https://www.advisory.com/daily-briefing/2020/02/21/universal-health-carere*_
Australia's public-private model
Australia's health care system gives everyone the option to choose whether they want to seek care from public providers under Australia's national health care program, called Medicare, or seek private care, which they can pay for out-of-pocket or via the country's private insurance system.
Does the system work? The country's health care model is putting private insurers at risk of a "death spiral," as more Australian residents use the country's public health coverage, leaving an increasingly sick and expensive pool to be covered by private insurance, Scott reports. In response, the government has increased the rebates it provides for patients who choose private coverage.
Australia's health care system also struggles with access to care in rural areas and among the country's indigenous population. But overall, the health care system still performs well in global comparisons, Vox reports. On the Healthcare Access and Quality (HAQ) Index, Australia scored a 95.9, which is higher than the U.S. score of 88. Australia also spends about 50% less per capita annually on health care than the United States.
The Netherlands' managed competition model
The health care system in the Netherlands relies on a managed competition, which uses a combination of private markets and government regulations to control health care costs and maintain care quality, Scott reports. The system involves private insurers, independently employed doctors, and privately owned nonprofit hospitals, which each have to meet strict regulations set forth by the government to ensure care is accessible and low cost.
Does the system work? The country's health system has its challenges, Vox reports. Doctors, particularly primary care doctors who serve as the backbone of the system, have said they feel strained. In 2001, nearly every physician in the Netherlands went on strike because they felt they did not have enough support to provide after-hour care. Some physicians complain about being underpaid, too.
Still, the Netherlands ranks third globally on the HAQ Index. In the Netherlands, more than 99% of residents have insurance.
Taiwan's single-payer health care system
In the 1990s, Taiwan transitioned to a government-run, single-payer health care system. Under the Taiwanese health care system, Taiwanese residents carry a national health insurance card, which allows providers to access a patient's medical records on a computer using a chip reader.
Quality of care: Though a majority of Taiwanese citizens initially disapproved of the transition to single-payer system, today the system has the approval of eight and 10 citizens. Still, it may spread doctors too thin, Vox reports: In Taiwan, the average number of physician visits per year is currently 12.1, which is nearly twice the number of visits in other developed economies. In addition, there are only about 1.7 physicians for every 1,000 - below the average of 3.3 in other developed countries. The shortages are particularly acute in Taiwan's less urban regions.
As a result, Taiwanese physicians on average work about 10 more hours per week than U.S. physicians. Physician compensation can also be a problem, Scott reports. One physician said the demanding nature of his pediatric practice led him to practice cosmetic
Medicine which is more lucrative and paid privately by patients—on the side, Vox reports.
And patients have complaints of their own. For instance, patients note they experience delays in accessing new medical treatments under the country's health system. Sometimes, Taiwanese patients wait five years longer than U.S. patients to access the latest treatments.
United Kingdom's government-run system
The U.K. health system provides health care through single-payer model that is both funded and run by the federal government. The result, as Vox's Ezra Klein reports, is a system in which "rationing isn't a dirty word."
Does the system work? The U.K. scores 90.5 on HAQ index, higher than the United States but lower than Australia. While Klein notes that the U.K. system is "underfunded," research has shown that residents largely support the system. "[NICE] has made the UK system uniquely centralized, transparent, and equitable," Klein writes. "But it is built on a faith in government, and a political and social solidarity, that is hard to imagine in the US.