Sometimes when I work in the Urgent Care in America, I sit there wondering what it would be like practicing medicine in different countries. So here are some tidbits about how the healthcare system works in other countries and how physicians practice there.
For reference, US citizen satisfaction rate: 63%. Norway, Netherlands, Switzerland, Iceland, and Denmark are in the 93-97% range.
🇦🇺 Healthcare in Australia
The public system in Australia is called Medicare. I know, weird!
Citizen satisfaction rate with their healthcare system: 88%.
Though many are quite content with it, the following are common complaints:
- long wait times
- overcrowded hospitals
- delay in care
- staff shortages
- outdated medical equipment
- lack of access in rural areas
Practicing medicine in Australia has a much lower malpractice risk – 0.4 claims per 1,000 compared to the US at 3.4 per 1,000.
🇦🇺 Australia: Public Health System
There is a mix of public healthcare along with the private system. Thore permanent residents or citizens have full access to the public sector.
The public system isn’t completely free. It’s funded by taxpayers and a 2% income levy.
Medicare will pay a portion of your care – called the ‘Medicare Benefit.’ The ‘Gap Fee’ is what the patient is responsible for and pays out of pocket.
You can read more about the recent Medicare Rebate freezes they have been dealing with in Australia.
For example, a knee replacement surgery has an average Gap Fee of $2,500, up to $5,000, and as low as $0 depending on subsidies, the patient’s income, etc.
🇦🇺 Australia: Private Health System
There is a private health insurance system, and patients can choose to pay out of pocket or through that insurance.
The main reason people choose the private option is so that they can be seen faster. But few in Australia believe that the private sector is better than the public.
🇦🇺 Australia: Private Insurance Costs
As expected, your health insurance premiums will be lower if you are younger.
However, expect to pay around $3,0000 annually for both inpatient and outpatient coverage. Or somewhere around $2,000 for inpatient only and $1,000 a year for outpatient-only coverage.
🇦🇺 Australia: Private Office Visit Cost
A cash-pay Primary Care visit in Australia costs, on average, $120 per visit. And it can range from $80 – 200.
- Dermatologist: AUD $200 – $300
- Gynecologist: AUD $200 – $300
- Sports Medicine: AUD $250 – $350
You can use My Health Engine, which is a healthcare price comparison site in AUS. I would love to see something like this in the US.
🇦🇺 Australia: Average Physician Income
The average Primary Care doctor can earn anywhere between $120,000 Australian dollars and up to $300,000 a year. The factors which affect this include years of experience and whether they work in the private sector.
As with many healthcare systems, you will earn more in the private sector.
🇪🇸 Healthcare in Spain
There is a public and private system in Spain. The private system often operates through insurance, but there are physicians who only take cash and bypass private insurance completely.
Citizen satisfaction rate: 76%.
The story goes that a growing political party in Spain is slowly dismantling the public sector to make room for a more lucrative private sector which has affected access and quality.
Practicing medicine in Spain is said to be fairly easy, and the hours my friends report are quite envious.
🇪🇸 Spain: Public Health System
The public healthcare system in Spain is called Sistema de Salud (SNS), and it provides healthcare to all Spanish citizens and permanent residents.
You will need to have a Tarjeta Sanitaria Individual (TSI), which is a health card that identifies you as a member of the SNS.
Unlike in Australia, all care in the public sector in Spain is completely free. You don’t have any out-of-pocket payments.
🇪🇸 Spain: Private Health System
There are private clinics and private hospitals in Spain, and often, physicians who retire from the public sector will work in the private, or they’ll work in the public sector by day and finish in the private clinics.
Most physicians aren’t content with this because when they work in the private sector, they get a large volume but a very low reimbursement. One PT told me he only got 4 euros per patient.
🇪🇸 Spain: Private Health Insurance Cost
The average monthly cost for private health insurance in Spain ranges from 60 to 100 euros. And it’s going up quickly.
You won’t have copays for the more expensive plans, but you will need to get authorization for certain procedures and tests. You’ll have to take the request for an MRI, for example, to your insurance and ask them to approve it, which they usually do.
🇪🇸 Spain: Private Office Visit Costs
Prices here will vary depending on whether you are in Madrid or a smaller city, for example.
- Primary care doctor: €50-€100
- Gynecologist: €80-€150
- Dermatologist: €100-€180
- Sports Medicine: €150-€200
- Podiatrist: €30-80
🇪🇸 Spain: Average Physician Income
Though my Primary Care friends in Spain tell me that they take home somewhere around €3k per month, they are likely earning much more but have to pay that towards their social security.
The average Primary Care doctor earns €60k a year. And it can be as high as €80k for those with decades of experience.
There isn’t a huge discrepancy between incomes and the private versus public for primary care physicians. This gap widens as you enter certain specialties.
🇨🇦 Healthcare in Canada
Canada, too, has a universal healthcare system – also referred to as … Medicare. They also have a private one along with private health insurance.
Citizen satisfaction rate: 84%.
All citizens and permanent residents will have access to any necessary inpatient or outpatient care. And the money for this care is funded through taxes.
Practicing medicine in Canada is more lucrative than in the United States, at least for primary care doctors, with a malpractice rate of 0.6 per 1,000 – similar to Australia.
🇨🇦 Canada: Public Health System
Each province does it a little bit differently and issues a health identification card to its members. Regardless of where you live in the country, you will have access to care, but depending on the province, it will be a little bit different.
What is not covered in the public healthcare system includes dental care, vision, and prescription medications.
Like many other countries, Canada will negotiate drug prices as a whole, and therefore prices are quite predictable and incredibly affordable.
🇨🇦 Canada: Private Health System
Private health insurance in Canada will be higher for those with pre-existing conditions and those who are older. But on average, it can be anywhere from $800 to $1,000 per person per year.
You can expect to pay as much as nearly $4,000 a year for a Cadillac plan in a province such as BC.
🇨🇦 Canada: Private Office Visit Cost
- Primary care doctor: $150-$200
- Gynecologist: $200-$300
- Dermatologist: $250-$350
- Sports medicine doctor: $250-$350
- Podiatrist: $150-$200
I was surprised to see these numbers. Imagine paying $150 per visit for just a primary care appointment which might take 15 minutes.
🇨🇦 Canada: Average Physician Income
The average salary for a public sector Family Medicine physician in Canada is nearly $270,000 annually. This is according to the CIHI.
Of course, it might change from province to province; for example, you are going to earn quite a lot more in Alberta and a little bit less in Quebec.
The income for that same primary care doctor in chiropractors will be higher by at least another $30,000 – $50,000 a year.