When it comes to healthcare, the United Kingdom is usually in the top league, especially when compared to most Asian and some of the other European countries. This is mainly because the National Health System (NHS), UK’s public healthcare system, has evolved rapidly over a period of time to become one of the largest and most developed across the globe.Public healthcare across the UK is free and based on need. The system is primarily funded by the general taxation collections. However, it only covers treatments of basic medical conditions, and the more complex ones may require the patient to make further payments or opt for a private health insurance policy. While basic services are free of charge, you will be required to pay for eye and ear treatments as well as prescription medicines. Fortunately, while prescriptions aren’t covered by the NHS, there is a cap on the amount you can be billed for such medication. For detailed information about the NHS and how it works, take a look at this PDF.
Foreigners are not exempt from medical charges when they visit the UK. However, exemptions are made for students as well as expats. In fact, you can receive free medical treatment at public facilities as long as you have worked for a company headquartered in the UK for more than six months. Keep in mind that your entitlement to free NHS treatment is based on the length and purpose of your residence in the country and not on your nationality. Click here to find out more about the services covered by the system and the eligibility to make use of them.
In 2014, the UK was ranked number 1 among other developed countries, in terms of quality of care, access to healthcare, equity and efficiency. The following year, it ranked 14 out of 35 nations in the annual Euro Health Consumer Index. The reasons for the poor rating included poor accessibility and an autocratic management culture.
Even though the standard of healthcare in the UK is generally fairly high, the medical facilities and professionals in the public sector face their share of problems. In the last five years, there have been several reports about NHS hospitals being severely understaffed and caregivers being overworked.
So if you are planning to move to this country mainly because of its high healthcare standards, you may want to think things over. There are several other nations that have been rated better than the UK in terms of their medical facilities, caregivers and payment options.
French healthcare, which includes a wide network of public and private entities, has ranked among the top systems for years, as per the World Health Organization’s data. This hardly comes as a surprise, since the country’s expenditure on healthcare is the highest in Europe.
The system in this country is partially funded by the obligatory health contributions, levied on salaried employees (paid by the employers) and those who are self-employed. The other part is funded by the central government. Users also have to pay a percentage of the medical expenses for most types of treatments that they receive.
Primary healthcare in the country is supported by a network of around 23,000 General Practitioners, which gives France a ratio of 1 GP for every 2,600 inhabitants. A majority of these doctors are self-employed and work on their own or practice in groups. The citizens can consult any GP they want but only their personal, registered doctor can refer them to a specialist under the healthcare system.
The combination of state and private healthcare ensures that nearly everyone who lives in France is covered, regardless of their age, income or social status. By law, every French resident has to be insured. To be eligible for healthcare cover under France’s Social Security system (Couverture Maladie Universelle, CMU), a resident should:
– Be living in the country on an ongoing basis (or spend more than 183 days per year in France)
– Hold a valid residency visa or permit
– Pay the contributions towards social security
Those who are not eligible under the CMU have to sign up for private coverage from a local or expat insurance provider, though this does come at a fairly high cost. Self employed people should refer to the Regime Social des Independents (RSI) to learn about registrations, contributions and reimbursements.
Every French resident over the age of 16 should have a health insurance card or a Carte Vitale, which is issued after the registration process with social service is completed. This card should be carried to all health appointments, as it allows you to get reimbursed directly from the insurance fund within a week.
While almost all types of medical bills are covered by the government, a majority of the locals have at least some kind of private insurance. Moreover, reports show that France has the lowest number of deaths that may have been avoided with basic medical insurance.
Each year, Italy makes it into the top 10 countries list issued by the World Health Organization, in terms of the quality of its health services. In general, Italians are known to be healthy people with a high life expectancy, in spite of the fact that the country’s expenditure is lower than the US and some of the other European countries.
Like in most other developed nations, the Italian healthcare system consists of public and private sectors, and the quality of service between the two varies to a great extent. The country’s public or state-owned health insurance is run by the National Health Service, locally known as Servizio Sanitario Nazionale (SSN). This system is managed by the governments on a provincial level, which means that there are bound to be differences in services even between the regions. It is funded by direct taxation (IRAP & IRPEF) and indirect taxation (VAT & excise on petrol).
The SSN provides the residents with free or low-cost medical services, including access to GPs, treatment at public facilities, ambulance services, lab tests, subsidized medication and specialist care (in some cases only). Patients who have made contributions to the Italian social security are required to make copayments; however, most of the medical bills are paid for by the government.
Italy has reciprocal healthcare agreements with the other EU countries and their nationals can therefore take advantage of this setup to access public healthcare. However non-EU expats are required to register formally with the SSN. To be eligible, you should have a residency status, along with the Italian Identity Card (Carta d’Identita). The documents required include your official identity, residency permit proof and proof of employment.
The entire procedure is handled by the Local Health Authority Service or the Azienda Sanitaria Locale (ASL) on a regional level. On receipt of a social security number and a health card (Tessera Sanitaria), you are entitled to low-cost or free treatment. The card has to be renewed on a yearly basis and must be presented when you want to use any medical service under the SSN.
A majority of the Italians rely completely on the public healthcare sector for all their medical needs; most of them don’t sign up for private health coverage. However, this is not the case with the expats living in the country. Unfortunately, a private health insurance cover comes at a high cost. Nevertheless, while Italy’s healthcare system is fairly good in several ways, there is no denying the fact that the public facilities are just about adequate for emergencies. Many of the state-owned hospitals are overcrowded and underfunded too.
Situated in the Pyrenees Mountains between France and Spain, Andorra is a very popular tourist destination because of its ski resorts and duty free shopping. This tiny nation also ranks very highly in most healthcare surveys and evaluations, including the one that is conducted by World Health Organization. This could be due to the fact that Andorra is a rich country with a small population and a high GDP. Moreover, its healthcare setup has been closely modeled after the French system.
A number of government entities run and coordinate the entire public healthcare system in the country, which is funded by social contributions. Statistics show that only around 8% of the local residents are without health cover. Those who don’t earn a salary in Andorra can utilize only the marginalized state welfare system for medical treatments. Even those employees who earn minimum wage have to pay their contributions; however, they aren’t entitled to some of the social security benefits.
To join the Social Security office or Caixa Andorrana de Seguretat Social (CASS), you should be employed by a local or private company and around 6% to 9% of your salary goes towards the contribution. Your employer also pays 13% per employee. Those who aren’t employed can also become a part of the state insurance system by paying around € 200 to € 400 per month.
CASS will reimburse 75% of your outpatient medical expenses and up to 90% of your hospital bills. The doctor that treats you will give you a stamped voucher, which has to be submitted (along with various bills) to the local CASS office to claim a reimbursement.
Andorra is home to some of the most advanced hospitals in terms of technology, across Europe and 10 of them are state-funded centers.
According to an evaluation conducted by the World Health Organization, Malta ranked 5th across the globe for its high standards of medical care. Its comprehensive public healthcare sector is funded by taxes and is free to all local and EU citizens. At the same time, people can choose to sign up for private healthcare too, if they wish to do so. In fact, the Maltese are entitled to free public healthcare services at the point of delivery but most of the foreigners residing in the country are required to sign up for private health insurance. Exceptions are made for British and Australian passport holders, as there is a reciprocal agreement between these nations.
The healthcare system in Malta is funded by the general taxes. Citizens are not obligated to sign up for health insurance but all employees and employers pay some amount towards the National Insurance contribution on a weekly basis.
In the last few years, medical tourism has increased significantly in Singapore mainly because the country’s healthcare system is of very high standards.
The Ministry Of Health, along with its statutory board, regulates the public and private healthcare sector. This island has a universal system, in which the government ensures affordability of basic services within the public sector by means of price controls, compulsory savings and payroll deductions, in order to provide subsidies in Medisave, the national health insurance plan. Under this plan, each individual accumulates funds, which can be tracked individually or pooled to include the family. A majority of the citizens save a substantial amount under this scheme. Those who don’t have adequate funds to meet their medical needs can opt for Medishield, a low-cost insurance scheme. Expats are required to purchase private health insurance.
No medical service is offered for free even within the public sector and the objective of this is to prevent over-utilization of the state’s healthcare services. Patients are required to pay out of pocket expenses, which may vary, for each service and level of subsidy.