Comparison of Healthcare Systems in France, Spain and UK

France

France is recognised as offering one of the best public healthcare in the world. The system is made up of private and public hospitals, while the doctors and other healthcare workers part of the multidisciplinary team work together to provide healthcare for every citizen, regardless of their age, wealth and social status.

Accident and emergency services are part of the healthcare system. The emergency ambulance service is known as SAMU and is available in all cities and large towns. The paramedics provide immediate assistance before transporting the patient to A&E.

In Spain, primary healthcare is available and provided by 23,000 general practitioners. People are able to choose the GP they want and they will act as their personal doctor. Citizens are able to consult other GPs as well however only their personal doctor is able to refer them to other specialists for further care.

For the majority of the time, patients have to pay a fee to visit a GP. In 2019, the cost for each visit was 25 euros, but this cost can be higher for visits to surgeries at night or during the weekends and home visits. Most of the fee will be reimbursed by the patient’s state-run health insurance provider and overall the patient will only have to pay between 0-6 euros depending on their age, medical condition or the type of health care insurance they have.

It is worth noting that health care insurance is partly funded by adding a contribution to salaries which is also paid by employees, employers and the self-employed. In 2016, employees paid around 8% of their salary whilst employers paid approximately 13%. It is also partially funded by the government and the patient pays a small contribution to the costs of their healthcare.

It is compulsory for residents to register for health insurance, whether public or private

Public healthcare is available to all residents. If you have lived in France for longer than 3 months, you are eligible to register for healthcare in France via your CPAM office. Once registered, you will be given a carte vitale – a green, plastic health insurance card that contains your personal (but no medical) information. It is vital that you take this with you to any appointment in order to access free healthcare.

Vocabulary

GPs= médecins généralistes

Accident and emergency services = les urgences

SAMU = Service d’Aide Médicale Urgente = urgent medical aid service

CPAM (= Caisse Primaire Assurance Maladie = Primary Health Insurance fund)

Spain

Spain is known to have one of the top healthcare systems in the world. In 2009, it was ranked 7th best in the world by the World Health Organisation.

The constitution requires the state to provide medical care to its citizens. The Spanish healthcare system is also called Sistema Nacional de Salud (SNS), also known as Seguridad Social. It is funded by taxation which is deducted from your salary.

Primary healthcare in Spain can be accessed through health centres and GP surgeries. Standard medical services are free of charge whereas staying overnight, surgery and extensive prescriptions have added costs. Health centres in Spain usually have approximately 6 GPs and you may not see the same doctor each visit however it is possible for you to book an appointment with a specific doctor.

In order to access public healthcare, one needs to be living and working in Spain and have SNS coverage. You can register at the local health centre and ensure you have your passport, social security number and foreign identity number.

Through the public insurance route, in order to see a specialist, you need to be referred by your family doctor. If you have private insurance, you can go straight to the specialist clinic.

Dental and eye care are available privately. Once registered under insurance, citizens are free to choose their own doctors but keep in mind the waiting list is relatively long.

Ambulance services are an additional cost, depending on the distance. For example, non-emergency trips cost between 20-120 euros and for those who are critically unwell, they are approximately 10 euros per month. Otherwise, emergency transport is covered by the public system with no additional cost.

Free healthcare is also provided to retirees, including those from other EU countries. The UK government used to pay an annual sum per retiree to Spain to cover the health costs. Alternatively, private healthcare is also available with an additional charge.

All foreigners and citizens are able to access care and be treated if they enter the emergency room regardless of their insurance status. However the benefit of having SNS coverage or private insurance is that you won’t have to wait for as long.

Citizens have to pay a non-refundable percentage of the medical costs, depending on their situation.

Vocabulary

Hospitals = hospitales

Emergency room = urgencias

Pharmacies = farmacias

Ambulance = ambulancia

World Health Organisation = Organización Mundial de la Salud

seguridad social = social security

Health centres = centro de salud

GP surgeries = médico de cabecera

UK

The healthcare system in the UK is known as the National Health Service (NHS). It is the major healthcare provider in the UK and is funded through taxation rather than health insurance. Alternatively, there is a private health sector that people can opt for. The biggest advantage of this is avoiding long waiting times as well as being able to use overall better facilities.

In order to register under the NHS, you should see a GP. Citizens are allowed to choose their own GP practice however some might refuse patients due to overbooking or your proximity to the practice.

In a report in 2014, carried out by the Commonwealth Fund, the NHS outperformed a majority of other Western European healthcare systems, including France.

The services offered are based on residency, a majority of them are free for residents. Treatment provided is completely free as long as it comes under the NHS. Some treatments have additional charges such as dental treatment and prescription charges.

Certain age groups and those who do not earn as much are permitted exemptions or reductions on the additional treatment charges.

There is a specific NHS body in each region of the UK. The main differences between them are structural differences as well as the way some services are delivered.

Visitors have to apply for a free European Health Insurance Card.

References

https://transferwise.com/gb/blog/healthcare-system-in-spain

https://about-france.com/health-care.htm

https://www.thelocal.fr/20170426/ten-ways-the-british-health-service-is-different-to-frances

https://www.theguardian.com/money/2008/apr/08/expat-finance-spain#:~:text=Spain%20has%20both%20public%20and,security%20system%20and%20their%20families.&text=The%20card%20only%20allows%20you,the%20cost%20of%20your%20care.

https://www.expatica.com/fr/healthcare/healthcare-basics/a-guide-to-the-french-healthcare-system-101166/

https://www.expatica.com/es/healthcare/healthcare-basics/healthcare-in-spain-101467/

https://www.expatica.com/uk/healthcare/healthcare-basics/the-national-health-service-and-health-insurance-in-the-uk-1092057/#:~:text=The%20UK%20has%20a%20free,can%20choose%20if%20they%20wish.