Best Healthcare in High-Income Countries

Healthcare has been a hot-button topic for a very long time, especially in the wake of a pandemic. Based on research by the Commonwealth Fund, Norway, Netherlands, Sweden, Switzerland, Canada, New Zealand, France, Germany, UK, and Australia constitute the top 10 counties for the best healthcare in the world

Overall results included countries being compared based on care process (hospital use), care outcomes (mortality rates), financial burdens, and the patient experience. The United States performed poorly compared to other high-income countries, placing last overall.

It is interesting to note that all ten countries are high income. According to The Commonwealth Fund’s website, “most analysis includes only high-income countries or sometimes affluent regions within larger countries.” 

The ranking does not account for lower-income nations that may have better quality healthcare. As noted in the research, the US is the only high-income country to achieve below-average performance. We will go more in-depth about why it ranks so poorly compared to other high-income nations.

1. Norway

Healthcare in Norway gets financing from the country’s health care system, payroll contributions, taxes, and private entities. Private insurance provides care to roughly ten percent of patients. Everyone in the country automatically has coverage for primary care health care services, as well as mental health, ambulatory, and hospital care.

Norway utilizes a system that closely models itself after the Bismarckian social insurance system. It has universal coverage, and the population receives free medical education and treatment when necessary. The 1997 National Insurance Act and the 1999 Patient Rights Act regulate Norway’s National Insurance Scheme (NIS). 

The NIS also helps to cover sick leave payments and public retirement funds. Visitors from other countries can receive health care but must pay in full. An undocumented adult immigrant can receive emergency health care. 

2. Netherlands 

Healthcare in the Netherlands is publicly financed and provided, funded by compulsory fees for residents. Insurance companies cover most services, which may take the form of either a subsidized statutory scheme or a private one. The country first began its national health insurance scheme in 1941, based on the German Bismarck model.

Health insurance companies provide a basic set of health care coverage and cannot refuse an application or impose special conditions. In other words, they cannot exclude people with pre-existing medical conditions. All residents must purchase some form of private health insurance of their choosing. One will get a fine if one remains uninsured. 

Citizens have the flexibility to change health insurance annually, but there are no family plans.

Those with a low income receive free primary and pediatric services. They can also get subsidies to cover insurance premiums from the government.

3. Australia

Healthcare in Australia is publicly financed and provided. The universal system is called Medicare and has been in place since 1984. The federal government funds Australia’s Medicare through taxation and from public hospitals. Local governments also play a role in running the healthcare system.

Medicare is not 100% universal. The “gap” or “safety net” is in place for people who need more than the system offers. This safety depends on the level of income a person has.

Australians have a universal right to care and can use any public hospital in Australia, subject to medical emergencies. Most Australians also have private health insurance. Additional private care gives them the freedom to pick the doctor, as well as spend more time with them. 

The government helps lower-income people with the cost of private health insurance with a means-tested rebate.

4. The UK

The National Health Service (NHS) is the public healthcare system in the United Kingdom. It provides healthcare to all UK permanent residents and certain temporary visitors that have been on a qualifying immigration visa for six months. The UK was the first country to have a publicly funded healthcare system in 1948.

Healthcare in the UK is publicly financed through taxes and provided by the National Health Service, which is government-run. It provides healthcare directly to residents, irrespective of their financial means. Under the NHS, one may get coverage for maternity care, outpatient hospital care, necessary dental care, nurse home visits, rehab, and more.

There are several safety nets under the system. Youth, pregnant women, students, and low-income residents do not have to pay dental co-payments. About 10% of residents add supplementary Insurance to their healthcare—usually to get faster service.

5. Germany

Healthcare in Germany is a universal right. So everyone can have access to this care, irrespective of their income or socioeconomic status. The health system gets financing from employers and employed citizens through insurance schemes. Both employers and employees make contributions to a public health insurance pool. 

Chancellor Otto von Bismarck formed this compulsory public insurance scheme in 1883, which has gone on to influence others. Expats and visitors to the country have often had great experiences utilizing the local Healthcare. A knee surgery that would have cost $14,000 in the United States cost $2,000 in Germany. 

Statutory insurance is compulsory for everyone. However, if you have earnings above a set limit, you may elect private insurance. Most hospitals in the country treat patients with both statutory and private health insurance.

6. New Zealand

Healthcare in New Zealand is publicly financed and provided. Funding comes from general taxation and direct patient charges. There are no private hospitals, and everyone receives the same level of care free at the point of use. Even if you are not a citizen, you can get public healthcare if you are a legal resident or have a valid work visa for two years

The system requires everyone to have health insurance, known as the National Health Act of 1974. Excellent health care has enabled a high life expectancy of about 82 years.

Unfortunately, despite the overall quality of healthcare, New Zealand suffers from inequality problems when dealing with the Maori. The Maori do not have the same access to care that others have in the country. 

7. Sweden

Healthcare in Sweden gets a large amount of its funding from taxes. Regional councils are responsible for managing it in the country. The system requires everyone to have health insurance, and most people get their plans through their employer, but the self-employed must take out a plan on their own. 

Sweden treats childbirth with great importance. The country has some of the best maternity leave—a total of 480 days. Paternity leave is also long—98 days. The culture also relies on the presence of professional midwives. As a result, maternal mortality during childbirth is extremely low—among the lowest in the world. 

Becoming a doctor is very cost-effective as medical schools are both public and tuition-free.

8. France 

The French healthcare system requires everyone to have health insurance. Funding for the Healthcare System comes from central government funding and obligatory contributions from income paid by both employees and employers. 

French citizens can choose whatever general practitioner they like. They will pay a flat fee when visiting their general practitioner doctor—as low as 25 euros a visit. 

Specialists may charge more money, but there is still a cap on their fees agreed upon by the National Health Service. Dental Care also falls under health care coverage and reimbursement rates.

The government reimburses patients for fees paid to a specialist if their primary care doctor recommends the specialist.

9. Switzerland

A combination of government subsidies, compulsory health insurance, and contributions from non-governmental sources make up the healthcare funding in Switzerland. Unlike many of the other countries on this list, Switzerland does not have a system of universal coverage.

Switzerland’s system requires everyone to have health insurance. The contribution rate is decided by the insured person’s income. People in Switzerland must purchase private health insurance from nonprofit insurers. 

In 1994 the country adopted the Health Insurance Law to set specific standards for health insurance. The country has 26 cantons that have responsibilities for hospital services and licensing providers. The regulation of research, training, pharmaceutical safety, medical devices, and public health initiatives all fall under the responsibility of the federal government.

10. Canada 

Funding for healthcare in Canada comes from general taxation, not social security contributions.

The system requires everyone to have health insurance, mainly provided through provincially-funded healthcare services. Medicare is publicly financed by general taxation.

The Canada Health Act of 1984 consolidated two previous Acts. The Act ensures that the government plays a role in setting national standards in medical services. General higher-income earners pay more for healthcare through taxes. It can take longer for certain services. 

Most Canadians have private insurance that covers outpatient prescription drugs, rehab, and dental care. Employers or other organizations such as unions usually pay the majority of private insurance for Canadians.

11. US

The United States comes last amongst high-income countries for healthcare performance and has the highest costs.

The only area the US ranked high on the Healthcare System performance rankings is in regards to the care process—it ranks at number two.

There are many health care insurance plans in the United States, but the monthly premiums are often very high. If a United States citizen is not subsidized by an employer insurance plan, that can be a lot of money out-of-pocket. As a result, many Americans go uninsured due to financial reasons. 

The US spends $9,451 per capita on healthcare annually—almost twice as much as other wealthy countries and more than two and half times the average of large industrialized nations. Private spending accounts for about three-quarters of total spending. There is no cap on what medical and dental institutes can charge for procedures.

Unlike many other countries on the list, dental coverage does not automatically fall under medical insurance in the US. It is usually a totally separate coverage with many out-of-pocket expenses.

Some plans don’t cover pre-existing conditions, even with a comprehensive insurance policy. Many plans only cover a certain percentage of major surgeries as well. Someone could pay for full insurance coverage in the United States without getting true full coverage.

Wrapping Up

This list shows that the United States is not performing well in terms of having a universal system, which we can see because they are last place out of all ten counties being compared. The United States simply does not have a true Universal Health Care system as these other countries with the best healthcare do. 

The US spends far more money per capita—likely because healthcare is not subsidized by taxes or funded entirely by insurance. Citizens must pay for it out of pocket if there is no employer-provided health care plan. If somebody loses their job in the US, their employer-backed healthcare plan will also be resolved shortly after unless they use cobra.

Medical Care is also a leading cause of bankruptcy in the United States!

Countries like Australia have some of the best care globally due to their universal right to healthcare, and they also spend much less money than the US. 

Countries like Germany subsidize their system with taxes to make it affordable for everyone, which can be seen in their place as second best. Germany has a system in which they believe in taking care of all of their citizens.

The belief in Germany is if someone makes more money, they can pay more money into the system. While if someone has less money, they should still be able to benefit, and most people should take care of each other. Unfortunately, this one-for-all mentality is not prevalent in the United States—even when it comes to healthcare.

In conclusion, medical care still has a long way to go in the United States. The United States has no shortage of doctors, insurance plans, or other medical facilities. American patients are highly likely to have discussions with their doctors that patients in other countries won’t have. 

However, access to medical care can vary based on income level, insurance plan type, pre-existing conditions, and what part of the country one lives in.