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Over a decade ago, in 2010, former President Obama signed the Affordable Care Act (ACA). The main purpose of ACA health coverage was to create a form of federal health insurance that was more affordable to more people, further expand Medicaid to citizens, and assist with the innovation of health care to lower costs nationwide. The United States is the third most populous nation in the world, over 330 million individuals (as of 2022). However, only around 13.6% of people have coverage related to the ACA. With this in mind, we wanted to share some interesting facts comparing the US’ ACA health coverage with other countries and their healthcare programs.
Germany
According to data taken by the OECD (Organisation for Economic Co-operation and Development) in 2021, the top 5 nations worldwide that have the highest percentages of GDP spent towards health are, from first to fifth respectively, the United States (17.8%), Germany (12.8%), France (12.4%), the United Kingdom (11.9%), and Canada (11.7%).
In Germany, the main program for government healthcare is statutory health insurance (SHI), or as the German say, Gesetzliche Krankenversicherung. Today, around 90% of the German population are members of their national healthcare program! Only roughly 4.3% of individuals receive complete coverage from private insurance companies.
SHI does not require people to provide upfront payments to receive benefits, unlike the ACA, where individuals must pay premiums before receiving insurance assistance.
Fun Fact: Statutory health insurance was formed under Bismarck’s Health Insurance Act of 1883, making Germany the first country to have a social health insurance system!
France
Similar to Germany, France’s national healthcare program is also a Statutory Health Insurance system known as l’Assurance Maladie. The main program that states all citizens have automatic rights to health care is the Protection Universelle Maladie (PUMa).
While the SHI does cover most medical needs, it does not cover it all. That’s where Voluntary Health Insurance (VHI) comes in. Around 95% of the French population utilizes VHI to assist with medical coverage in addition to SHI.
The ACA states that the yearly out-of-pocket limit is $9,450 per individual and $18,900 for families. In France, the SHI typically covers around 70 to 80% of costs and individuals pay around 20 to 30% out-of-pocket. While 20-30% sounds like a high amount, French citizens pay less than their American counterparts due to the usage of VHI. However, French citizens pay a much higher income tax than US citizens.
United Kingdom
United Kingdom’s universal healthcare system is called the National Health Service (NHS). This system provides free healthcare coverage to all permanent residents of the region. Taxation is responsible for all payments and taken from about 4.5% of all citizens’ income. That said, multiple countries comprise the UK, including: Wales, Scotland, England, and Northern Ireland. Each country has some varying systems. For example, the NHS supplements most of England’s healthcare. Also, the Health and Social Care (HSC) funds Northern Ireland’s healthcare system.
In comparing the US and UK healthcare systems, the US healthcare system is the most expensive worldwide and does not offer universal health insurance. Meanwhile, the UK provides coverage for every citizen, unlike the ACA, which accounts for less than half of all citizen’s coverage. In most cases, the US has better, quicker treatments and several private insurance options available for citizens to choose from compared to those in the UK.
Canada
In Canada, they utilize a publicly funded healthcare system known as Medicare. Unlike the US, this program and system is universal to all Canadian citizens and provides medical coverage with zero out-of-pocket fees. Plans and exact coverage details will vary from territory to territory among the 13 provinces.
The biggest difference between the US and Canadian healthcare systems is that ACA will help cover medical fees while Canada’s Medicare covers everything 100%. However, because plans vary between each territory, there may be some services that one territory will cover while another will not. Due to this, 90% of Canadian citizens still have a form of private health insurance. The majority of US citizens partake in what is known as private for-profit insurance. In 2021, the average amount spent for medical expenses for US citizens was $12,914 per person, while Canada was around $6,500 per person.
Have Health Insurance Questions?
We hope that this information comparing the United States ACA health coverage to other nations’ was interesting to you.
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