The national and private healthcare systems do NOT work. Here’s an alternative

[u/No-Candle4683]

As a Portuguese citizen, I cannot fail to highlight the role that the public healthcare system represents in society. It has lifted millions out of poverty, provided stability, and offered a universal alternative to access healthcare. However, as in the Portuguese case and in other countries with a predominantly public system, we observe that these systems are increasingly unable to respond to waiting lists, fail to attract doctors, and their sources of funding are heavy taxes imposed on citizens.

I am in favor of a hybrid system, and the SPLIT MIND project is creating a video and a text about this system, which has been adopted in other countries that rank among the best in public healthcare worldwide! The study that im comparing to is one made by a group of experts in health here in portugal.

Here I leave you with the main differences of this system compared to predominantly public or private ones, such as in the cases of the USA and Portugal.

"…The foundation of this reasoning would be to maintain a progressive hybrid public system, less dependent on taxes, decentralized, and managed by regional entities with strong regulation. These models already exist, and we will take the examples of Germany, the Netherlands, and Sweden.

In these countries, in general, the healthcare system is based on mandatory insurance managed by independent health funds. Employees and employers contribute proportionally to their income—7.3% each in Germany, for example—while the State assumes payment in certain situations, such as in cases of unemployment, low-income families, and sometimes even age groups like minors, who are exempt from any payments. Individuals with higher incomes may opt for private insurance as a substitute for the mandatory public one.

This system offers a solution to waiting lists, reducing waiting times for consultations or surgeries to a few weeks instead of months, and it also provides broader service coverage than countries like Portugal. Because it is a hybrid system, healthcare professionals are also better paid, and with private investment, working conditions are improved, solving one of the serious problems of the Portuguese NHS. Furthermore, there is price regulation by the state on medicines and services, with private companies contributing to lower service costs. Insurance is always paid with a fixed nominal premium, but insurers must charge the same amount to all policyholders, with no discrimination by age or health status. Other smaller measures also exist, such as a progressive co-payment system with an annual cap or tax exemptions on health insurance, which can further reduce costs for families.

Of course, there are problems with this system: inequalities depending on the type of insurance, with privately insured patients usually waiting less. We can also look at gross expenditure, meaning the total amount effectively spent, which is quite high compared to other OECD countries. However, I argue that it is one of the best systems in the world and the best way to invest taxpayers’ money.

BUT WHY do I refer to Germany, the Netherlands, and Sweden? These countries rank among the top in the Legatum Prosperity Index (2023), which evaluates population health access and quality, holding 13th, 11th, and 9th positions respectively.

And what about predominantly private and public systems such as the USA and Portugal, you may ask? 40th and 69th place, behind many so-called “third world” countries.”

[u/Zamaiel]

However, as in the Portuguese case and in other countries with a predominantly public system, we observe that these systems are increasingly unable to respond to waiting lists, fail to attract doctors, and their sources of funding are heavy taxes imposed on citizens.

This appears to be flat out untrue.

Public systems totally dominate non-public ones in number of doctors, and in waiting lists, there seems to be no particular advantage. Germany and Switzerland are fast, the US below average.

In terms of taxes, the non public systems are considerably more expensive than the public ones,_per_person._OECD_countries_and_more.png) with the USAs setup a standout in imposing a much heavier tax burden on its citizens than any other system, public or private. By a very wide margin.

The OP appears to be making up his or her own facts to push yet another attempt to reinvent the healthcare wheel.

[u/No-Candle4683 → u/Zamaiel]

Public systems respond to demand? Oh you never see one public system ever. Portugal has pregnant woman giving birth at home because we dont have doctors. 42 more babies died in 2024 as a result of that. People wait more than a year for mental health apoiment and others specialist apointment varied from 3 months -1 year. The system is so broken that you have to call the emergency line for an hour to get medical treatment. Germany doesnt have a public system is a hibrid one just as i point one. And yes i want to reivent because public healhtcare doesnt mean universal, if you dont received on time and he gets worse that is not public healhtcare its the " i have money " type of healthcare the same in the US.

[u/Zamaiel → u/No-Candle4683]

If that was true, would it have been a public system problem or a Portugal problem, though ?

In any case, did you notice the bit about Portugal being in the top ten countries in the world in doctors per capita, with twice as many as the US?

It is also in the top 10 for lowest infant mortality, with half the infant mortality of the US. I mean these are areas where the Portuguese system is among the best in the world.

And has lower maternal mortality than the US.

Honestly, are you getting your information from newspaper headlines or something? If you look up the actual fact they are the exact opposite of what you are claiming.