Medicare for All Part 2

What do other countries do? And How much does it cost?

In Medicare for All Part 1, I looked at the current outline for a form of universal single payer healthcare in America. I started with the current US COngressional Bill to define this healthplan and looked at the plans it wouod supplent Medicare, Medicaid and Private INsurance.
In Part 2 I look at three Europena Universal Healthcare Insurance systems; Ubited Kingdom, France and Germany.

What do they cover?

United Kingdom

The UK's National Health Service (NHS) is a publicly funded healthcare system, primarily financed by general taxation, providing comprehensive healthcare services to all residents based on clinical need, not ability to pay.

The UK's National Health Service (NHS) provides universal healthcare, free at the point of use, primarily funded by general taxation, covering a wide range of services for residents based on clinical need, not ability to pay.

[SOURCE]

https://en.wikipedia.org/wiki/National_Health_Service#:~:text=Eligibility%20for%20treatment,-See%20also:%20Immigration&text=Some%20health%20services%20are%20free,and%20some%20family%20planning%20services.

https://eurohealthobservatory.who.int/publications/i/united-kingdom-health-system-summary

FRANCE

France's national health service, a universal statutory health insurance system, covers a wide range of healthcare services with cost-sharing, meaning that while the system covers a significant portion of medical costs, patients typically pay a portion, often supplemented by private insurance.

Enrollment in France’s statutory health insurance system is mandatory. The system covers most costs for hospital, physician, and long-term care, as well as prescription drugs; patients are responsible for coinsurance, copayments, and balance bills for physician charges that exceed covered fees.

[SOURCE]

https://www.commonwealthfund.org/international-health-policy-center/countries/france#:~:text=Enrollment%20in%20France's%20statutory%20health,charges%20that%20exceed%20covered%20fees.

https://eurohealthobservatory.who.int/countries/france#:~:text=France%20runs%20a%20statutory%20health,are%20ongoing%20to%20expand%20coverage.

https://eurohealthobservatory.who.int/publications/i/france-health-system-review-2023

GERMANY

Germany's healthcare system, a universal multi-payer system, is primarily funded through mandatory statutory health insurance (SHI) and private health insurance (PHI), covering a broad benefits basket including inpatient, outpatient, mental health, and prescription drug coverage.

Health insurance is mandatory in Germany. Approximately 86 percent of the population is en-rolled in statutory health insurance, which provides inpatient, outpatient, mental health, and prescription drug coverage. Administration is handled by nongovernmental insurers known as sickness funds. Government has virtually no role in the direct delivery of health care. Sickness funds are financed through general wage contributions (14.6%) and a dedicated, supplementary contribution (1% of wages, on average), both shared by employers and workers. Copayments apply to inpatient services and drugs, and sickness funds offer a range of deductibles. Germans earning more than $68,000 can opt out of SHI and choose private health insurance instead. There are no government subsidies for private insurance.

[SOUREC]

https://www.commonwealthfund.org/international-health-policy-center/countries/germany#:~:text=Health%20insurance%20is%20mandatory%20in,shared%20by%20employers%20and%20workers.

https://eurohealthobservatory.who.int/countries/germany#:~:text=Health%20insurance%20in%20Germany%20is,hospitals%20come%20from%20states'%20budgets.

How much do other countries pay?

United Kingdom

According to the UK Government:

361.77 Billion Dollars

Source

In 2021, the UK spent a total of £280.7 billion on healthcare, which included both government and non-government spending, equating to £4,188 per person.

[SOURCE] https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukhealthaccounts/2021#:~:text=1.,non%2Dgovernment%20spending%20on%20healthcare.

A Look at Countries providing UNiversal Healthcare which covers everything, similar to Medicare for ALL.

How big is the UK Population ?

According to the World Bank 68.3 Million

[SOURCE] https://datatopics.worldbank.org/world-development-indicators/

So the UK spends 361.77 Billion Dollars on 68.3 Million people, or 5,406 USD per person

How much does France Spend?

France's healthcare system, largely financed by government national health insurance, spends approximately 11.5% of its GDP on healthcare, with public expenditure accounting for 77% of total health expenditures.

https://www.commonwealthfund.org/international-health-policy-center/countries/france#:~:text=Role%20of%20public%20health%20insurance,contributes%2034%20percent%20of%20funding.

http://eurohealthobservatory.who.int/publications/i/france-health-system-summary-2024

https://en.wikipedia.org/wiki/Health_care_in_France#:~:text=The%20French%20health%20care%20system,covered%20by%20government%2Dfunded%20agencies.

Accordin to the French Ministry of Health France Spends US$ 5740 per person in France

https://en.wikipedia.org/wiki/Health_care_in_France#:~:text=The%20French%20health%20care%20system,covered%20by%20government%2Dfunded%20agencies.

https://www.oecd.org/en/topics/policy-issues/health-spending-and-financial-sustainability.html

French Population?

68.29 million

Source: https://www.worldometers.info/world-population/france-population/

Germany

In Germany, the general statutory health insurance rate is 14.6% of gross salary, with employers and employees each contributing 7.3%. There is also a supplementary contribution, a nursing care contribution, and out-of-pocket costs for some services.

https://www.expatrio.com/about-germany/costs-health-insurance-germany#:~:text=in%20more%20detail.-,Costs%20of%20Public%20Health%20Insurance%20in%20Germany,Health%20Insurance%20in%20Germany%20page.

https://www.euraxess.de/germany/information-assistance/social-security-and-optional-insurances/health-insurance#:~:text=If%20your%20gross%20salary%20is,7.3%25%20of%20the%20insurance%20rate.

https://www.mckinsey.com/industries/healthcare/our-insights/how-germany-is-reining-in-health-care-costs-an-interview-with-franz-knieps

This statistic shows annual expenditures in the German health system from 1992 to 2021. In 2021, expenditure in the German health system amounted to almost 497.6 billion euros.Jan 13, 2025

SOURCE

https://www.statista.com/statistics/693858/health-expenditure-germany/#:~:text=This%20statistic%20shows%20annual%20expenditures,to%20almost%20497.6%20billion%20euros.

Germany appears to spend Annual per capita spending is around €4,500.
That is approximately 4,875.08 USD per person per year

Source: https://www.expatrio.com/about-germany/costs-health-insurance-germany

** Discussion**

These numbers must be viewed in two viewpoints

One is cost per person in these countries compared to cost per person in America
Two is what do you get for your money.

While the cost is higher in the US 8800 versis 5400, 4800, 4500 in these three countries, the Universal COverage nature and stabndardized essentially single system payer natures of these countries, plus cultural differences in How the people utilize healthcare are all matters of discussion.

But just the numbers would suggest that a health plan which covers more , for less cost, is possible.

Some of the low hanging fruit aspects of efficience include a single payer, one of the most objectively factual means of reducing cost in practically any system where there are over 1000 payers, 1000 paperwork systems and 1000 times as much administrative costs as a result is a starting point for discussions on cost and coverage.

As you can see this is a BIG TOPIC and not as simple as personal choice , since the cost of healthcare has far reaching effects beyond simply concepts.

This article is just a starting point for discussion, and I tried to give you plenty of links to click and follow-up on these issues.

An important question I have for Hivers living in the UNited Kingdom, France and Germany...
How does this description compare to your everyday lived experience?
I know government descriptions or articles written by healthcare experts may be different from the everyday experiences of people living in these countries.

What is your lived experience?

How happy are you with your system?
What is your experience in another country in Europe with their healthcare system?
What is your experience with the American Healthcare System?
I think it's good to try and be neutral, but I don't expect it really. We all have our biases but hopefully we can share our experiences here.