In this article, we will be taking a look at the 20 countries with free health care. To skip our detailed analysis, you can go directly to see the 5 countries with free health care.
The U.S. is one of the only advanced countries in the world to not have free healthcare, which is said to cost the country trillions of dollars. According to Public Citizen, if Medicare for All is not implemented, the Federal government will end up spending $42.9 trillion on healthcare in just the next decade alone. The primary reason behind this is that health insurance is generally tied to a person’s employment in the U.S., because of which attempts to make healthcare free have failed consistently. The individual healthcare market in the U.S. is worth an astonishing $1.68 trillion. On the other hand, Europe is home to the most countries with free healthcare.
The healthcare industry is one of the most valuable and important sectors in the world, not just in terms of direct value but also in the indirect value it generates by improving the standard of living in a country. In fact, it was because of healthcare advancements that the world was able to emerge so quickly from the Covid-19 pandemic. At the same time, the pandemic has revolutionized the healthcare industry which is changing rapidly, especially in terms of new technology and innovation.
A healthcare professional discussing a treatment plan with a patient in an outpatient clinic.
According to Deloitte, one of the ways that the healthcare industry is changing is virtual health delivery. One way that the pandemic has changed lives on every level is through increased remote interaction, initially out of necessity and then out of efficiency and cost-effectiveness. While this doesn’t mean that in-person care is being replaced, it will provide new methods of care delivery, and will allow for a reach far greater than what has been possible before, especially in remote areas where there are barely any doctors or healthcare facilities available. The first step in this is electronic health records, followed by using many different digital and tech innovations including machine learning and cloud computing to cut costs and alleviate the shortage of physicians, even in countries with free healthcare as population needs outweigh the number of healthcare staff available in many such countries, including in the UK, whose National Health Service is currently in a crisis due to lack of staff and low payment.
Most of the most profitable pharmaceutical companies in the world have started to incorporate digital and tech solutions in the products and services they provide. This was mentioned by Johnson & Johnson (NYSE:JNJ) in its Q2 2023 earnings call, where it mentioned the pivot to tech solutions stating “This was a strong quarter for Johnson & Johnson with market-leading performance, important advances across our innovative pharmaceutical and medtech pipelines, and a successful initial public offering of Kenvue. We delivered solid sales and earnings growth for the second quarter of 2023, reporting operational sales of 7.5% and adjusted operational EPS growth of 9.7%. These strong results contributed to our confidence in raising our expectations for this year. You may have seen this morning the announcement that we intend to split of Kenvue shares through an exchange offer as the next step in the separation of Kenvue. Joe will provide additional information later in the call. We are excited about entering a new era for Johnson & Johnson, one built around science, innovation, and technology, and strategically focused on pharmaceutical medtech while maintaining our position as the world’s largest, most diversified healthcare products company with 25 platforms over $1 billion in annual sales. And on today’s call, I would like to share recent highlights and achievements from across the business that have contributed to our year-to-date results, as well as upcoming catalysts that give me great confidence in our near and long-term future performance. Starting with medtech. For the second quarter of 2023, we generated 14.7% operational and 9.9% adjusted operational growth, which excludes the impact of the Abiomed acquisition. On a pro forma basis, using sales publicly reported by Abiomed prior to our acquisition, medtech grew 10.2%. These strong results continue to show that our efforts to improve the growth of the medtech business are working.”
While Johnson & Johnson (NYSE:JNJ) has mentioned how well medtech has performed, traditional portfolios haven’t been performing as well, which has led to a decline of nearly 12% in share price YTD. Even then, it is important to remember, especially in uncertain times right now, that the healthcare sector has historically demonstrated resilience even when the economy has been stagnant or declining, as evidenced in 2022 when the MSCI World Index declined by 18.1%, while the MSCI World Health Care Index only declined by 5.4% in the same time period. In the last 7 recession, on average, the healthcare industry has outperformed the overall broader market by 10%, while also delivering above-average earnings growth in similar times.
While major pharmaceutical companies are undoubtedly behind the progress in healthcare available to the world right now, they often also rightly face criticism on medicines being priced too highly for the average person to be able to afford them. While pharma companies do have programs where they provide medicine for free in impoverished countries, medication prices are a huge concern in the U.S., where price caps are not imposed by the government. On one hand, this is beneficial to the development of healthcare as higher prices result in higher revenue and profit, which then allows greater investment into R&D which in turn results in innovation, often times, patients have to bear the brunt of this and costly medicine can even result in people having to forego them in the worst cases.
Having realized this, some prominent personalities and companies are stepping in to make medicine cheaper for the average person. Mark Cuban, a billionaire entrepreneur, started Mark Cuban’s Cost Plus Drugs Company (MCCPDC), which sell medicine for the lowest possible prices to make sure every American has access to the medicines they need. The company is said to have revolutionized the healthcare space in the country and currently has a customer base of more than 1.5 million people, and is looking to engage in manufacturing generic drugs too, possible paving the way for even lower costs. In fact, pharmaceutical companies are even taking a leaf out of MCCPDC by applying similar pricing, while other companies such as Cosette Pharmaceuticals are even partnering with the company to make medicine more affordable.
Similarly, Amazon.com, Inc. (NASDAQ:AMZN), the largest retailer in the world, has slowly started making its presence felt in various industries, and has similarly established itself in the pharmacy sector, by launching Amazon Pharmacy in 2020. Amazon.com, Inc. (NASDAQ:AMZN) aims to make drugs more affordable to the general population and in August 2023, announced that manufacture-sponsored coupons would now automatically be applied to 15 diabetes and insulin medication, which will greatly reduce costs. Amazon.com, Inc. (NASDAQ:AMZN) called out progress in this space in its Q3 2023 earnings call, stating “The Amazon Pharmacy customer experience has significantly evolved this year, and customers are responding that both in their purchasing behavior and qualitative feedback. We built RxPass for customers to get unlimited supply of eligible medications for $5 per month, meaningfully reduce the cost for customers to get insulin and diabetes products, and partnered with Blue Shield of California to offer a first-of-its-kind model to provide more affordable pharmacy care to its 4.8 million members, providing fast and free delivery of prescription medications and 24/7 access to pharmacists. We remain convinced that we can be part of the solution of making healthcare a better customer experience. And our low Earth orbit satellite initiative Project Kuiper, which aims to bring fast, affordable broadband to underserved communities around the world, took a meaningful step forward in the last few weeks with the successful launch of two prototype satellites.”
At the same time, biotech is also where the future of the healthcare industry is moving towards, both in countries with free healthcare and in countries where healthcare is private. One of the largest drug companies in the world, GSK plc (NYSE:GSK) spun off its consumer healthcare business in 2022 and rebranded itself as a biotech company. Keeping in line with trends in the pharma industry, GSK plc (NYSE:GSK) has also placed increased focus on tech which it mentioned in its Q2 2023 earnings call, stating “For me, this really means two bits, first, doubling down on leveraging our scientific capabilities with the use of new platform and data technology; and second, developing our partnering and external sourcing capabilities. With AI and machine learning applications now rapidly maturing access to proprietary data to feed models and generate novel insights as a key strategic differentiator. For example, we recently presented data needs better reversal from the B-Clear Phase IIb trial. This deep multimodal analysis helped us to develop a clear heterogenous [ph] the chronic hepatitis B, stratifying individuals treated with the [indiscernible] set topsa highly enriched response — a mixed response and a non-responsive, each defined by distinct clinical, urological and molecular trajectories and associated with a number of markets. These predictive models provide greater precision in existing markets and suggest potential enrichment strategies. We’re competitively placed in platform technologies and have laid strong foundations in data technologies. I want us to vigorously scale and build on these foundations to better derisk targets and rapidly test and progress high-quality first-in-class candidates, all with the aim of accelerating and improving success rates of our department progress.” GSK plc (NYSE:GSK) has seen its share price increase by over 4% YTD 2023, illustrating the trend of biotech stocks outperforming other stocks in the healthcare sector, with biotech stocks returning 10.3% in 2022, as opposed to 3.2% for pharmaceutical companies, 2.6% for healthcare providers and -25.1% for medical devices & supplies companies.
Methodology
At this point in time, universal healthcare is available in dozens of countries, though even among the countries with free healthcare, Brazil probably has the best plan, where all surgeries, treatments and medications are provided for regardless of whether a person there is a resident or a non-resident. For our rankings, we have ranked each country based on its population, as a greater population means more people have access to free healthcare.
20. Australia
Australia has been facing significant challenges in its universal health care system since 2000, and calls have been made for its Medicare system to be properly reformed.
19. Malaysia
In 2022, Malaysia earned plaudits from the World Bank for its efforts to provide universal healthcare to all residents.
18. Peru
Multiple Latin American countries have free healthcare including Peru, and the country has been progressing well in this regard in the last decade.
17. Saudi Arabia
Saudi Arabia is one of the few Middle Eastern countries with free healthcare, though it requires 175,000 extra healthcare workers including doctors and nurses by 2030 to fulfil demand.
16. Poland
While private healthcare options are still available in Poland, free healthcare is also available to residents.
15. Canada
The Canadian government recently agreed to spend more than C$200 billion over the next 10 years to revamp the country’s declining healthcare system.
14. Ukraine
Russia has been accused of deliberately attacking Ukraine’s healthcare facilities and will likely need a significant rebuild when the war ends, a worrying thought considering there is no end in sight to the war right now.
13. Algeria
Algeria being one of the countries with universal healthcare has been credited with the country being able to become malaria-free, according to a representative from the World Health Organization.
12. Argentina
Argentina is currently in the midst of a heated election cycle, and depending on who wins, social protections are likely to be decreased significantly which could impact its healthcare system too.
11. Spain
Spain is among the countries with the highest life expectancy in the world mainly thanks to its healthcare system.
10. Colombia
Colombia’s government subsidizes health coverage to nearly 96% of its total population, though it has often been accused of placing profit over access. A recent proposal that will radically change the country’s healthcare system has seen opposition from health insurance companies as it would potentially impact their profits.
9. Myanmar
Myanmar’s public healthcare system accounts for nearly 80% of all hospitals in the country, and has been absolutely devastated since the military coup, with many healthcare workers refusing to return to work.
8. UK
Once one of the most idolized health services in the system, UK’s NHS is now considered to be in its biggest-ever crisis, which is now resulting in an increased demand for private healthcare.
7. France
Despite being one of the pioneer countries with free healthcare, France’s healthcare has been struggling recently, with France President Macron announcing an overhaul of the entire healthcare system.
6. Germany
The largest country in Europe, Germany’s healthcare system has been lauded as the perfect model of what efficient universal healthcare looks like, though like many countries with free healthcare in Europe, ageing populations and workforce considerations are impacting healthcare systems.
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Disclosure: None. 20 countries with free healthcare is originally published on Insider Monkey.