International Differences in Healthcare Payment

Healthcare is tumultuous. There’s talk among every politician currently campaigning about the Affordable Care Act, what they think of it, and how they would change it. But one thing is certain: many Americans are increasingly looking at other countries’ models of healthcare to determine how they would like to see the American healthcare system evolve.

While there certainly won’t be any drastic changes happening any time soon, it’s important to understand how different countries operate their healthcare systems as our own model continues to evolve.

France and a Public & Private System

France’s healthcare system was ranked as the world’s best in 2000 by the World Health Organization (WHO). The country’s universal healthcare is funded by “required contributions based on income” (that is, income tax). France then reimburses around 70% of medical bills, leaving 30% to be paid by the individual. But many patients don’t simply pay this out of pocket. Instead, they often utilize private insurance to help cover the remainder.

Germany and The Efficient, Required Insurance

Germans are renowned for their engineering skills, and they seem to also have engineered a highly revered insurance system. Like in the US now, all German citizens are required to have health insurance, but they receive their coverage through private, nonprofit funds. Also like the ACA, none of the 200 plans can deny any person coverage based on pre-existing conditions.

About 90% of the country’s population utilizes the nonprofit plan, while 10% (the wealthiest German citizens) can opt out of the system in favor of a for-profit plan. For the non-profit plan, about 8% of Germans’ income is used to pay for the system, while employers match the 8%.

The UK and Socialized Medicine

In Britain, socialized medicine is the name of the healthcare game. Essentially, the government pays for all citizens to have insurance, and the government is also in charge of running hospitals and paying healthcare providers. That’s right: doctors are government employees. British taxes are allocated to these providers via the National Health Service (NHS), which pays for all services rendered for an appointment—particularly preventive and mental care. Even many prescriptions are paid for, though certainly not all of them.

However, it’s not all so simple. The National Institute for Health and Clinical Excellence (NICE) helps determine which services and treatments the NHS will pay for. Based on quality of life improvement, the length of time the treatment will help, and cost, it usually allows most treatments up to $45,000. Beyond that, though, you may be on your own.

Of course, none of these systems are perfect—it’s impossible to build one that is. And it’s certain that the American healthcare system will never emulate any of the foreign systems. The political landscape will continue to shape the system we operate in, and ideally, will continue to work in the favor of both the healthcare providers and the patients you’re caring for.

In the mean time, hospitals must focus on their own revenue cycle management. If you’re interested in how HCM can help you efficiently manage your accounts receivable, contact us today.  


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