Not on a theoretical level, but how would you practically have to pay costs, access specialist doctors?
I’ll start with the German system. Here you are either automatically insured in one of the public insurances (there are many), which marginally differ in their cost (think single digit euro differences) and have to cover basically the same procedures. If one reaches a certain income level, being privately insured is possible.
If you are publicly insured, you wont see most costs, as these are directly handled between your insurer and the doctor/hospital. For some medications and procedures there are co-pays that are flat fees (5 Eur for Medications, …).
Access to specialists mostly need a referral from your family doctor.
In private insurance, often you yourself will be billed and you will need to hand this to your insurance company.
The good side is that in most common situations I have never needed to worry about cost in public insurance, wait times for referrals can be very long and understanding what you need to get certain care can be very difficult. Private insurance often has better payment schemes for providers and less artificial limits on number of patients or which doctor is able to provide services, so access to most care is faster and more widely available.
Access to specialists mostly need a referral from your family doctor.
That hasn’t been the case in many years now, you can just make an appointment without a referral.
Well, for most specialist. There are still a few cases were it is required, e.g. radiologist.
Also with public insurance you might have to wait longer for your appointment with a specialist - but if you have a referral from your family doctor, they can add a urgency note (Dringlichkeitsvermerk) on it and you will get an appointment faster. With that you can also call the health service hotline (116117) and they have to find an appointment for you.
That is not correct anymore - they are absolutely insured as long as they are entitled to Bürgergeld,even if they don’t actually get it or have the three month block in it. The problem is more that the insurance works retroactively in that situation and they often are billed privately by health care providers (which is somewhat illegal) and some of these claims “stick”, especially if you don’t have the resources to fight it.
Sweden: Healthcare is mostly tax-funded. There is a small fee (for adults between 20-85 ) for each appointment. This fee lies between 150-330 SEK (~15-33 €), depending on which region you’re in. Emergency care is usually about 10 € more (40€), and an ambulance trip double (so ~60€). If you’re admitted to a hospital the fee is 120 SEK/day (in my region). Total fees paid for appointments during a year is capped at 1300 SEK (130 €), after that they’re cost-free.
The above is regarding “necessary” care, so things like cosmetic surgery, vasectomies, etc. you’ll have to pay more.
Access to specialist doctors varies, some you can contact directly (usually private practice), and others you’ll have to first make an appointment with a general practitioner at a health center, then get a referall if they deem it necessary. In my region there’s quite a long wait time for many specialists (I had to wait 6 months for a head MRI), and sometimes you’ll have to travel quite far because the care is only offered in one hospital in the region (My wife had to drive 200 km for a surgery).
UK here. Everything is free at point of use (paid via taxes) except prescriptions. It’s around £10 per item. But they are free if you have certain long term health conditions, are pregnant etc.
To see a specialist your doctor writes a letter and they contact you.
Australia here.
For most medical services, the govt will reimburse you a set rate. The GP or specialist can charge you whatever, sometimes the same as the govt reimbursement, sometimes quite a lot extra. You don’t pay anything at public hospitals (which are nice).
I recently had some great problems, I stayed overnight in hospital twice, for a total of 3 nights in private rooms, had an internal scaffold inserted in my artery. i also had numerous consults with specialists and drs.
The whole thing cost me about $500, a few days work on average wage.
Canada. It’s free, but slow.
They’ll keep you alive, but it’s up to you to stay healthy. Little prevention support around here.
Define slow. I have to wait months or more for an appointment in the US. Is it that slow? Emergency visits take hours, sometimes charging people who wait but don’t get service. Is it that slow?
Not the other poster but a Canadian too. It varies. To see my GP I can get an appointment within the week, usually same day, though most people here need to wait a couple weeks. Then there GP refers me to specialists, that’s usually between 1-6 months wait.
Emergency yeah you are usually looking at 4 hours wait absolute minimum. Though you don’t get charged for it at least. Though I guess it depends on severity, they will prioritize by how serious it is not by first arrival.
The other thing the other poster didn’t mention is that medication is not covered so you have to pay full for that unless you have insurance. Also for some reason dental isn’t covered at all without insurance (or I think recently for low income families but I’m not 100% sure if that’s implemented yet or not)
Depends. I have had a bunch of specialist appointments for cardiologists, endocrinologists, reproductive health specialists and pulmonologists. The average wait for an appointment is about three months.
We are very fond of calling the Canadian system slow but my understanding is it’s decently comparable to a lot of the States and is actually pretty impressive considering how spread out and small our population is.
Not only province, but doctor/hospital but mostly urgency.
If you’ve got something critical, it’s super fast, otherwise it can be pretty slow.
Examples:
went to the emergency for something stuck in my eye, 3am. Went in, waited 3 minutes to be checked, saw a doctor 15 minutes later, by the 1h mark I was out with 1 nurse and 1 doctor who had seen me and removed what I had and another nurse who had given me a vaccine shot.
On my way out, I talked to someone in the waiting room I had seen at 8PM getting a softball to the side of the eye, she finally saw someone around 11h after getting to the E.R. (they quickly evaluate the urgency when you arrive).
Almost 4 years later, I’m still waiting for my vasectomy appointment.
