Training Blog

Healthcare in Europe is run through a variety of systems which operate on a national level, in Germany it is a mix of public and private funded healthcare; although throughout Europe it is predominately funded by private health insurance Although their are government alternatives such as the EHIC which has replaced the E111.

Here is a list published by the World Health Organisation which shows the top European countries ranking both within Europe and also in terms of the whole world:

• 1st France
• 2nd Italy
• 3rd San Marino (its at the top of Italy)
• 4th Andorra (its between France and Spain)
• 5th Malta

In France people earning less than 6,600 euros per year do not have to contribute to the cost of their healthcare; but due to the fact that it is largely privatised there is a high quality service without the waiting times of the NHS. Apart from those mentioned above people pay a premium for their healthcare which is approximately 20% of their payroll (employers paid 12.8% and employees 6.8%) this however caused problems with employers complaining that they were meeting too much of the burden…probably because it meant less profit for them; anyway this led to reform. The insurers are non-government, non-profit agencies, which owe allegiance to employers and employees. As well as their compulsory contribution most employees pay an additional voluntary 2.5% of their salary to a mutual insurer.

The French are able to enjoy freedom of choice when choosing their medical practioner, whether GP or specialist, and typically pay their doctor’s fee and then claim back 75-80%. Payment may deter the poorest people from seeking care and so when this was recognised legislations were introduced to help these people so about 6 million people are not expected to pay. All patients, may go directly to a specialist either outside or within a hospital.

The evidence suggests that French Healthcare is considerably better than that provided by the NHS, but as the saying goes “the grass is always greener on the other side”. If you weigh up the merits of both systems they probably work out about the same

Health care in the United States is provided by several separate legal entities it is estimated that the U.S. spends more on health care than any other nation in the world. In 2007, the U.S. spent a projected $2.26 trillion on health care, or $7,439 per person. In the U.K that would equate to approximately £3,700 per person. This is due to the sheer size of the U.S.A and the fact that it is divided into many states therefore a system such as the NHS would be impractical.

According to the Institute of Medicine, the U.S. is the only wealthy, industrialized nation that does not have a universal health care system. Around 84.7% of U.S citizens have some form of health insurance; either through their employer, purchased individually or provided by government programs. There are a few publicly-funded health care programs to provide for the elderly, disabled, children, veterans, and the poor. There is a federal law in place that basically states that the public are entitled to emergency treatment regardless of their ability to pay.

As with any system the U.S healthcare system is not without problems. For example it is estimated that 47 million U.S citizens, 8.7 million of which are children, are without any health insurance with this figure rapidly increasing as employers are shifting the cost to employees who are unable to meet the cost of the premiums. The costs of healthcare are rising at 5 times the rate of inflation. As a result of employers shifting the cost to employees there are strikes taking place all over the U.S such as the Southern California grocery workers’ strike and lockout in which nearly 60,000 workers saved health care benefits and beat back employer demands to freeze pension funds after holding strong on the picket line for five months. Under grocery management’s original proposals, a worker making slightly less than $20,000 a year would have had to pay nearly $5,000 to maintain the same level of benefits they had in the previous contract. Other cost increases hitting workers include larger hikes in the cost of family coverage, less access to needed prescription drugs through stricter HMO formularies and higher prices for more comprehensive coverage. According to the statistics consumers are using more prescriptions, at younger ages and for more conditions, and substituting newer, more expensive medications for established products.

In the U.K on the other hand healthcare is provided by the central government and is mostly free but there a few areas where costs apply; although there are private practices within the healthcare sector. Forming the basis of healthcare in the United Kingdom, each system—National Health Service, NHS Scotland, NHS Wales and the Health and Social Care in Northern Ireland—operates independently, and is politically accountable to the relevant devolved government of Scotland (Scottish Government), Wales (Welsh Assembly Government) and Northern Ireland (Northern Ireland Executive), and to the UK government for England.

The NHS is divided into two sectors the primary sector which includes the following:

• NHS Direct
• NHS walk in centres
• GP practices
• Dentists
• Opticians
• Pharmacists

The secondary sector includes the following:

• Emergency and urgent care
• Ambulance Trusts
• NHS Trusts
• Mental Health Trusts
• Care Trusts

The NHS is also not without problems for a start the NHS is over budget in several areas by as much as £105 billion. It is also understaffed. As a result waiting times are at an all time high, although some argue that it is due to the credit crunch and the growing immigration to the U.K. As previously mentioned in the article “The privatization of the NHS” the government’s idea to resolve some of the problems with the NHS is to privatise healthcare; the question is will this actually help or is just a social construction created to justify increasing taxes to make more money for the government?