Globally, health insurance systems are a subject of great concern to countries. Due to historical, economic, and cultural differences, Europe and the United States each have their own distinct health insurance systems.
What are the differences between the European and American health insurance systems?
- Differences in the Nature of Systems
European countries often adopt national health insurance systems, with government management, financing, and oversight. In contrast, the US health insurance system is primarily provided by private insurance companies. Because the US lacks universal health insurance, individuals bear the majority of medical expenses.
- Differences in Coverage
In Europe, most countries have universal health insurance systems, meaning that all residents are required to participate and receive free or low-cost health care. This approach encompasses all citizens, regardless of wealth, and improves the distribution of medical resources. In the US, however, most health insurance is purchased by employers or individuals. If someone does not have health insurance, they are considered unprotected and uninsured.
- Differences in the Allocation of Medical Resources
In Europe, the widespread use of national health insurance systems allows for better distribution of medical resources to all individuals. Furthermore, government funding for health care is greater, allowing medical practices to focus more on disease prevention and treatment, reducing the need for medical services. In the United States, however, the uninsured, low-income, and vulnerable groups have a greater need for healthcare. The existence of private insurance companies has led to an uneven distribution of medical resources. Coupled with price transparency and a lack of competition in the healthcare market, high medical costs have become the norm.
- Different Cost Burdens
In Europe, under national health insurance systems, the government covers the cost of healthcare services. Residents pay a small out-of-pocket contribution, while the government covers all other costs. In the United States, however, due to the lack of universal healthcare, the majority of medical expenses are borne by individuals or insurance companies. This is particularly true for the uninsured, who often experience worsening illnesses due to lack of insurance and are unable to seek timely medical care due to unaffordable medical costs.
Patients and Public Protection in Europe
- In the EU and the UK, health is considered a fundamental right, with the state responsible for organizing healthcare and providing medical assistance. Generally, European healthcare systems fall into two main models: national health services and mutual insurance.
- The national health service model predominates in 11 EU countries, including Italy: this system is funded by citizen taxes, with the state providing healthcare services free of charge or through a small "registration fee." The mutual insurance model is concentrated in 13 countries, including France and Germany: all residents must purchase public, affordable, compulsory insurance. Premiums are proportional to individual income, subject to a cap. Insurance covers most medical expenses, making it rare for patients to be unable to claim reimbursement for a particular service, and most healthcare facilities are publicly funded. For the unemployed or those on low incomes, the state covers all costs.
- Three countries (Austria, Bulgaria, and Greece) use a mixed model: basic services are guaranteed, but a significant portion of healthcare services must be paid for directly by citizens or through voluntary insurance.