We’re all aware of the amazing service that the UK’s National Health Service (NHS)provides to people every single day, helping patients overcome illness and injury regardless of wealth, status, gender, religion or any other criteria. In the UK, healthcare is available for all without costs. However, there are drawbacks to a nationalised healthcare system that caters to such a large populace, for example waiting times for minor healthcare treatments. But what are the alternatives?
Other countries around the world have a wide variety of different healthcare systems, some are privatised and some are nationalised similarly to the UK’s NHS.
United Kingdom healthcare system overview
The well-known NHS is a government sponsored healthcare body that is publicly funded. The NHS is actually a series of services that come under the umbrella term, NHS. This includes National Health Services (England), NHS Scotland, Health and Social Care in Northern Ireland and NHS Wales.
The NHS is built around the concept of providing patients with more power, information and better access to beds, treatment, doctors, nurses, appointments and prescribed medication (where needed). While everyone contributes to funding the NHS throughout the UK, all patients have the option to opt for private alternatives.
Comparison of healthcare systems by country:
In 2015, the Commonwealth Fund conducted a comparative survey of 10 of the world’s leading healthcare systems, and the UK’s NHS was deemed impressive on the grounds of its efficiency, effectiveness of care, safety of care, coordination of care, patient-centred care, and cost-related efficiencies. But how does the UK NHS compare to those other systems?
France: Insurance pays for medical fees
France has a similar service to the UK’s NHS, however patients must have mutuelle insurance policies (usually obtained through employment) and the insurance company pays the doctor or clinician.
Ireland: Subsidised medical payments
In Ireland patients are expected to pay for appointments (approx. €40-€60), although children under six or those with a medical care pass are exempt from fees.
Belgium: Mixture of state and non-profit facilities
Patients have a health card which they use to pay for treatments, appointments and prescriptions, the state then reimburses between 50% and 75% of the costs by their mutuelle/mutualiteit scheme, similar to France. Dentist services are almost all private with minimal state support, however, homoeopathy, acupuncture, osteopathy and chiropractic care are recognised equally as western medicine and are reimbursable from the state.
Sweden: Capped healthcare payments
Sweden’s patients pay a low fee for medical services, although there is some regional variation. Within a 12-month period, medical fees are capped once you hit 1,100 kronor (typical GP appointment costs 100-200 kronor (£8-£16) for adults), all further medical treatments are free from that point.
China: Low appointment fees, quite high treatment and prescription fees
China abolished its free public healthcare system in the 1970s. Now consultations and appointments are relatively inexpensive with a blue government “social insurance” card, where a hospital appointment can cost as little 2 yuan (20p). However, prescriptions and treatments are comparatively high and can be very financially damaging to a low-income family.
USA: Private healthcare reliant on insurance policies
The US healthcare system is leading the charge with innovation and discovery, however they can be inhibited by a risk-averse stance for fear of malpractice lawsuits. Insurance policies are the mainstay of medical usage there, however there is a huge discrepancy between policy payouts and the cost of treatments and many Americans can have to pay a lot for medical services.
Japan: Public health insurance
Many Japanese citizens will have public health insurance, typically this is covered by their employer but the self-employed or unemployed have to join the national health insurance scheme. Fees above a certain threshold, calculated individually based on age and income, are paid for by the government.
Spain: Nationalised healthcare system
Spain has a free universal healthcare system that is available to all, including legal or illegal residents, tourists, refugees and students. Whilst the system is nationalised, it is decentralised which can cause variations in treatments or quality of care on a regional basis. This causes a significant amount of internal health tourism. Most dentistry and optometry services are private.
Italy: Universal health coverage
Italy has a national health service that offers health coverage, treatments and services that are either free or extremely low-cost. Similar to Spain, there can be regional discrepancies in the quality of care in some state-funded hospitals, causing many southern citizens to invest in private insurance.
Germany: Public health insurance scheme
Anyone residing in Germany is required to take out a health insurance scheme, and the country has many non-profit “sickness funds” (Krankenkassen) available. Rates are typically 15% of salary, with employers paying at least half of that amount.
Benefits of working for NHS vs Private systems
In the UK there are many amazing opportunities in the NHS and in private healthcare facilities. But how do you choose between them? Here are some of the benefits of working for either so you can make an informed decision:
Pros of working for the NHS:
Job security
Flexible work patterns and shift options
Progression and experience opportunities
Great pension scheme
Variety of opportunities available
Pros of working in a private facility:
Competitive salaries
Tailored employee benefits schemes
Great opportunities to specialise
Great control over your future/career
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