Okay, this can be confusing. Bear with me whilst I explain a few different systems…

The UK System

Beloved. Ours. Free… at the point of use. Technically, the NHS is not a free service. We pay via taxes and national insurance (and also pay for dental care, hearing care, eye care and prescriptions which contributes about 2% of the budget). However, the NHS is ‘free at the point of use’. This means you get treatment at the time of need without having to pay. Mostly.

Pretty good. No one misses out.. sort of.

The French System

A solidarity based system. Everyone pays, based on income, via payroll contributions, government subsidies and taxes, such as on tobacco and alcohol (makes sense).

Visiting a Doctor costs money. Lets say you need to see a GP (médecin généraliste). It would cost you approximately £25 up front. You swipe your state health insurance card and get 70% (£17.50) reimbursed back into your bank account in a few days. The rest, £7.50, is either paid out of pocket or more often covered by a mutuelle (top-up insurance).

Those less fortunate are covered by the state and so are long-term and expensive conditions like diabetes, cardiovascular disease and cancer.

Overall, not bad.

The German System

A universal multi-payer system with compulsory health insurance. This is either government-run (90%) or private (10%) for the wealthy and self-employed.

Funded through wage-based contributions and a government subsidy for those who cannot afford / elderly / students.

Patients have a choice where they go, what Doctor they see and there’s no need for a referral to see a specialist (although it is encouraged).

The cost? Free at the point of use (due to insurance). Some stuff costs like prescriptions and hospital stays (max 10er a night or about 2 pints in my money).

Pretty good. After all, the Germans are very efficient.

The Taiwan System

Regarded as the best in the world. It’s a single-payer, universal health insurance system called the National Health Insurance (NHI). It’s funded by payroll-based premiums (the more you earn the more you pay), supplementary taxes and small co-payments to discourage overuse.

Like the Germans, patients can choose their provider. Luckily for the Taiwanese, their health system includes dental care, prescription costs and traditional Chinese medicine. Although interestingly they do have to pay to see a GP, about a 10er.

And similar to the French, they have a card with their medical and insurance information on it to make everything smoother. We could learn a thing or two.

The American System

Just across the pond things are pretty bleak. There is no universal coverage and individuals must actively seek insurance. Most, about 2/3rds, have insurance via their employment. About 8% have no insurance. These are the people who end up out of pocket completely.. or dead.

Patients face high premiums, with excess and co-payments. The cost to see a GP; insured individuals will pay about $30 (co-payment), uninsured individuals may pay up to $250 just for the visit. Lab tests and further investigation will cost much more.

Not ideal for a first-world country.

In conclusion

That was a whistlestop tour of some healthcare systems across the world. Before diving into the costs of certain procedures, conditions and medications I thought it would be important to explore how and where the UK system may go should the NHS fall.