 10.2m
Denmark 5.8m
Norway 5.5m
New Zealand 4.9m
Population to the nearest 100,000. Correct as of 04/05/2021
UNIVERSAL PUBLIC INSURANCE SYSTEM
Country Population
Japan 126.2m
France 65.4m
Ukraine 43.5m
Romania 18.1m
Belgium 11.6m
Serbia 8.0m
Hong Kong 7.5m
Dubai 2.9m
Monaco 0.3m
Population to the nearest 100,000/1000. Correct as of 04/05/2021
UNIVERSAL PUBLIC-PRIVATE INSURANCE SYSTEM
Country Population
Mexico 130.0m
Turkey 85.0m
Argentina 45.5m
Chile 19.2m
Netherlands 17.2m
Israel 8.8m
Switzerland 8.7m
Population to the nearest 100,000. Correct as of 04/05/2021
NON-UNIVERSAL HEALTH INSURANCE SYSTEM
Country Population
United States 332.6 m
Nigeria 219.3m
Bangladesh 166.0m
Kenya 54.7m
Uganda 46.9m
Yemen 30.4m
Population to the nearest 100,000. Correct as of 04/05/2021
Free healthcare
Let’s talk about what free healthcare means relative to all the other possibilities for healthcare. Many argue that nothing is free, and healthcare is no exception. Government funded-single payer systems are not entirely ‘free’.
Again, taking the UK as an example, citizens pay a relatively small contribution through employment known as NI (national insurance). This is relative to your earnings.
The less you earn the less you pay. Therefore, if you don’t work or are under working age, then you do not pay NI, but will still receive all the healthcare you need.
So where did the ‘free’ label come from?
The NHS is free at the point of service, which simply just means that when you visit the GP, hospital, A&E, minor injuries unit or anything similar then you do not pay anything for that trip.
You do not pay for surgeries, x-rays and scans, or anything of that nature that is necessary for your health. This means you never need to worry about the cost of taking an ambulance or having tests done.
In the UK however, those who do earn over a certain threshold contribute to their prescriptions in order to help fund the NHS. The current charge for this is £9.35 per prescription.
There are no payments for low-income citizens or children, and there are programs in place to help those who need many prescriptions in one year.
What can we learn?
Healthcare is not a one size fits all, and all systems have their strengths and flaws. In free healthcare countries, there can be long waiting times for services, however, there is always the option to pay for private healthcare if that is your choice.
Free healthcare systems usually mean that your income should not determine your access to healthcare.
As a UK based company, we show our greatest appreciation for our healthcare system and recognize the value of the NHS.
For more healthcare related information, check out our blog post about UK hospitals here.
Read more
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Sources
- https://www.worldometers.info/world-population/
- https://en.wikipedia.org/wiki/Health_care_systems_by_country
- https://www.internationalinsurance.com/health/countries-free-healthcare
- https://worldpopulationreview.com/country-rankings/countries-with-universal-healthcare
- https://www.forbes.com/sites/theapothecary/2015/01/27/conservative-think-tank-10-countries-with-universal-health-care-are-economically-freer-than-the-u-s/
- https://www.who.int/health_financing/taxed_based_financing_dp_04_4.pdf
- https://fullfact.org/health/how-nhs-funded/
- https://www.pfizer.com/news/featured_stories/featured_stories_detail/universal_healthcare_vs_single_payer_healthcare
- https://www.expatica.com/be/healthcare/healthcare-basics/the-belgian-healthcare-system-100097/
- https://www.expatica.com/fr/healthcare/healthcare-basics/a-guide-to-the-french-healthcare-system-101166/#Costs
- https://www.swisslife.com/en/home/media/media-releases/news-archiv/the_swiss_healthcare.html
- https://www.ehealthinsurance.com/resources/individual-and-family/does-your-state-require-you-to-have-health-insurance
- https://www.theguardian.com/society/2021/mar/04/labour-30bn-dhsc-budget-cut-will-hit-emergency-nhs-england-funding
- https://www.advisory.com/en/daily-briefing/2020/04/03/health-spending#:~:text=Spending%20growth%20details%20for%202020,up%20from%2017.7%25%20in%202018
