Public health insurance is typically only available in countries which happen to possess a public health care system. Systems such as this do not exist in every country and public health care systems can also vary greatly from country to country. The National Health Service (NHS) in the United Kingdom is a prime example of a well-run, success proven health care system where the general population are subject to free GP visits, health treatments, hospital stays, consultancy etc. In countries without such a system, all of the above would require payment.
In 2010, the World Health Organization (WHO) put together rankings of the world’s various health systems. Interestingly, the United Kingdom’s NHS ranked 18th, whilst France’s health care system ranked first with Italy second and San Marino third. Notably, Canada ranked 30th and the United States of America ranked 37th.
The public health care system in France is commonly known as ‘universal health care’ which basically means that the majority of health care is funded mainly by the government and is available freely to all. As a sacrifice to finance such a health care system, France spends a little over 10% of their entire GDP on health care, however, due to their high number of doctors per capita it means that the system works well with patients always having a choice of doctors. In the UK, where there is a similar system, the strain is much higher, however, as the ratio of doctors to general population is not as high and as a result, issues such as long waits for appointments arise. For this reason, many people still opt for some form of private health care to compliment the government funded public system.
In the United States, there has been an ongoing debate for some time now, discussing ways in which they can improve the health care system with the view to perhaps publicise the very much privatised system in place currently. The proposal has been to set up a health insurance plan which is financed by the government. This is not exactly the same as a system like the United Kingdom’s NHS or France’s system where health care is generally publically funded, however, as instead, this government funded health insurance plan will act as a rival or alternative option to the private health insurance plans offered by existing private insurance companies. Unfortunately, however, the proposal for such a publically funded insurance plan option never really materialised and the health care system remains much the same.
There are a large number of countries in the world that have the luxury of a public health care system. In Europe, countries such as Norway, Belgium, the United Kingdom, Netherland and Finland have one. In Asia, South Korea, Hong Kong, Singapore and Japan are among the nations that have such a system, where as elsewhere, Canada, New Zealand and Kuwait also have such a system.
Generally, there are two types of public health insurance systems. Single payer systems and two-tier systems. The single payer system refers to a situation where a single establishment pays for the health care which is provided for the general population. Although not applicable to government run systems such as in the United Kingdom, they operate in the same way, with the government acting as the single establishment providing the funding to cover the cost of health care. These types of systems are implemented in the United Arab Emirates, Norway, Portugal, Italy etc. Two-tier systems, however, refer to a situation where the entire population receives health care at no cost, but there is an option to pay for a higher level of care. It should be noted that this does not necessarily mean the quality of treatment or medicine or even the doctor is more elite. Instead, it generally refers to a more comfortable experience, i.e. a nicer hospital, an en-suite hospital room, nice meals etc. Two-tier systems are implemented in countries such as France, Australia, Ireland and Israel. To find out about countries with private health care systems, please check out the relevant past posts in our blog for additional information.
To give you an idea of the extent that which public health insurance systems we can take a look at the NHS and examine exactly what is included under this system deemed ‘universal’. To begin with, the NHS provides the entire population with the ability to meet with General Practitioners. The emergency helpline provides you with rapid access to ambulances and the number of NHS health centres and hospitals is frequent throughout towns and cities across the country. The provision of sexual health care is available and this includes STI testing and treatment. There are many NHS STI clinics all over the country and they are all free to use. It should be noted, however, that dental care is not covered by the NHS and patients will be subject to various fees and bills after dental care visits.
All in all, it is easy to say that all countries should attempt to adopt some form of public health inusrance programs, however, in large countries it can be extremely difficult to regulate and it is very much a situation of being easier said than done. Especially for countries such as the United States, to operate a fully public health care system would where the entire population received health care totally free would cost an astounding amount. However, with propositions in the past such as the public health insurance option, there may be room for adjustment in the future.