# What percentage of industrialized countries have socialized health care? **URL:** \ **Category:** Factual Questions\ **Created:** [October 9, 2013, 11:11am UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765 "2013-10-09T11:11:53Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [October 10, 2013, 4:31am UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/21 "2013-10-10T04:31:28Z")
> [@filmstar-en](#): > > In the UK there were several local government schemes for socialised healthcare before WWII. The sentiment arose, I think from the after affects of WWI which left an awful lot of widows and disable veterans. Then the depression of the 1930s when there were hunger marches from destitute communities in the industrial north petitioning the government to take responsibility for the welfare of the people. > > There were a whole series of national reforms covering education, welfare, pensions much of it initiated by the dominant Liberal party at the time. Considering that the last time the Liberals won a majority government was in 1906, it’s doubtful they were the dominant party in the inter-war years. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [October 10, 2013, 4:49am UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/22 "2013-10-10T04:49:06Z")
Aother model not yet mentioned is Switzerland. Switzerland instituted a health insurance mandate in the mid-1990s, with subsidies to keep premiums at about 8% of income. Initially it was disliked and fought, but now is accepted and efforts to remove it have failed. (There is no employer provided coverage, everyone is in the tightly controlled individual market.) ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [October 10, 2013, 4:56am UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/23 "2013-10-10T04:56:27Z")
> [@sisu](#): > > In Australia there is a standard Medicare charge for seeing a doctor but almost every doctor I know charges more. You pay the gap, doctors that bulk bill with no out of pockets tend to be pretty flat out and don’t offer the level of service most people desire. > > We also have a levy (tax) as a percentage of salary, I also have private health care to cover me for private hospitals, dentist, chiro, elective surgery etc that are not covered by Medicare. Again most people have this on top of Medicare. So what happens when you have to go into the hospital, and the hospital bills you 10% of that $1500/day for the week you’re in there; and the doctor -surgeon and anaesthetist, the emergency room doctor, etc. - all want to slap you with a few hundred extra? Come out of the hospital a few thousand lighter than when you went in? I’m guessing Australia has not reached the point of the Ontario system, where fees were reaching over 20% of billing amount, and 80% of doctors extra-billed before the government stepped in. Why would you pay taxes for the privilege of paying out of pocket? The employers started complaining too, because they did not want to be sucked into a USA-style system where not only did we pay high taxes for no reason, but then they had to offer benefits to cover the extra costs. Plus in the long run it benefits the doctors - they know what is covered, there’s one set of forms, no need to chase people for money, deal with cash, argue with a fifty different health insurers over whether they would be reimbursed for a procedure, etc. The single system keeps everyone honest. The middle class does not ignore Medicare shortcomings as “just the poor’s problem”, if the government fails to keep the system useful, the electorate will let them know… Politicians can bypass the system for private care at their peril. When one prominent Conservative backroom operative got a heart transplant about 20 years ago, there was some serious screaming about whether he’d jumped the queue. ---
**Author:** ![sisu](https://avatars.discourse-cdn.com/v4/letter/s/df705f/32.png) [@sisu](https://boards.straightdope.com/u/sisu)\ **Post date:** [October 10, 2013, 5:49am UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/24 "2013-10-10T05:49:36Z")
In a public hospital you don’t have out of pockets, in a private one or if you are in a public as a private patient you do. The alternative is raise the taxes higher and at least this way we have the market to push higher services. This way I can bypass the waiting list for elective surgery, for example me ex wanted a knee reconstruction, the public waiting list was about 12 months (and it would have costs zero) but the private could be done in about 2 (with some out of pocket). So in some respects we have a two tiered system, but Australia is a rich country and most people have private health care. In fact you are penalised if you don’t have it after turning 30. A GP is what I meant by a doctor, not a hospital visit. ---
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [October 10, 2013, 6:53am UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/25 "2013-10-10T06:53:16Z")
I asked a [similar question](http://boards.straightdope.com/sdmb/showthread.php?t=656950) the other day. And the largest GPD-per-capita nation after the US that does NOT have universal healthcare is [Turkey](http://boards.straightdope.com/sdmb/showpost.php?p=15222946&postcount=10). ---
**Author:** ![Ken001](https://avatars.discourse-cdn.com/v4/letter/k/43a26b/32.png) [@Ken001](https://boards.straightdope.com/u/Ken001)\ **Post date:** [October 10, 2013, 8:10am UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/26 "2013-10-10T08:10:10Z")
In New Zealand we have universal healthcare. Hospitals are free as is the treatment. Doctors (GPs) are paid a base sum per consultation ($15?) and the patient is billed the rest - usually $45. Children and elderly $20. Nevertheless we have private hospitals and private healthcare insurance for those who can afford it. Plus there are plenty of surgeons and specialists willing to take on private patients. The way our system works is a surgeon may spend two days in a public hospital and then time in his consulting rooms and two days in a private hospital. The reason people have health insurance is to cover elective (non-urgent or by choice) operations. In the public system you typically have to wait 6 months to be attended to whereas its 3 -6 weeks in a private hospital. And private is rolls royce - hot and cold running nurses, only the best hallucinogenics, soft pillows sigh… 😃 ---
**Author:** ![filmstar-en](https://avatars.discourse-cdn.com/v4/letter/f/50afbb/32.png) [@filmstar-en](https://boards.straightdope.com/u/filmstar-en)\ **Post date:** [October 10, 2013, 12:09pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/27 "2013-10-10T12:09:53Z")
> [@Northern\_Piper](#): > > Considering that the last time the Liberals won a majority government was in 1906, it’s doubtful they were the dominant party in the inter-war years. If you look up the career of that great Welshman LLoyd George, he led the post war coalition up until 1922. He launched a whole tranche of social reforms. There were proposals for a UK version of the US New Deal. Again in WW2, another coalition and we had hugely influential Liberal figures like Beveridge who outlined the social reforms which were to become known as Welfare state. There was another (sometime) Liberal who also supported these reforms…Winston Churchill. These social reforms were initiated not by a party with a socialist ideology like the Labour party, but by the mainstream Liberal party as a matter of popular social justice and nation building. There was pretty much a consensus that this was the way forward. Socialism took the whole concept much, much further extending state ownership into parts of the economy where a free market would have been a better, much more efficient. The UK economy was pretty much hamstrung by this ideological wrangling for decades. Other European countries had a much more pragmatic approach. The USA had the same sort of dynamics before WW2 with the New Deal, but it did not survive into peacetime. I am guessing because while the European states were still trying to deal with feeding people and dealing with bankrupt economies devastated by war, the patient was still in ‘intensive care’. The US meanwhile was on the crest of wave of prosperity and economic expansion. So little appetite for state intervention when everything is running free and going well and people have money in their pockets? ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [October 10, 2013, 12:25pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/28 "2013-10-10T12:25:37Z")
> [@sisu](#): > > In a public hospital you don’t have out of pockets, in a private one or if you are in a public as a private patient you do. The alternative is raise the taxes higher and at least this way we have the market to push higher services. This way I can bypass the waiting list for elective surgery, for example me ex wanted a knee reconstruction, the public waiting list was about 12 months (and it would have costs zero) but the private could be done in about 2 (with some out of pocket). > > So in some respects we have a two tiered system, but Australia is a rich country and most people have private health care. In fact you are penalised if you don’t have it after turning 30. > > A GP is what I meant by a doctor, not a hospital visit. This was the fear that lead to the effective exclusion of private health care completely from the Canadian systems. If a doctor can do an operation for the government fee on Mondays, and do the same work and charge twice as much at a private clinic on Tuesdays - how do you know you’re getting the best care? Is there collusion to push the ones who can afford it out of the public system to the private one? Why should I pay taxes to get the equivalent of that American $15,000-a-year health care, then pay extra on top of that? Is the doctor selecting patients who need help, or patients who can pay more? Oddly enough, some doctors can be greedy self-centered dicks, just like real people. What does health care insurance cost for a typical Australian family of 4? How about for someone after a heart attack? (do you have the same USA pre-existing condition issues?) I assume the government still pays the lion’s share of costs, even in private clinics and to extra-billing doctors. However, where’s the incentive now for the government not to get cheap on its fee schedule, thus dumping progressively more costs on the individual and their insurance? ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [October 10, 2013, 12:34pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/29 "2013-10-10T12:34:19Z")
> [@filmstar-en](#): > > If you look up the career of that great Welshman LLoyd George, he led the post war coalition up until 1922. > … > Again in WW2, another coalition If the only time you’re in power is via coalitions, you’re not the dominant party. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [October 10, 2013, 12:55pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/30 "2013-10-10T12:55:01Z")
If you’re in power every time and the rest of the players change, yes you are. And sometimes you can manage to make the whole rest of the country dance to your tune despite being an extreme majority, because you have a key vote. There’s been quite a few examples in recent years in multi-party locations, but I don’t want to hijack the thread. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [October 10, 2013, 1:38pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/31 "2013-10-10T13:38:20Z")
Not in the context of the British Westminster system, which favours majority governments. ---
**Author:** ![Hari\_Seldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hari_seldon/32/5173_2.png) [@Hari\_Seldon](https://boards.straightdope.com/u/Hari_Seldon)\ **Post date:** [October 10, 2013, 3:37pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/32 "2013-10-10T15:37:07Z")
One thing to point out is that Canada has not one, but 13 health care systems, with different rules in each province and territory. They are similar. In Quebec, extra billing is forbidden and doctors are either in or out. I have used private doctors on a few occasions (if you require a house call for any reason, you have no choice). Doctors still get paid on a fee-for-service basis (which could change to inhibit unnecessary procedures) and hospitals get an annual budget that they have to live within. You don’t see hospitals here running two-page spreads in slick magazines to drum up business, nor do they compete with luxury hotels. You get a bed and you get basic bland meals and whatever medical you require. Now let me add my 2c on “socialism”. To me, the word is properly used as in “Britain socialized the coal and steel industries.” In other words, it is bordering on communism to socialize everything, but you can have a limited socialism and it doesn’t bother me. For Obamacare (Romneycare, whatever) to socialistic, they would have to socialize the insurance industry, or at least the health insurance industry. I guess it is correct that Quebec has socialized the health insurance and hospital industries, as well as car liability insurance. But really, is silly to argue over a word. Obama has not socialized anything nor has he proposed to. If I were in his shoes, I would have insisted on equity positions in any bank that was bailed out, but even that is long way from socializing them. ---
**Author:** ![Schnitte](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/schnitte/32/9033_2.png) [@Schnitte](https://boards.straightdope.com/u/Schnitte)\ **Post date:** [October 10, 2013, 4:36pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/33 "2013-10-10T16:36:32Z")
> [@md2000](#): > > I’ll steal a page from Justice Roberts, then - a “health care premium” which is a proportion of your income and mandatory and bears no resemblance to payout… is a tax, pure and simple. For a government paid service. If the only way out is special qualification and buying an equivalent service - still a tax. I fully agree with that. For the payer, it doesn’t really make a difference if his percentage-of-income levy is styled a “tax”, an “insurance premium”, a “public healthcare contribution” or whatever; it is, in substance, a tax. But since you said this in response to a post of mine, I’d just like to reiterate the point that quite a significant percentage of the German population is in the private health insurance pillar of the two-tiered system and pays premiums that are not computed on the basis of income but on the basis of the risk you represent to the insurer, very much as in car insurance or any other insurance that deserves this word. You may, in some some sense, call it an opt-out of a tax-financed healthcare scheme. Interestingly enough, some of the patients who are eligible for this scheme are legally obliged to get it (but free to choose the provider), whereas others aren’t (mostly self-employed people), meaning that the German system is not strictly “universal”. ---
**Author:** ![Esco](https://avatars.discourse-cdn.com/v4/letter/e/9de053/32.png) [@Esco](https://boards.straightdope.com/u/Esco)\ **Post date:** [October 10, 2013, 4:42pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/34 "2013-10-10T16:42:31Z")
> [@chappachula](#): > > I think a better way to phrase the question would be: > “can anybody name an industrialized country which does _not_ provide government health care to all its citizens”? > > As far as I know , the only country on that list would be the USA Yeah, pretty much. And the US is also the richest country in the world, go figure ---
**Author:** ![Doughbag](https://avatars.discourse-cdn.com/v4/letter/d/aeb1de/32.png) [@Doughbag](https://boards.straightdope.com/u/Doughbag)\ **Post date:** [October 10, 2013, 4:50pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/35 "2013-10-10T16:50:47Z")
> [@Esco](#): > > Yeah, pretty much. > > And the US is also the richest country in the world, go figure Some are rich - lots are poor. You’re sick and lose your house - awesome system Your employer fires you, you lose health insurance while having a chronic health issue – no insurance will then cover you – prepare to die - awesome ---
**Author:** ![suranyi](https://avatars.discourse-cdn.com/v4/letter/s/e36b37/32.png) [@suranyi](https://boards.straightdope.com/u/suranyi)\ **Post date:** [October 10, 2013, 4:55pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/36 "2013-10-10T16:55:01Z")
> [@Hari\_Seldon](#): > > One thing to point out is that Canada has not one, but 13 health care systems, with different rules in each province and territory. They are similar. In Quebec, extra billing is forbidden and doctors are either in or out. I have used private doctors on a few occasions (if you require a house call for any reason, you have no choice). Doctors still get paid on a fee-for-service basis (which could change to inhibit unnecessary procedures) and hospitals get an annual budget that they have to live within. You don’t see hospitals here running two-page spreads in slick magazines to drum up business, nor do they compete with luxury hotels. You get a bed and you get basic bland meals and whatever medical you require. > > Now let me add my 2c on “socialism”. To me, the word is properly used as in “Britain socialized the coal and steel industries.” In other words, it is bordering on communism to socialize everything, but you can have a limited socialism and it doesn’t bother me. For Obamacare (Romneycare, whatever) to socialistic, they would have to socialize the insurance industry, or at least the health insurance industry. I guess it is correct that Quebec has socialized the health insurance and hospital industries, as well as car liability insurance. But really, is silly to argue over a word. Obama has not socialized anything nor has he proposed to. If I were in his shoes, I would have insisted on equity positions in any bank that was bailed out, but even that is long way from socializing them. I have used a private doctor in Montreal once. I’m an American and so obviously not part of the Quebec (or any Canadian) medical system. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [October 10, 2013, 5:38pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/37 "2013-10-10T17:38:24Z")
> [@Hari\_Seldon](#): > > One thing to point out is that Canada has not one, but 13 health care systems, with different rules in each province and territory. They are similar. In Quebec, extra billing is forbidden and doctors are either in or out. The health care delivery is a provincial responsibility, but to get federal funding, the provinces have to comply with the principles of the Canada Health Act. That Act doesn’t forbid extra-billing, but if a province permits doctors to extra-bill, the Act provides that the feds can reduce the amount the feds will pay to that province. [The CHA has effectively ended the practice of extra-billing across Canada.](https://en.wikipedia.org/wiki/Canada_Health_Act#Violations_and_penalties) ---
**Author:** ![Mk\_VII](https://avatars.discourse-cdn.com/v4/letter/m/5f9b8f/32.png) [@Mk\_VII](https://boards.straightdope.com/u/Mk_VII)\ **Post date:** [October 10, 2013, 5:45pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/38 "2013-10-10T17:45:28Z")
‘socialised’ is not a word we would use here about industries (or medicine). It’s what you do when you go around your friend’s place with a pack of beers. ---
**Author:** ![ruadh](https://avatars.discourse-cdn.com/v4/letter/r/d2c977/32.png) [@ruadh](https://boards.straightdope.com/u/ruadh)\ **Post date:** [October 10, 2013, 6:13pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/39 "2013-10-10T18:13:42Z")
In Ireland, unless you earn below minimum wage, primary health care is run on pretty much a free-market basis: you pay out of pocket to see your GP, who can charge you whatever they like. My GP charges €55 per visit (currently around $75 US) and I understand she’s one of the cheaper ones. Not surprisingly, this has the effect of keeping a lot of lower-income people from seeing a doctor when they need one. Once you get sick enough to be hospitalised or develop one of a few specified long-term illnesses, though, _then_ you get free public health care. ---
**Author:** ![Gullible\_s\_Travels](https://avatars.discourse-cdn.com/v4/letter/g/9de0a6/32.png) [@Gullible\_s\_Travels](https://boards.straightdope.com/u/Gullible_s_Travels)\ **Post date:** [October 10, 2013, 9:41pm UTC](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765/40 "2013-10-10T21:41:31Z")
> [@md2000](#): > > This was the fear that lead to the effective exclusion of private health care completely from the Canadian systems. If a doctor can do an operation for the government fee on Mondays, and do the same work and charge twice as much at a private clinic on Tuesdays - how do you know you’re getting the best care? Is there collusion to push the ones who can afford it out of the public system to the private one? Why should I pay taxes to get the equivalent of that American $15,000-a-year health care, then pay extra on top of that? Is the doctor selecting patients who need help, or patients who can pay more? Oddly enough, some doctors can be greedy self-centered dicks, just like real people. > > What does health care insurance cost for a typical Australian family of 4? How about for someone after a heart attack? (do you have the same USA pre-existing condition issues?) I assume the government still pays the lion’s share of costs, even in private clinics and to extra-billing doctors. However, where’s the incentive now for the government not to get cheap on its fee schedule, thus dumping progressively more costs on the individual and their insurance? Not sure how much it costs for a typical family - I don’t have private health insurance, I’m happy to use the public system. There is no additional or different premium because you’ve previously had a heart attack or any other medical condition. It’s the same whether you’ve never been sick a day in your life or whether you’ve had numerous and severe health problems all your life. It was mentioned earlier that after age 30 you are penalised for not having private insurance. It’s not actually that you’re penalised for not having it - it’s that if you delay obtaining private insurance until after age 30, your premiums will have a ‘loading’ of 2% for every year after age 31 that you first took out the insurance. Maximum loading is 70%. You can have ‘gaps’ in cover of a total time of 3 years without any penalty on the loading. If you maintain the insurance for 10 years, the loading is removed from your premium. There’s no penalty for not having private insurance unless you have a high income in which case you have to pay a Medicare levy surcharge unless you take out private insurance. The idea is to encourage high income earners to obtain private insurance and ‘reduce the burden on the public system’. So in that way, yes, they are trying to push more people towards private insurance. Although it must be said that even if you have full private insurance, you don’t have to use it. Sometimes people with insurance don’t in fact use if for hospital stays because there are no charges at all if you go in as a public patient and there’s always gap payments (some can be quite high) when you’re a private patient. I think the government would love to push more costs on to the individual but there will be a point where that becomes too unpopular politically. The government of the day has so far been fairly reluctant to do more than minor tinkering lest they get thrown out of office. Time will tell if that continues I guess. [Previous page](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765.md?page=1) [Next page](https://boards.straightdope.com/t/what-percentage-of-industrialized-countries-have-socialized-health-care/670765.md?page=3)