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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

What to do if you haven’t yet received your Swiss health insurance card

Switzerland is late in issuing health insurance cards for new policy holders or those who have switched their providers at the end of 2022. What should you do if you need medical help before your new card arrives?

What to do if you haven’t yet received your Swiss health insurance card

When you buy a health insurance policy in Switzerland from any of the dozens of approved providers, you will receive a credit card-sized card to be used as proof of insurance. Aside from your name, date of birth, and AHV / AVS number, the card also includes the name of your insurance company, client number, and the date of validity.

You will have to present this card each time you seek medical treatment that is included under the obligatory KVG / LaMal scheme.

Residents of Switzerland are allowed to change their compulsory health insurance coverage from one provider to another by November 30th, to go into effect from January of the following year.

The sharp increase in the cost of the health insurance in 2023 — 6.6 percent on average, but higher in some cantons — has prompted many people to look for cheaper options and change their carriers.

READ MORE: Millions of Swiss residents switch health insurance amid rising costs

This massive switch has caused a backlog in the production of new insurance cards, which means that many policy holders have not yet received theirs.

The cards for all insurance carriers are issued by a subsidiary of the Santésuisse health insurance association, whose spokesperson, Manuel Ackermann, said that the delay is caused by the “extraordinarily large number” — three times as many as in an average year — of switches.

He did not specify how much longer is needed to issue and send out all the cards.

What should you do if you haven’t yet received your card?

Say you need medical help, or another situation arises where proof of health insurance is needed — for instance, if you are applying for a new job or registering in a new municipality.

In such cases, you can present the insurance certificate letter your carrier has issued when you took up your policy.

While not having an insurance card is a minor inconvenience in Switzerland, where such a certificate can be used in the interim, it could be more of a problem when travelling in the European Union.

Under normal circumstances, if you fall ill in the EU, all you have do is present your Swiss card, which is equivalent to the European Health Insurance Card (EHIC). This way, you can be treated and the bill will go directly to your Swiss insurance company.

However, absence of the card could mean that hospitals in those countries may not recognise the insurance certificate alone, and require Swiss residents to pay for medical care on the spot.

While not an ideal situation, you can submit the bill, along with all the required documents such as details of your treatment, to your insurer in Switzerland.

READ MORE: Reader question: Can my Swiss health insurance refuse to pay my medical bills?

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