Healthcare Systems In The U.S. And Other Countries Explained

Healthcare Triage has created a number of videos explaining the healthcare systems in the U.S. and other prominent countries. Below is a selection of those videos to give you a better sense of how these countries provide healthcare to their citizens.

Healthcare in the United States:

Mixture of both private and public components listed below:

1) PRIVATE: About 60% of citizens get health insurance from their employer. 

2) MEDICARE: 15% of Americans are covered by Medicare (and most of them are elderly people.) "Medicare is a national social insurance program run and administered by the federal government." It is the closest thing to a single payer system in the U.S. The video then explains the differences among the different types of Medicare (A, B, Medigap, etc.).

3) MEDICAID: Medicaid is a state run program that is supposed to provide care for those at the low end of the social economic spectrum. There are minimum federal guidelines that are set for Medicaid and then each state gets to implement it as it sees fit." The video then explains the Medicaid expansion. 

4) THE VA: Veterans Health Administration (socialized medicine) and Tricare (private).

The video ends with the observation that, "Interestingly, while about two thirds of people get their insurance from private companies, only about one third of spending comes from the private sector. In other words, the Government has to cover about one third of people in the United States but has to pay about two thirds of the bill."

Healthcare in Canada:

Canada has a single-payer system called Medicare. 

Most Canadians receive their healthcare through public funding (with spending decisions made at the province level.) Healthcare is free with no out of pocket costs, "medically necessary care is covered including maternity care and infertility treatments."

The government pays for about 70% of healthcare spending. The other 30% is for private spending, mostly for drugs, dentists and optometry not covered by the government program. many Canadians buy supplemental insurance through their jobs to cover those areas.  

Canada has a "Single Payer" system (because the government is the sole payer) but it is not a "Socialized Medicine" system because most family physicians are private. It is "public spending but a private delivery system." 

The video then debunks some "myths" around Canada's health insurance system including wait times that exist but are generally for elective procedures, doctors flocking to the U.S. which is debunked by immigration data from Canada, Canadians come to the U.S. for care that is debunked by a number of peer reviewed journals on hospital visits and a Canadian survey of its population.  

Healthcare in France:

France has a national healthcare system called "Social Security" enacted as a result of World War II.

Insurance is obtained from 5 non-profit funds: General (covers almost 85% of the population), Independent, Agricultural, Student, and Public Service.  For those not covered by those 5 sources the government has its own plan (e.g. for lower income people)

The healthcare plan is financed by a payroll tax (40%), income taxes (30%), the rest comes from a variety of other sources including tobacco and alcohol taxes and transfers from other branches of social security.

The coverage is extensive and covers 70% and 80% of costs. There is also voluntary health insurance that more than 90% of the French have through their work, this covers what social security doesn't.

Most primary care physicians and specialists are private or self employed which is what makes France's healthcare system a single payer system but not socialized medicine. 

The video also goes into some of the details of the system including that copays are regulated by sickness, which means that "people who use the most care, in general, pay the least" and the expense of the system which is more than most other single payer systems but not over the United States. 

The video concludes, both because of satisfaction and quality, that "there is a good case to be made that the French have the best healthcare system in the world."

Healthcare in England:

The National Health Service of England is a socialized medicine system that is a "government run system."

The system covers everyone who is an "ordinary resident" and is broad including preventative services, in- and outpatient care, physicians drugs, and more. It is "pretty much free to citizens once they have paid taxes." 

3/4 of the healthcare spending in England comes from general taxes and most of the rest from a payroll tax. 

Individuals are required to register with GPs who provide most of the care. Unlike other countries, GPs and specialists are considered to be working for the government. Hospitals are generally run by NHS trusts.

England spent 9.4% of GDP on healthcare (Compared to the U.S.'s 17.7%). The video also goes into more statistics around healthcare including physicians per 1000 people, life expectancy, and others.

However, the NHS makes certain decisions that keep costs low including: making some drugs unavailable, technology is not as prevalent, waiting times can be longer, and quality is not where they would like it to be, and others. 

Healthcare in Australia: 

Australia has a universal healthcare system called Medicare that provides care for citizens, permanent residents and many with temporary visas and others.

There is a complimentary private healthcare system that compliments and supplements the public healthcare system. This system gives private healthcare owners access to some private hospitals and care not available under the public option. There are incentives to encourage Australians to partake in the private insurance system early. 

There are a number of different rules associated with the medical system including paying co-pays on prescription drugs, and out of pocket maximums. 

According to this video, Australia's Medicare one of the cheaper healthcare systems at 8.9% of GDP and is paid for general taxes, patient fees, and a 1.5% levee on tax deductible income. 69% of healthcare spending in Australia is covered by the government, the rest comes from non-government sources: either out-of pocket spending or private spending. 

The video also goes into public and private hospitals, physicians public and private status and fee-for service and salary, and pay for performance systems, personally controlled health record, how Australia keeps spending down, and some of the problems and complaints about the public healthcare system.

Other countries' healthcare systems can be found at these links:

Healthcare in Singapore (universal healthcare system uses health savings account for healthcare and provides tiers of care) 

Healthcare in Switzerland (universal coverage offered by competing non-profit companies)

Healthcare in Germany (universal healthcare system is a compulsory private healthcare system)

Single Payer
United States