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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 INSURANCE

How to save money by changing your Swiss health policy

Switzerland’s compulsory health insurance is notoriously expensive, but you can lower the cost of premiums substantially by changing your company or coverage.

How to save money by changing your Swiss health policy

The cost of health insurance premiums usually represents at least 7 percent of a typical household budget.

An adult spends nearly 4,600 francs a year on average on the mandatory basic coverage (KVG / LaMal) alone – covering only medical care, not dental. If any extra policies are taken out, the cost is even higher.

Not only that, but premiums have been rising practically each year, and look set to go up again in 2023, possibly by as much as 10 percent — the sharpest hike in 20 years.

READ MORE: Why Swiss health premiums are set to rise — and what you can do about it

Even though these costs are high and climbing, many people keep the same health insurance for years.

However, significant savings — to the tune of thousands of francs a year — could be made simply by switching carriers or plans, from the more expensive to the cheapest ones, according to a new study by the cost comparison site Comparis.

How much and where

The amount of the savings varies depending on policyholder’s place of residence, because rates are determined by cantons.

However, Comparis calculated that over a 10-year period, people living in Zurich could have saved 33,396 francs in premium costs and for those living in Bern this amount is 30,064.

Lausanne residents could cut their costs by 36,494 francs over 10 years, 31, 032 in Geneva, and 33,490 in Basel-City.

“With the strong premium increases expected this fall, the savings potential is even greater,” said Felix Schneuwly, health insurance expert at Comparis.

So how can you save money? Here are some of the ways:

Increase your deductible

In Switzerland, the deductible (franchise) ranges from 300 to 2,500 francs – this represents the medical costs that you have to pay out of your own pocket before your health insurance kicks in.

As with most types of insurance, the lower your deductible, the higher your premiums, and vice-versa.

If you are young, healthy, and are not on any long-term medication then you can save substantially with the highest franchise.

Keep in mind, however, that if you choose the highest deductible and end up having an accident or falling sick and needing medical care, you will have to pay a greater proportion of the costs.

Switch to a less expensive plan.

The standard model for healthcare in Switzerland is that you can consult any medic that you want, and you do not need a referral to see a specialist.

However, there are some types of health insurance plans that have cheaper premiums, but impose certain limits on your access to non-emergency medical care.

For instance:

Health maintenance organisation (HMO)

Under this model, policyholders are required to consult a particular HMO practice. Two disadvantages of this alternative is a limited choice of doctors and you also need a referral to see a specialist.

However, the benefit is a premium reduction of up to 25 percent compared to the conventional insurance.

Family doctor model

Your family doctor, a general practitioner, will be designated by your insurance company and will be in charge of all your non-emergency medical treatment.

He or she will refer you to a specialist if necessary. 

If you opt for this option, you could save 20 percent on your insurance.

READ MORE: Five tips for getting cheaper health insurance in Switzerland

The Telmed alternative

If you choose this option, you have to call a telephone service and get a referral to a doctor or hospital.

This does not apply to medical emergencies and there are other exceptions, such as eye exams and annual gynaecological check-ups.

Total savings could range between 15 and 20 percent. 

Cancelling or changing your policy

If you want to cancel your current insurance policy and take up a cheaper one , you have to do so by registered letter before November 30th.

By then, you will know what your premiums will be in 2023 because your carrier must notify you of the new rates by October 31st.

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