Healthcare systems beyond the UK and US

Jess Gill

March 13, 2023

If you’ve ever criticised the NHS or advocated for reform in our healthcare system, you’ve probably heard the classic response that “at least we’re not like the United States!” This argument is often used to fearmonger that if the UK has any free market reforms to the NHS.

To bring up the United States as a counterpoint to market-based reform is a complete strawman. Even those brave enough to question the dogma around the NHS explicitly do not want to replace it with the American model. As Kristian Niemietz, Head of Political Economy at the Institute of Economic Affairs, said during my interview with him: “there’s no political demand for it and no one’s suggesting it.”

In reality, the notion that we can only choose between the healthcare models of the United States and the United Kingdom is a false dichotomy. There are many other systems of healthcare other than that of the crony capitalist US model and the socialist UK model. It’s ironic that the FBPE tribe all of a sudden forgot about how great other European countries are as soon as it comes to healthcare. 

Many systems in Europe have a greater element of marketisation and have better outcomes than the NHS. Though they’re not completely free market systems (though to clarify, neither is the United States model), they are a lot better than the UK’s current model which is squeezing the health out of our country. 

During our conversation, Niemietz used the system of the Netherlands as an example:

“I often bring up the system of the Netherlands because that’s a system where healthcare spending is almost exactly the same as here as a proportion of the size of the economy. T

That’s a universal private insurance system where everyone has private insurance, and you are obliged to get insurance from a private company and the private companies are obliged to accept all applicants… There’s also a support package in place if you can’t afford your premiums.”

Though the other European countries aren’t the only ones who have better healthcare than the UK. Another example that Niemietz has previously written about is Australia:

“Today, Australia has a part-private, part-public hybrid system. A government-run health insurance programme, Medicare, covers all citizens and legal residents. In addition, most Australians also have private health insurance, so unlike in the UK, “private healthcare” does not mean “expensive luxury healthcare”. It is a widely available option.  

Part of the reason for that is that if you take out private health insurance in Australia, you receive a tax rebate from the government, which usually reduces the insurance premium by about a quarter. This is a recognition of the fact that once you have private health insurance, you are less likely to make use of publicly funded healthcare. Private insurers cannot discriminate on the basis of health status: they must cover everybody, and on the same terms.  

Overall, the results are not too shabby. In the above-mentioned international league tables of health outcomes, Australia is usually among the top 10. The total bill for all that comes to just over 9 per cent of GDP, which is less than in the UK.”

Another example of where the UK can take note is Singapore. Like the other systems, Singapore’s healthcare system which is funded both by government and private as well as private insurance and out of pocket payments. It is highly developed, accessible, and affordable. The government relies on competition and market forces to improve services and raise efficiency. 

The Economist Intelligence Unit placed Singapore 2nd out of 166 countries for health-care outcomes. The Bloomberg Global Health Index of 163 countries ranked Singapore the 4th healthiest country in the world.

Singapore’s health system is built around the three M’s: Medisave, Medishield and Medifund. The Medisave program is a forced saving plan that represents 7% and 9.5% of a working person’s wages. Medishield is a nationwide catastrophic insurance program to help out with expensive healthcare. The final layer of protection is Medifund which provides a safety net and pays for the medical bills of those financially in need. 

The fact of the matter is that it’s not extreme or crazy to want reform in the UK system. As demonstrated, there are plenty of examples of systems which give the patient more autonomy over their healthcare. 

The reality is that it’s crazy to continue with an inefficient system that constantly fails patients and underpays workers despite the constant increased cost on the taxpayer. If we want to save lives and improve the welfare of the public then we must abandon the NHS dogma and learn from our European and Asian neighbours.

Author

  • Jess Gill

    Jess Gill is a British libertarian political content creator. She is the Creative Director of Reasoned U.K. Jess creates political and economics videos on TikTok and YouTube where she has gained a following of over 30,000.

    View all posts

Written by Jess Gill

Jess Gill is a British libertarian political content creator. She is the Creative Director of Reasoned U.K. Jess creates political and economics videos on TikTok and YouTube where she has gained a following of over 30,000.

Leave a Reply

Your email address will not be published. Required fields are marked *


  • SHARE

Capitalism and freedom are under attack. If you support 1828’s work, help us champion freedom by donating here.

Keep Reading

SUBSCRIBE TO OUR

WEEKLY NEWS BRIEFING

Sign up today to receive exclusive insights