I was going to post this on Graham’s thread but I decided it’d derail it a bit.

jambalaya – Member
Other health provision systems are available however and would have been at least equally as good.

On reflection, I realise that I am fairly unfamiliar with the natures of other countries’ health care provision systems. Horror stories about the cost of health care in the US notwithstanding.

Which countries’ systems would provide similar levels of care, for example for my teenage self’s Hodgkin’s Lymphoma and for GrahamS’s daughter’s recent injuries? Of those which would not result in a substantial bill or a large insurance hike landing on the doorstep of the patient or their family?

I do this for a living. It’s a complex question but as a very high level guide most other countries offer a mix of social and private care. Much more so than the UK. Compulsory salary sacrifice usually covers most social arrangements. Private cover will get you access to private facilities.

If money was no object I’d want to be treated in Switzerland.

If money was an issue then the French and German systems are very good and the standard of care is excellent. Scandi countries are also very good. Austria is surprisingly strong.

It does depend on the condition but the “nearest centres of medical excellence” in Europe would normally be Geneva, Vienna or London.

Can’t really relate to serous injuries but I have spent some time in Hong Kong hospitals due to mountainbiking, recent case was after breaking my collarbone in June.
Government hospital, maybe waited about 20 minutes after triage before I was prep’d for xrays, then within 2 hours of prodding etc I have a bed for the night in a shared ward (this was a government hospital).
Apart from my wife having to bring a phone charger, only Cantonese TV being available and me being the centre of interest for the other 7 patients relatives during visitors hours it was a pleasant stay.
Left the next day with a crackin brace, some painkillers that could knock out an elephant and a reservation to see an occupational therapist for the princely sum of 100 HKD, about 9 GBP.
This is typical of my other visits, either just A&E or overnight, though the private healthcare matches that in the UK also (wife has great company healthcare available to spouses).

Here in Germany, I am on the compulsory government scheme. The percentage of gdp in Germany paid for healthcare is higher than in the UK. I could save money now by going private, and/or get better service, but then the costs are likely to rise as I got older. On the compulsory scheme I do not pay after retirement on private I would.

It is hard to say whether outcomes are better in Germany than in the UK, I would say the the general population is fitter and healthier than the UK to start with, and it seems that you are likely to be forwarded onto a specialist doctor earlier. But the insurance system adds a high administration overhead into the health system, far more than the mythical NHS administration. And those specialists are frequently not required and just ways to get insurance payments for the doctors/clinics.

Most of the world still sees the NHS as a hugely efficient system, and I doubt there are many if any countries that provide better results without higher costs. And for many a very important measure of healthcare must be inclusion, if you are wealthy enough in the US, you get excellent care, if you are poor enough you get the square root of **** all care.

OP specifically I can’t answer your question but ime European nationals from the richer countries prefer their domestic healthcare (could be a comfort factor too of course). Quite a lot of people think the NHS is rather poor.

I have lived in US and Singapore and also used healthcare in France. I have British friends who have been able to have medical “work” done in Switzerland at NHS expense which took a lot of effort but was well worth it as the service quality is so much higher. I have numerous European friends (French, German, Dutch, Belgian) who always get medical work done at home (inc gp type visits) as in their view the service is better. I did have an ex-boss super wealthy who sadly contracted cancer and was wonderfully cared for by NHS in London, critical care we do do very well.

We in the UK get what we pay for, imho the healthcare budget shouod be more like £180bn pa instead of £130bn but there is zero chance I would recommend just giving our existing NHS structure that much more money, it’s far too inefficient due to natonalised nature and inability of people to chose one provoder ober another (ie competition).

I really like the hybid French system, most people with an ok job have a private policy which they use to top up the state service, eg pick a better specialist doctor / hospital. You can see who you want and pay the diference and reclaim on insurance if you have it. If you don’t have private the state still takes care of you. What I like is if you go state or private the state pays it’s flat rate either way. Now its worth noting taxes are much higher 50%+ and national insurance is much higher too and 5% vat on food.

Singapore was basically a private system not dissimilar to the US. In either country if you have money the healthcare is fabulous. Both have low taxes (Singapore especially) but they are not places to be poor and sick. Not a healthcare model I like.

The bottom line is we have an ok not great service but its the service we pay for. I do not subsribe to the view that the NHS is efficient,mwe are getting a second rate sevice for a second rate budget as that’s all people are prepared to pay for. All 3 political parties are spinning a line when they say / claim they can deliver a world class service based on anything like the current budget

MSP – is the German government scheme paid for via a form of proportional tax? But you don’t have to pay that charge/tax if you have private medical cover? If someone has no income are they still covered by the government scheme?

I suppose my angle here is the thought that in some countries, the cancer I had as a teen would have resulted in either a huge bill to my parents, a debt that’d hang over much of my life (and difficulty getting insurance subsequently) or in the worst case no treatment because of its cost. Other than the US system however I’m not sure how much that actually happens or how widespread the principal of a universal/inclusive system actually is.

If money was an issue then the French and German systems are very good and the standard of care is excellent.

https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

We’re at $3235 with France at $4124 and Germany at $5002. So between 27% and 55% dearer…

it’s far too inefficient due to natonalised nature and inability of people to chose one provoder ober another (ie competition).

Being nationalised and a monopoly does not mean that it is inherently inefficient. Similarly competition is not always a good thing. The mantra of “competition good, monopoly bad” is as economically illiterate as the reverse. Both systems have their strengths and weaknesses.

@br Yup and you get what you oay for that’s my point. The staff are better paid too and thats good too.

Not included in that 27% for France (I think) is the private insurance top ups people use, that’s why I said it’s a hybrid system

@gone Yes I take your point, but look at inefficiencies above and the disaster that’s the nhs drug purchasing programme

Thanks, I’d rather keep that thread as apolitical as possible.

We’re at $3235 with France at $4124 and Germany at $5002. So between 27% and 55% dearer…

You can also compare healthcare spending as % of GDP – we spend far less than most of Western Europe.

(Good tool to explore this data at World Bank)

Graham I think it is apolotical as all parties are equally bad on health funding. Yes those charts are very depressing

We’re at $3235 with France at $4124 and Germany at $5002. So between 27% and 55% dearer..

But that’s quite misleading.

The cost of pensions in the French and German healthsystems is fully funded. The NHS pension liability is completely unfunded and has already passed £500B.

http://www.thetimes.co.uk/tto/business/industries/banking/article4562906.ece

If you add on apportioned existing NHS pension liabilities of around £32B a year to the annual budget the NHS the real cost is around £160B a year and quite possibly equal to, or more than the total healthcare spend per capita in France, Germany or the Netherlands.

I have British friends who have been able to have medical “work” done in Switzerland at NHS expense which took a lot of effort but was well worth it as the service quality is so much higher.

Conversely one of my mates has MS and he moved from Switzerland back to the UK specifically because the treatment was better here. There are more drugs available here and he gets them on the NHS without bankrupting himself.

Similarly competition is not always a good thing.

Quite. My relatives in the US are having to do research and shop around for healthcare providers, which is a ballache you may not necessarily need. And the outcomes aren’t necessarily any better either judging by the stories.

But in general when you have competition, quality of service is only one selector. Cost is another – so you can get business by being better, or by being cheaper. Which doesn’t necessarily do much for standards.

I think that the US system does more work than is needed because they are afraid of being sued if they miss something. And by happy coincidence more procedures means more money for the hospital, which is a commercial business. My sister in law was considering having another kid because she’d just finished paying for the ‘advised’ tests she had on her (turned out to be) healthy kid, that the insurance co wouldn’t pay for. Kid’s five.

MSP – is the German government scheme paid for via a form of proportional tax? But you don’t have to pay that charge/tax if you have private medical cover? If someone has no income are they still covered by the government scheme?

Yes it is proportional, it isn’t tax it’s health insurance but is “tax like” shall we say. If you are on the compulsory government scheme and you lose your job/retire then you are still covered, I am not sure on what happens if you opt out and go private, then I think you are **** if/when you loose your job or retire.

Pretty much everyone I know who has opted out are not planning on staying in Germany after retirement. I think this could become a problem for countries like Spain in the future, how they handle health care for people retiring there.

iirc Alpin is on the opt out scheme, and has not spoken favourably of it.

molgrips there are also options in the NHS is you know where to look, the thing with the NHS is that having the right contacts can make a big difference.

The US does do more work than needed, but on the flip side the NHS typically does less tests than it should.

If you add on apportioned existing NHS pension liabilities of around £32B a year to the annual budget the NHS

Okay.. taking those figures as true and assuming they are liable for all of that (I honestly have no idea).

£32 billion is $42,601,612,050 USD (at current rates)

UK population is currently 65,184,391 (Source)

So I make that an additional 42,601,612,050 / 65,184,391 = ~$653.6 per capita per annum.

Is that right?

Add that to our original figure of £3235 gives us $3888.6

Still way behind the quoted figures for France at $4124 and Germany at $5002

The cost of pensions in the French and German healthsystems is fully funded.

Are you sure, as I thought that the French civil servants ‘funds’ were in deficit?

just5minutes – Member – Quote
We’re at $3235 with France at $4124 and Germany at $5002. So between 27% and 55% dearer..
But that’s quite misleading.

Yip. If you want a true indication of relative costs based what would cost you as a patient, in Germany the treatment cost would be on average 50% of what it costs in the UK, and in France it would be about 36%