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European healthcare: how does your country rank?

Most healthcare systems in Europe offer a good level of care. But which countries spend the most money on healthcare? Which do well in independent ratings? And which regions have the best life expectancy?

European healthcare: how does your country rank?
Photo: Getty Images

There are significant variations between countries in terms of these factors. If you’re an international resident, knowing a little about these differences could help you better understand the health system in your adopted homeland.

In partnership with international insurance broker ASN, The Local presents a guide to some of the key differences in European healthcare that every expat needs to know.

Hey big (healthcare) spender…

For you, healthcare is all about your well-being and that of your loved ones – something nobody can put a price on. But staying healthy is a priority for everybody. Looked at on a national basis, spending on healthcare is therefore a major topic of debate wherever you live.

Comprehensive global health coverage to fit your life: find out more from ASN

Some governments spend significantly more on healthcare than others. The level of private coverage – and related spending – also varies between European countries.

So, how does your country compare with others in Europe when we look at total healthcare expenditure? France and Germany have the highest spending on healthcare relative to GDP in the EU, according to Eurostat, the statistical office of the European Union.

The figure stood at 11.3 percent in both countries in 2017, with Sweden next (11 percent). However, if we also include European Free Trade Association (EFTA) countries, Switzerland (12.4 percent) ranks as the undisputed leader.

Major countries that spend below the 9.9 percent EU average on healthcare in relation to GDP include the UK (9.6 percent), Spain (8.9 percent) and Italy (8.8 percent). Scroll over the map below to find out how much your country spends.

 
Independent country ratings

The Euro Health Consumer Index (EHCI) has been providing international comparisons for the performance of national healthcare systems since 2005. It looks at 46 indicators, including access to care, treatment outcomes, and the range and reach of services.

So, which countries come out on top? Switzerland ranks first in the latest index, followed by the Netherlands, Norway and Denmark. Countries with small populations dominate the top ten, which also includes Sweden (eighth) and Austria (ninth).

While France and Germany may have topped the European spending list, here they come in 11th and 12th positions. That still puts them ahead of other major nations in Europe such as the UK (16th), Spain (19th) and Italy (20th).

Switzerland has an “excellent, although expensive” system and it was no surprise to see it knocking the previous leader the Netherlands into second position, according to EHCI. The experts who produce the index added that “many countries have inefficient ways to fund and deliver healthcare services” – but lots of Europe’s smaller countries are setting a good example. 

Understanding public provision

The benefits of good health are huge – for you as an individual, your family and your wider community. As a recent OECD report stated: “Healthy people create healthy communities and contribute towards a well-functioning, prosperous and more productive society.”

Living abroad or frequently crossing borders can sometimes place extra strain on you – as well as leading to difficulties in understanding a foreign healthcare system. 

Many European countries have universal public healthcare systems. But this doesn’t always mean every treatment is free at the point of care or accessible immediately, so it’s worth checking your local rules and waiting list times.


Photo: Getty Images

Switzerland’s highly-rated system is based on compulsory insurance and Germany has what is known as a ‘multi-payer’ healthcare system involving a combination of public and private insurance.

Confused yet? If you’re new to a country, you may not even be fully aware of how the relevant national system works.

This is one reason why some busy expats seek out a comprehensive solution such as international health insurance. Whether you live in another country, plan to relocate, or just want private coverage for peace of mind, ASN can offer options to fit your needs. You can get worldwide coverage, ensuring you always have the same level of cover even as you travel between countries.

The many benefits can also include 27-global service, an English-speaking personal advisor, routine or annual check-ups with your preferred doctor, quick access to a second opinion, and treatment with alternative medicine. You can upgrade or downgrade your policy and add or remove benefits – meaning you stay in control of what matters most to you. All of these services are free for ASN customers.

Here’s to a long life

Increasing life expectancy should be celebrated – and it’s risen fast in many European countries this century. Across the EU, life expectancy at birth reached 81 in 2018. Women can still expect to live longer than men (83.7 years versus 78.2) – but men have closed the gap a little in recent years.

Ageing populations are one of the big trends of the 21st century – and as Eurostat itself has pointed out this adds to the pressure on people in work to support services for the elderly through their taxes.

So, where can people expect the greatest longevity? The ten EU regions with the highest life expectancy for women at birth in 2018 were all in just two countries: Spain and France. For men, four of the top five regions were in Italy, with the only exception being Madrid (which also topped the women’s list).

Find out more about what ASN provides, from 24/7 English-speaking customer service to annual checkups with your preferred doctor

 
For members

HEALTH

How Norway’s health insurance scheme works and the common problems foreigners face

Learning about Norway's National Health Insurance Scheme is essential. So here's a look at some common problems foreigners in Norway come up against and how to avoid them.

How Norway's health insurance scheme works and the common problems foreigners face
Here's how to avoid common problems with the National Health Insurance Scheme. Photo by National Cancer Institute on Unsplash

Norway’s National Health Insurance Scheme

The word ‘free’ is used loosely when it comes to describing healthcare in the Scandinavian country. Norway’s healthcare system is financed through national and municipal taxes. So residents are supporting their ‘free’ services through tax. Truly free health insurance is only offered to those under 16 years of age who do not pay taxes to Norway. 

Access to Norway’s healthcare and social services is not determined by whether you are a Norwegian citizen, nor whether you are registered in the National Population Register or pay taxes in Norway. It is based on residence or employment. But before you settle in and assume you’re covered from day one, there are some provisions.

  • To be considered a resident of Norway, you must have plans to live in the country for at least twelve months.
  • Membership with Norway’s National Health Insurance Scheme is only available for those who are in the country legally.
  • If you are planning on staying in Norway for less than twelve months, are not working, but have strong ties to the country, then you may be entitled to voluntary membership of Norway’s National Health Insurance Scheme.

If you are legally living in Norway but plan on studying or working abroad for a period of time, look here to see your healthcare membership eligibility while outside the country. 

And the common problems foreigners need to overcome?

  • Signing up 

According to the Norwegian Labour and Welfare Administration (NAV), you will be automatically enrolled in the Norwegian National Health Insurance Scheme if you are legally working or living in Norway.

Processing times can range from a few days to a month, and you will usually receive confirmation through the post when you have been added to the system.

Healthcare is a large part of the Norwegian National Health Insurance Scheme, as are social services such as welfare. If you need economic support, you can apply for assistance if you are legally living in the country. How much you will receive depends on your situation and application processing times vary between each individual evaluation and municipality. 

READ MORE: Seven things foreigners in Norway should know about the healthcare system 

There are many rules and guidelines if you decide to apply for economic assistance. To see what procedures, information, and advice you are entitled to, look here.

Self-employed workers are also entitled to the same benefits as traditional employees in Norway. Though it is up to them to register events like sick leave on their own. 

  • Somethings are not free

The healthcare system in Norway is of a high standard and covers most expenses. Because it is so comprehensive, many new to the country assume that all health matters are covered by national health insurance. It is important to remember that vision and dental insurance are not a part of the public health care plan. 

Dental treatment is free for those between one and 18 years of age. If you are 19 or 20 years old, you must pay 25 percent of the total bill. If you are 21 or older, then you are required to foot the bill. 

However, there are exemptions for special cases. You can find out more about the payment exceptions here.

Eye exams, contact lenses, and glasses are not covered by public health insurance. These are normally services offered by private companies such as Spec Savers and Brilleland.

In addition to vision and dental, cosmetic surgeries are also not covered by public health insurance. 

Here is a price list for common services in Norway.

What is a frikort?

frikort or an “exemption card” is a card given out once you have reached the maximum limit of fees the public is required to pay per calendar year. In 2021, the maximum amount in fees you are expected to pay is 2,460 kroner before being eligible for a frikort

  • Many things have gone digital 

Many newcomers to Norway are surprised to find how digitalised health services in the country are. After you have become a member of the national insurance scheme, you can go online to order prescriptions, find available appointments with your GP, have digital communication with their doctor, and look at summaries of past medical appointments. 

For an overview of all the services and information, you can use online, look here.

  • Finding your GP

While your acceptance into the National Health Insurance Scheme may be automatic, it is up to you to choose your GP. 

There are a few guidelines to be aware of if you, for some reason, want to change from your original choice. You are allowed to change your GP up to two times in one year. You can also choose to switch if you officially change your address or if your GP cuts their patient list. You can find a list of general practitioners at legelisten.no.

  • The waiting times

As previously stated, the standard of health care in Norway is high, and you can visit your GP or a specialist as often as you need them. But it is not uncommon to have to wait a few weeks before you find an available appointment. The same goes for non-critical surgeries. It is not unusual to wait up to six months for a non-life-threatening yet necessary surgery.

Useful Vocabulary

egenandel – deductible

fastlege – general practitioner 

optiker – optometrist 

tannlege – dentist 

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