When considering a move abroad, there is much to research and weigh up; from cost of living and employment to housing and culture. Healthcare can be a particular concern, especially for those travelling overseas with family. We have explored some of the most popular expat destinations with particular focus on accessibility and affordability of healthcare as well as the overall standard.
Australian healthcare is provided through a combination of public funding and private insurance, offering the best of both worlds. Any permanent resident is entitled to funded healthcare with the state covering around 75% of primary care and almost all hospital visits. This is partly financed by a 1.5% income tax (2.5% for higher earners) but largely government funded.
If you have a temporary visa then you will need to take out private health insurance to cover any medical costs. If you are a permanent resident, you may still chose to take out health insurance as, like half of all Australians, you may want to ensure any additional costs for you or your family are covered. There is also a tax rebate of up to 40% on such insurance as an added incentive.
This clear and fair system means Australia has one of best funded and most cost effective health systems in the world with well trained, fairly paid staff and state of the art facilities carefully balancing value for money and patient choice.
With a public health system even older than the UK’s NHS, it is no wonder that New Zealand is proud of its world-class health service. New Zealand has, however, operated a dual private/public system since the seventies in order to ensure financial balance as well as universal access.
Access to emergency and hospital treatment is free for all permanent residents and anyone with a work visa valid for two or more years. Visits to your GP and prescriptions are not free, although they are heavily subsidised. A doctor’s appointment will typically cost around £25, although there are further subsidies for children with under-sixes treated for free. Many living in New Zealand do, however, take out health insurance to ensure speedy treatment and avoid unexpected expense.
New Zealand also operates a unique system whereby any costs incurred through accidental injury are reimbursed through the Accident Compensation Committee. Anybody in New Zealand legally, be they tourist, temporary worker or permanent resident can claim compensation. This system allows the government to keep spending to a minimum and ensuring it has one of the lowest cost per capita rates for healthcare in the world. In spite of this, it remains committed to giving everyone access to medical care regardless of his or her financial background.
The US is a world leader in areas such as medical innovation and diagnosis. They boast the highest survival rates in the world for several types of cancer, more MRI and CT scans per capita and are consistently at the forefront of medical technology, research and treatment.
The US system has often been viewed as bureaucratic and costly but recent changes have begun to make healthcare simpler, fairer and cheaper. The Affordable Care Act and the now legal requirement for all citizens and residents to have health insurance have marked a shift in attitude and policy
Naturally, the best treatments, hospitals and doctors come at a cost and the US spends more on healthcare per head than any other developed country. Good health insurance is essential but if you are travelling to the US for work, it is likely that you will be able to sign up to your employer’s group plan which will offer the best value for money as your employer will contribute towards the cost.
Like the UK, Canada established a universal, state funded health system in the 1940s and, while it has undergone a few changes in the last two decades, Canadians are still rightly proud of the affordability and equality of their health system. While only spending 11.4% of GDP on healthcare, compared to 17.3% in the US, it manages to outperform in key indicators such as life expectancy and infant mortality.
‘Medicare’ ensures anyone working in Canada for six months or more will receive basic and emergency medical care for free. Levels of treatment covered and waiting times vary from province to province, but the standard is generally high. New arrivals will also need to take out private insurance to cover the few months it can take to apply for and receive your Medicare card. All permanent residents and their families should be eligible as are temporary workers, although families of temporary workers are not covered.
Private health insurance is becoming increasingly popular as it allows greater choice and faster treatment. Also, if you will be travelling between provinces, you may need to take out health insurance to ensure you have cross-Canada cover for you and your family.
France is a world leader in medical research with hundreds of ground-breaking discoveries from antibiotics to HIV. The health system was named best in world in both 1997 and 2000 by the WHO and its state of the art hospitals are clean, well staffed and well equipped.
If you live and work in France for three months or more, you are entitled to sign up for state medical cover, ‘Couverture Maladie Universelle’ (CMU). This allows you to claim back around 70% of GP costs and 80% of hospital costs and is paid for through a 6-7% levy on salaries. Retirees with an E121/S1 card are also entitled to sign up for CMU.
Most residents, both nationals and expats, also take out ‘top-up insurance’ to avoid the additional costs not covered by CMU. Whatever you decide to do, rest assured that you will receive excellent treatment without extortionate costs.
As you’d expect from Europe’s largest economy, Germany’s health system is advanced and efficient. Treatment times are amongst the fastest in the world and standards are consistently high. Established in 1880, the health system is the oldest in Europe and still upholds the principal of a fairness and accessibility.
Health insurance is a legal requirement for both nationals and expats although an international policy will not cover treatment in Germany. If you earn under around €56,000, you can sign up to one of the 130 or so public insurance schemes which are paid jointly by both you and your employer. This public insurance is amongst the most comprehensive in the world, covering pre-existing conditions, chronic illness and elderly care. If you earn more, you will, however, need to sign up for private insurance.
The 2014 Euro Health Consumer Index rated the Netherlands as the best in Europe for healthcare. It ranked highly in several areas including waiting times, accessibility, outcomes and patient rights.
Health insurance is statutory and split into ‘basic insurance’ (Zvw) which is usually paid for through a 12.65% deduction from your salary and long term nursing and care (AWBZ) which is paid for through specific taxation and employer contributions.
Providing you have basic insurance, the costs of GP appointments and maternity care are completely covered, although you may need to pay an excess for other services. Those working in the Netherlands for less than a year will also need private insurance.
If you’re seeking a healthier lifestyle, Norway has consistently been voted the best country to live in by the UN Development Program. Doctors and nurses are trained to the highest standard and facilities are state of the art.
Permanent residents are required to sign up to the national insurance program which entitles them to free healthcare, from GPs to hospitals admissions, although you are expected to pay an excess for the first £175 of any fees incurred. Once you have exceeded this limit, you are given a ‘free card’ which entitles you to free treatment for the remainder of that calendar year. Care for children under 16 and expectant mothers is entirely free.
Spain has a long established, world-class health system with well-equipped hospitals and highly trained staff. While southern Europe was undoubtedly rocked by the financial crisis, the quality of care in Spanish hospitals and surgeries has not dropped in the slightest.
Anyone living and working in Spain is entitled to free healthcare paid for partly through social security contributions deducted from your salary and partly through tax funds. If, like thousands of Britons, you are considering spending your retirement in Spain, private health insurance is strongly advised. To ensure you are covered and get the most cost effective deal, it is worth researching and taking out insurance before you travel.
The UAE prides itself on the standard of care offered to both Emirati and the large expat population. The hospitals are state of the art and doctors and nurses are well trained and often multilingual.
Over the next few years, a law will come into force requiring all employers to ensure all employees and any dependant spouses and children have medical insurance. If your employer does not yet offer this, you can purchase a health care card for around £100 each year which entitles the holder to free emergency care and reduced cost general care.