Belgium's healthcare system is rated by Expatica.com, a UK expatriates web site, as having one of the best healthcare systems in Europe. Dating from 1945, its quality is largely down to its sponsorship by competing mutuals, and provisioned by a mixture of state and non-profit hospitals. Each mutual is funded by the state, the funding dependent on its membership numbers.
Like the system in France, citizens pay and swipe a health card at the point of care. They are then reimbursed between 50% and 75% of the costs by their mutuelle/mutualiteit scheme. Some GPs and hospitals have local arrangements with mutuals to reduce payments at the point of care.
Also as in France, most citizens also sign up for mutual insurance to top up their healthcare reimbursements (complimentaire).
As in Germany, Belgian citizens can visit any healthcare establishment they wish - quite literally walking in off the street, although referrals from private or practice-linked GPs are increasingly being used, and language pays a major part in choices.
Like the UK, France a two-tier healthcare system, with a state-run equivalent of the NHS - Couverture Maladie Universelle (CMU) - and the private sector. In 2000, the World Health Organisation said it ran the best national healthcare system.
Almost all state health interactions are carried out using a smart card (carte vitale). This contains details of you and your family's rights to medical treatment and, like the UK driving licence, comes with a paper form - an attestation - that is used to augment the card in identifying citizens to state-run healthcare professionals.
GP visits cost EUR23 and, after your card is swiped, the money is paid back into your bank account by the state, usually within a few days. Currently one euro is 'voluntarily' withheld to fund a number of worthy healthcare activities.
Outpatient and pharmacy interactions are similarly smart card enabled, but the carte vitale system reimbursement rate is between 70% and 100%, depending on the type and point of treatment.
Most French citizens belong to a mutual society (mutuelle) that tops up the reimbursement to 100%. The mutual also liaises with the state healthcare operation - the CPAM (Caisse Primaire d'Assurance Maladie) - on reimbursements.
Germany's state healthcare system is the oldest in Europe, dating back to the 1880s. Around 15% of people opt out of the state scheme for private health insurance, usually when they are younger, as premiums are lower.
Citizens pay into one of the 300 statutory state sickness funds through their payroll or bank. Payments are around 13% of gross earnings, although citizens can elect to switch funds to save on premiums with government blessing - people can even compare fund rates online.
Some funds operate on a pay-for-treatment-and reimburse basis, but some treatment centres - notably GPs and hospitals - have arrangements with local sickness funds to save patients paying.
Inpatient stay reimbursements are complex and are not based on treatments, a situation that has caused many experts to suggest health reforms (Gesundheitsreform). The German health care reform law (January 2004) simplified a previously highly complex administration, seeking to reduce paper trails and sickness fund premiums as a result.
Comparing healthcare contribution rate is made more complex because accident (Arbeitsunfallversicherung) and long-term care insurance (Pflegeversicherung) is usually bundled with health insurance by many funds.
The Federal Ministry of Health controls all aspects of state healthcare, organised in a similar structure to the pre-1974 NHS in the UK, with the ministry working directly with hospitals and GPs and with local council delegations in many city areas.
German hospitals operate under diverse ownership, with a mixture of state, private, mutual and friendly societies. Germans can visit any GP or specialist they wish - they can even walk into a specialist clinic off the street.
The unemployed are funded separately though the social fund or the AOKs (Allgemeine Ortskrankenkasse), the local funds of last resort, which cover about one-third of the population.
Spain: The General Health Law of 1986 (Ley 14/1986 General de Sanidad) was formulated on two bases. First, it carries out a mandate of the Spanish Constitution, whose articles 43 and 49 establish the right of all citizens to protection of their health. The law recognizes a right to health services for all citizens and for foreigners resident in Spain.
Second, Title VIII of the Constitution confers upon the autonomous communities broad purview in matters of health and health care. The autonomous communities have first-order importance in this area, and the law permits devolution of these functions from the central government to the autonomous communities, in order to provide a health care system sufficient for the needs of their respective jurisdictions. Article 149.1.16 or the Constitution, a further basis for the present law, establishes substantive principles and criteria that allow general and common characteristics to be consistent throughout the new system, providing a common basis for health services throughout Spanish territory.
Originally posted by finnegan[/b]wow it must be 1879 in America, they guys still were raccoon hats and build log cabins?[b]Belgium
Belgium's healthcare system is rated by Expatica.com, a UK expatriates web site, as having one of the best healthcare systems in Europe. Dating from 1945, its quality is largely down to its sponsorship by competing mutuals, and provisioned by a mixture of state and non-profit hospitals. Each mutual is funded by the state, the funding ...[text shortened]... e new system, providing a common basis for health services throughout Spanish territory.