Is Free Healthcare a Possibility for International Citizens or Travelers?
They say that the best things in life are free – but does that really apply to healthcare? The idea of free healthcare seems far too good to be true. But in actual fact, there is a long list of countries that offer free healthcare, universal healthcare, or even both. However, the extent to which travelers and expats can take advantage of these generous services varies widely. Here’s what all travelers should know.
Is “Free” Really Free for Foreigners Abroad
It’s important to note that “free” healthcare isn’t actually quite so free. Healthcare that is provided by government agencies is indirectly funded by citizens. Their taxes support all government operations, including healthcare expenditures. Savvy travelers know not to make offhand remarks about how lucky local residents are to have “free” healthcare in their country. You never know when you might get a sarcastic remark about how their tax bill didn’t seem so free!
Furthermore, in many countries with free healthcare, patients often pay a small fee or deductible each time they visit the hospital or doctor. Sometimes patients have to pay in advance and then submit reimbursement forms with the government. Therefore, free healthcare often does require money.
Understanding Free vs Universal Healthcare
Free healthcare is also different from universal healthcare. The terms are often used interchangeably but there are differences.
- Free Healthcare means that all citizens receive health care at no cost or a very minimal cost.
- Universal Healthcare means there is a health care system that provides coverage to at least 90% of citizens
Both of the above are subsidized programs typically paid for by the citizens of the country via taxes.
One form of universal healthcare is when the government pays for the healthcare needs of its residents (aka “free” healthcare). This is often called the “single-payer” system. But this is not the only method. A country may have universal healthcare, in a sense, through legislated, expensive mandatory insurance coverage. A country may also have a basic level of universal health care, however, in reality, the majority of citizens still purchase supplemental global health insurance to ensure an appropriate standard of care.
Where Can You Find Free Healthcare?
According to the STC report, all but 43 countries in the world offer free or universal healthcare. However, the standards among these countries can vary widely. The list includes everyone from Norway, one of the healthiest countries in the world and the first country in the world to introduce free healthcare in 1912, to Yemen where raging conflict has made healthcare from international relief agencies nearly impossible to access.
List of Countries Offering Universal Health Care Systems
Please note. Not all citizens or residents receive free healthcare in all of these countries. In many of these countries, employers and individuals share in the cost of healthcare through contributions, cost-share arrangements, co-pays, and other related fees. However, the goal with these programs is to make healthcare as affordable and accessible as possible for the largest number of people – “Universal Care”.
Countries With Universal Healthcare
- Canada (Canadian Health Care System)
- France (French Healthcare System)
- Germany (German Healthcare System – GKV)
- Hong Kong
- Ireland (Healthcare System in Ireland)
- Italy (Healthcare System in Italy)
- Japan (Japanese Healthcare System)
- New Zealand (New Zealand’s Healthcare System)
- Portugal (Healthcare System in Portugal)
- South Korea
- Spain (Healthcare System in Spain)
- Sweden (Sweden’s Healthcare System)
- United Arab Emirates
- United Kingdom (Healthcare System in the UK)
Source: New York Dept. of Health: “The (above) listing is provided as a courtesy to use as a reference when determining the applicable surcharge on services provided to foreign patients. If the patient resides in any of the countries listed, then that patient may be a part of the country’s national healthcare system, rather than be insured through a private insurer. If they are part of the country’s national healthcare system, that country is deemed to be an unspecified payor and subject only to the current elector surcharge rate which is payable to the provider of services.”
Is Healthcare Ever Free for Visitors?
What does this mean for travelers and expats? Travelers must do ample research on their intended destinations and not make any assumptions. Just because a country offers free health care for its citizens doesn’t mean that travelers have any coverage at all. For instance, healthcare in Canada can be tremendously expensive for uninsured travelers and also for Canadian citizens who have returned from an extended time abroad and have yet to reapply for their free provincial health insurance card. On the other hand, a visit to a public hospital in Europe might cost a traveler nothing more than the promise to return the crutches loaned out as part of treatment for a sprained ankle.
Often, public hospitals have a mandate to never refuse emergency care or deny treatment on the basis of ability to pay. However, those same hospitals may have a broad interpretation of what “ability to pay” may mean and can draw a fine line between what is a true emergency versus simply a very pressing and uncomfortable situation. It is far better to be prepared with the knowledge and comprehensive insurance and then have a very pleasant surprise if you do not receive a treatment bill as opposed to finding yourself unprepared and praying your credit card payment will go through.
Related: Visitors Insurance Coverage
Quality and Affordability
Of note, on this list of the countries with the best healthcare systems and standards in the world, all countries offer free healthcare. The list includes countries such as Israel, Qatar, Singapore, France, and Australia. However, none of the countries on the list offer unlimited healthcare to travelers. Nor are any of those countries on this list the most affordable with regards to out-of-pocket health care costs. For travelers who are willing to accept the pros and cons of paying for health care as they go, they’re better off focusing on countries with very affordable healthcare, not countries with theoretical “free” healthcare.
Free Healthcare in Unexpected Places
Last but not least, travelers will want to note that excellent, affordable health care services can often be found in unexpected places, all over the world. Public health campaigns may offer free influenza or tetanus vaccines to anyone and everyone who shows up for a community immunization day. International border crossings may have a health care bureau that offers free malaria testing and treatment. University-based student health clinics may also provide free sexual health services to anyone who requests them. You never know when you might stumble across an opportunity to enhance your health at no extra cost!
- Best International Medical Insurance Companies
- Comprehensive Global Medical Plans
- Expatriates Guide to International Health Plans
- Health Insurance When Working Abroad
Sources: STC Consulting who states: The vast majority of the data was taken from the World Health Organization World Health 2018 Statistics Monitoring http://www.who.int/ and data on Global Food Security Index by the Economist Intelligence Unit.
Written by Joe Cronin. Joe Cronin is an expert in the areas of global health and international insurance, with specific expertise in advising individuals and groups on international health insurance plans. Follow Joe @Joe_Cronin_Jr