Countries with best healthcare quality disregarding cost/financial?
Posted by Logical_Maximum_9481@reddit | expats | View on Reddit | 58 comments
Hi folks just like the question especially to those who have access the host various countries healthcare, what countries has the best healthcare? of course some here will say countries with universal healthcare, but some disadvantage on that is the waiting times and since it is free of course there is had an effect on the quality itself got a friend before that was misdiagnosed on a country which is supposed to be developed.
on the question, which countries standout to you as the best in terms of quality disregarding the cost? like example on curing cancer or other deadly disease.
DingoOk6400@reddit
I’ve lived in the U.S., Japan, France, Hong Kong and Spain, albeit at different stages of my life. As another commenter has posted, if cost is not an option then American health care is probably the best in terms of treatment. If you factor in cost then all the other systems are probably better.
Logical_Maximum_9481@reddit (OP)
I heard some good reviews on Catsalut (don't know if I got the name right) before
hardyz@reddit
I normally don't comment on old threads but this came across when I was searching for something else. I had a close family member with a medical emergency in Spain. While they were a top ranked hospital, I would suggest if you have any emergency you leave the country as soon as possible to get healthcare.
It's kind of weird. They had the expertise to do emergency brain surgery which most countries can't do. They were talented but the level of laziness was extreme.
They didn't want to treat my family member and almost killed them multiple times (family member was there for a while) because it wasn't a weekday during normal business hours. My family member was in the ICU equivalent. We had to force them to and each time they were like "oops". The doctors even went as far as telling us it was our responsibility to watch the family member, record all issues throughout the day, and give them a daily report of hourly breakdown what happened so they could treat my family member. We did this and even then they were like we can wait until Monday to run the tests despite the patient losing all mobility and the next day losing complete consciousness.
The healthcare was extremely cheap but we paid a boatload of money to medivac my family member out of that country before they killed them.
Logical_Maximum_9481@reddit (OP)
Sorry to hear that so where did your family member continue the operation? Is he okay?
DingoOk6400@reddit
I’m living in Spain at the moment and have DKV insurance. So far I’ve had no complaints. My wife had some oral surgery done and that has not been a great experience. That is more likely due to the surgeon than the system. But in terms of prescriptions and all that I’ve found the cost for drugs even w/out insurance is lower than my insurance copays in the U.S. The American system is just brutally expensive and seems designed to run every American into destitution, albeit w/ decent outcomes on the actual care. However, I don’t believe the U.S. system is sustainable.
Tardislass@reddit
Unless Europe imports more doctors Edu healthcare isn’t sustainable either. The European birth rate is plummeting. Without large scale migration their won’t be enough people to pay the taxes needed to support the health care system. Yet, many Europeans are still opposed to immigration.
DifficultBudget9864@reddit
If you can get seen by a doctor. The US Healthcare system is a disaster.
Mr_Lumbergh@reddit
If you have the cash, you get seen. Health insurance adds a shit ton of friction.
mortaine@reddit
Not always true. I had to discontinue care for my hand because my insurance changed and the doctor "doesn't accept cash payment." They canceled my appointment on the day I was supposed to go in for what would hopefully have been the last treatment.
Almost a year later, it still has chronic pain and reduced mobility.
BobcatSpiritual7699@reddit
Yup, costs be damned it's the best. I miss it so.
labnotesz@reddit
Moving countries really makes you realize how different systems feel day to day. I kept comparing wait times and access more than rankings. Separately I sorted a basic policy with Ethos Life Insurance since I didn’t want gaps while figuring out healthcare abroad.
Professional_Ad_6462@reddit
Ok My Background I am a retired Primary care MD who had worked in military medicine,and on the U.S. west coast for a HMO. I retired early in my mid 50‘s and moved to PORTUGAL.
US medicine is expensive but our outcomes due to project management, chronic disease management, prevention and high tech surgical and oncology care is the best in the world. I had to re test and decertify in my specialty on a regular basis.
Euro systems are underfunded necessitating buying into private hospital care.
Portugal physicians are not mandated to get Continuing Medical education.
Typically prevention care, as in colonoscopy, mammography, spot chest CT in smokers have to be asked for by the patient. My wife is 54 I had to contact a real story to get her a screening colonoscopy. The NHS primary docs are too busy dealing with acute care and our loading patients to sub specialists. There more air traffic controllers, frankly I would not last, I could not feel good in a system that did not allow me to give my best.
If I did not return a email in a four hour window, if I did not explain clearly what the patients condition was, and how it should be treated I would get a visit by the chief of service. Every fifth patient I saw would receive a email asking for rating the provider along five domains.
In 16 years in Europe I never Received a follow up call on a procedure or a notice of an abnormal lab report. Personally just in friends, family and employees I have seen more cases of would be medical malpractice her than in all the Quality conferences and tumor boards I attended in American hospitals.
Necessary_Ad8010@reddit
I've lived in the US and Ireland. Irish public health is excellent in some ways (access to medicine) and a disaster in others (waiting lists to see a specialist). However, I also have private health insurance in Ireland. With insurance the care is likely better than the US in every way my family have used it. It's also a fraction of the cost even though Ireland has similar cost of living to the US.
Therefore it is impossible to compare. In the US without insurance, we could all be dead. In Ireland without insurance I could get by. In my honest opinion there is no US healthcare system versus Ireland's shoddy one. If you have insurance, Ireland is easier to deal with and has been better for us. We've used many different areas of care.
PicDuMidi@reddit
France is outstanding IMHO. Like many countries, people do complain but they've rarely any idea how green or otherwise the grass is elsewhere and compared to the UK where I used to live the standard and scope of care is outstanding. I had some serious heart issues a year or two ago and I know, from people I know who were dealing with similar issues in the UK system, I would probably have been dead by now if I was still over there. The insurance element is minimal.
But I do get peed off with people constantly claiming how great the US system is. Tens of thousands die every year in the US because they can't afford adequate care, sometimes at any level. This is NOT a "great system".
maratmatisbelagio@reddit
I stumble upon this article below .. quite interesting how tech can change the world and personally used the tech too for my own need
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Pro_ismyrealname@reddit
Thailand
fraxbo@reddit
I’ve written this before here on similar posts, but it deserves repeating:
Medical care is ultimately cultural.
What I mean by that is just like any other aspect of life, what we consider medical care to be, how we expect it to be carried out, by whom, and with which values being weighted all depends on the medical culture one is used to.
Those praising the US system typically do so because the US system is very high on patient autonomy. This is both due to how it’s funded and the ever-present risk of lawsuits. So, if you want a doctor to test for x, y, or z beyond the doctor’s better judgment, you’ll get that done. If you want to try a new drug you saw advertised on tv because you think it will treat your condition, you’ll get it. If you disagree with five doctors in a row who all agree about your diagnosis and prognosis, and want to see a sixth, you can get that done too. There’s a reason costs are so high in the US beyond the rapacious insurance companies, and this patient autonomy approach is a large reason for it. It’s also incidentally why drugs are prescribed far more frequently in the US than most other places.
The other thing the US system is very high on is preventative care. Most centralized health systems have looked at the data and only do preventative care/physicals in special circumstances because it’s been shown to be ineffective and poor use of limited time and resources. But in US medical culture, because it is both desired and patient autonomy centered, people get all the preventative care they ask for, efficiency be damned.
Outside of these areas, and looking at any outcome based measures, US is either no better or demonstrably worse than other medical systems. This includes life expectancy and life expectancy after x age (40, 50, 60 etc) even correcting for drug use, gun violence and traffic accidents, all of which US is also an extreme outlier for.
So, if the only goal is to get what you want then US is indeed the best. But if the goal is to have the best chance at living a long life and actually curing diseases instead of just treating symptoms, then there are numbers of other better options.
Professional_Ad_6462@reddit
I think you are wrong about prevention in the U.S.. primary care physicians follow preventive task force guidelines based on studies. These are subject to change over time.
fraxbo@reddit
But what part does that make me wrong about? Not challenging, it’s just unclear. Do they not do a lot of preventative care and recommend yearly or bi-yearly physicals anymore? It’s possible. I haven’t lived there in 20 years. Or they do, but this is recommended as best practice?
I am just sure that when I first moved abroad, and asked about physicals in several of the countries I’ve lived in, physicians looked at me like I was nuts. And when I protested, I was shown the directives with reference to studies I then have read the studies and seen that there is little to no correlation with preventative care with most areas of health. It’s literally just in a few instances where it pays off (screening and panel blood tests every once in a while among them).
I haven’t lived no doubt their following a task force recommendation either way. But I would also guess that task force is part of and enculturated in the US health culture.
Professional_Ad_6462@reddit
Well i think those physicians look at studies might even agree with a preventive exam or test but it is way above the average PCP in for example Europe to order a screening colonoscopy etc unless it meets specific criteria. I don’t think I am disagreeing with you but providing an explanations.
My feeling now after a decade and a half in Europe is that medics is more algorithmic and not to much deviance is tolerated. Remember Euro Docs arrive at residency much younger than in the U.S. where an undergrad degree is needed. They will swear there following best practices, but even as helpful as AI is turning out intuition still plays a roll. In my HMO I saw a patient that had multiple visits for knee pain. All with normal imaging and physical exam. I ordered a lumbar CT at l3-4 level and bingo a big disc herniations.
Not once in 25 years in HMO medicine was I second guessed or got in trouble for some perceived deviation.
Altruistic_Fun3091@reddit
Japan offers quality universal healthcare. Premiums are income-based.
DingoOk6400@reddit
Japanese health care is very good but has some flaws. Yes, it is largely free or very well covered by the Kenko but if you are hospitalized and want to actually eat a meal or maybe have a nurse look in on you your family will have to camp out there to feed and take care of you. Hospitals just don’t provide any patient care, like at all.
manishsharma64@reddit
Hospital doesn't serve meal or nurse doesn't spoon feed you?
DingoOk6400@reddit
They often do not provide any meals at all
eunma2112@reddit
It’s the same in South Korea. The hospital beds even have a little trundle bed underneath the patient’s bed that is for the relative (or paid helper) who is there to assist the patient.
DingoOk6400@reddit
Yeah, it’s an Asian/Confucian thing. Like who else would care for your family but your family?
DifferentWindow1436@reddit
It's sort of a reasonable quality at a reasonable cost though. So it depends on your pov. If you want the highest level of quality and cutting edge, it's not the place. But it is effective for the broad population.
Citadel-TT@reddit
Have you been to Japan? They let you die on the street rather than saving you or having an emergency room for you. I have seen a patient called ambulance and they told her no room available in the hospital and she had to call around until a hospital accepted her, worst healthcare system in the world.
Logical_Maximum_9481@reddit (OP)
Wow this is the first time I heard some negative about Japan especially healthcare here in reddit
Fit_Internal_2153@reddit
If we focus on quality and outcomes, Germany, Switzerland, and the US often stand out. They have access to top specialists, advanced technology, and cutting-edge treatments. For serious conditions like cancer, the expertise of the hospital or clinic often matters more than the country itself.
3a5m@reddit
If you remove cost entirely, the USA is probably the leader as far as specialized care goes.
Taiwan excels at efficiency, Korea at tech, Switzerland and Germany at precision and speed.
Logical_Maximum_9481@reddit (OP)
Sometimes USA got really bad name due to the cost of healthcare, My friend I've mentioned on the post have considered to have a check on his lump before on a country that is salwaya on the rankings in terms of good healthcare (I'm not gonna mention the country btw don't want to trigger some users) He went to a supposed to be good hospital on that country, He told me the doctor/physician have used some google search to identify what kind of disease does he have and concluded it as some kind of boil which is not benign on cancer....I was shock on how can a doctor use a Google search engine to identify sickness of it's patient sorry to be rude but that is kind of really ridiculous, so he just told him to have some warm compress and gave painkillers. Days passed by it seems like the symptoms worsened. Luckily he had relatives on the US, Minnesota to be exact, therefore it was detected it was cancerous and he need to undergo multiple operations since it is critical. Luckily it was all sort out good for him, just upset that there are physicians like that although I understand a lot of physicians are not really exposed to various kind of disease, so yeah a big shout out to USA for this one which is sometimes rare on reddit
Btw yeah, the cost on the US hospital was pretty bloody though, but if it is life threatening it doesn't matter since life is more gold thah money though
tuxedovic@reddit
There are specific medical data bases that are fee based. Looking up information or checking your opinion is good medical practice. If a doctor only sees the condition once or twice a year knowledge might be inaccurate or out of date.
fraxbo@reddit
Moreover, ChatGPT and google are standard in every single medical culture in which I have any experience. This behavior is not special. Nor is misdiagnosis.
Logical_Maximum_9481@reddit (OP)
Actually my friend have been back on several session with that physician though before transferring to US
Strict-Armadillo-199@reddit
What are your sources for Germany excelling at precision and speed? In what, exactly?
Because it's well-known/generally accepted that the health care system here is flawed/problematic in a number of areas and has seriously declined, especially since COVID. I've witnessed the decline in non-hospital care myself in my 24 years here, although that's anecdotal. Re. hospitals, I've experienced medical error during surgery twice, and have family members say the same. Read an article about how rates are higher here because German doctors work longer hours than EU average.
So I'm personally interested in the research that shows that Germany overall (some issues are regional) is still doing better in these factors than other countries.
GaryLifts@reddit
If you are a Billionaire and could afford absolutely any treatment, whenever, wherever and without insurance, the US is the best. With insurance is better, but only because refusal to pay out wont impact you as you can afford it anyway.
However if you are a high net worth professional, or a multi millionaire (say,<$10m), you will probably get better outcomes in places like Norway, Switzerland or Australia (with insurance) as they are all better for chronic condition treatment and preventative care and are far more efficient from an administration perspective.
Logical_Maximum_9481@reddit (OP)
Didn't heard about Norway's healthcare maybe some worth promising to have a look though, Regards to Aussie yes it's also good especially on cancer lots of my kiwi colleagues transfer there though
GaryLifts@reddit
Norway's is funded by their sovereign wealth fund, so its not short on money.
However the question is too ambiguous as anybody for whom money truly was no object, wouldn't be asking the question on reddit. What do you consider relevant to you when you say, money is no object?
Logical_Maximum_9481@reddit (OP)
I mean the quality like waiting times and the focus on the patient itself, and also the knowledge of identifying a disease, I know some rich people in rich countries that are transferring to other countries for diagnosis my friend is an example
GaryLifts@reddit
Yes, but achieving those things requires different levels of money in different countries.
Would you rather:
Pay $800k for the very best treatment in Country A
50k for 97% of that treatment in country B
No cost for 90% of that treatment in country C but with a wait time for not threatening conditions.
That is the difference between the US, Australia & UK right now. If you have unlimited resources, the US will always be the best, but your spent to outcome ratio will be dramatically worse than many other countries.
Places like those mentioned previously get you comparable outcomes at a more achievable price point.
Logical_Maximum_9481@reddit (OP)
Correct and I agree it really depends to the person though, It seems like my question is related to A the most since let's assume money is not a thing and you want the best treatment
GaryLifts@reddit
You need to look at it depending on your level of wealth - my view is:
100k > Australia Public/Norway: universal coverage, low risk, strong outcomes without needing optimisation
1m > Australia Private/Germany: excellent hospitals, high floor, private top ups remove wait times
10m > Switzerland: best balance of quality, speed, prevention, and simplicity (for outcomes alone Australia and Germany compete)
100m > US: highest medical ceiling and access to elite centres
1b > US: custom global care teams and cutting edge treatments
Logical_Maximum_9481@reddit (OP)
That's a good range to consider though thanks for the insights
No-Butterscotch0503@reddit
I’d say Australia has some of the best healthcare in the world. Top quality, top research (for example some of the best and most advanced cancer research in the world comes out of Aus), the system is not too complicated (your GP will help you navigate it through and through, AND it’s not too hard to get a gp) and you will get fast tracked enough according to the urgency, AND both private and public sector are honestly the best I’ve ever seen.
Canada has good quality but my oh my! It takes FOR EVEEEER and you can spend years waiting to get a GP. Availability is nil, but it literally costs nothing (I mean, your taxes obviously). The system is really frustrating to navigate because you have no alternatives.
Mexico, go private and there is really good quality and not too expensive (not as expensive as the US or Aus in private settings), it can be hit and miss thought as most of the specialized care is privatized and non standardized at all, in this case price does not always mean quality care. The public sector, in my experience and with family members, has pretty good quality, but it takes forever, availability is very limited and there is a lot of bureaucracy involved and lack of resources, doctors do miracles with the budget/resources they have.
worldisbraindead@reddit
I grew up in the U.S., but have lived in Chile, Argentina, Mexico, Thailand, and now live in Spain. My wife and I are in our mid-sixties and are, fortunately, pretty healthy, so our experiences are somewhat limited. However, setting aside costs and insurance coverage, we have come to the conclusion that the best overall healthcare in the world is in the United States. Care in Chile and Argentina is a general clusterf\^ck and a lot of doctors work with completely outdated information. Thailand was great, but only in certain hospitals. In Spain, we haven't had too many medical issues, but my wife was misdiagnosed with gout by two doctors and was treated with a couple of meds that just didn't do squat. She was limping and in pain for a year. When we visited friends and family back in the US, she went to our old doctor and he took an ex-ray and sent her for a scan (I think an MRI) and they found a hairline fracture in her foot. A couple of weeks in a boot...problem solved.
Good friends here in Spain are going though some cancer issues and have reported excellent care. Family members who live in Canada and France HATE their systems...not the costs...just the care.
If costs and horrible insurance companies weren't a factor, the US is probably towards the top. I hear Taiwan is supposed to be quite excellent as well.
Logical_Maximum_9481@reddit (OP)
That's what I'm saying,universal healthcare is sometimes a double edge sword, it's really hard to have it all most excellent quality and cheapest price as far as I observe. Strengthening the saying that "you get what you pay for"
LowPsychological6734@reddit
i am a Turkish immigrant living in Spain. i want to comment on that. in my opinion the problem here is not the healthcare system rather the Spanish mindset. they have a "i dont give a fuck " mindset. even if you go to private hospital. my wife is pregnant. we tried a lot of hospitals (all private), none of them come close to any public hospital in Turkey. the doctors simply does not give you any attention. even if they do its pretty limited. they try to rush you out of the door.
we waited more than an hour at emergency room (unacceptable in turkey, especially in a private hospital), we waited more than an hour at a doctors office despite having an appointment, they asked some tests at wrong weeks etc. these all happened at private hospitals and we try to go to the "best one" without any regard to cost.
only proper care we got was from a Dutch doctor and a Turkish doctor in Spain. if it wasnt for these 2 doctors we would be going back to Turkey for childbirth
my friend's wife gave birth in Spain, she had C section. her scar got infected. they did not gave her anything for it or did any treatment, they simply said something like "it must be infected in hospital it happens. just put some ice". she literally screamed in pain for days before they decide "yes that's bad lets treat it" .
you can also look at Turkey. Turkish people live all over europe and most of them still goes to Turkey for their health needs. Never heard any of them saying any European country have better healthcare service than Turkey.
if you have enough money then you can easily get the literal top doctors in turkey to care for you.
Elephant6352@reddit
There is no country that is best at everything regarding healthcare. I think Switzerland might be the best overall but that's just my opinion.
StriderKeni@reddit
Despite every complaint about the German health care system, when there's a real urgency, it's the best, at least in my experience.
If living here wasn't hard enough, I've had several health emergencies over the last few years, and honestly, I'm surprised by how well they took care of everything and the professionalism of the staff, doctors, etc. The food was so so, but that's just a detail. I'm in public health insurance, btw.
Strict-Armadillo-199@reddit
Where are you comparing it to?
Mag-NL@reddit
Do note though that the disadvantages you mentuon of countries with universal healthcare are even worse in countries without.
Logical_Maximum_9481@reddit (OP)
Yes I've mentioned that on my other comment
USS-Enterprise@reddit
This is mostly not relevant for people with enough resources to even be expats, but the point of universal healthcare is not really best possible outcomes for those individuals that have the ability to pay for the best care. Everyone having the ability to access a base level of reasonably good healthcare means that society is in general healthier, because people don't die for not having money (could potentially argue that the American system is eugenics lol) and also everyone has some access to preventative care. Society being healthier means collectively saving money on healthcare (taxes and such, which again, helps everyone). Even if you're necessarily considering only the super rich by completely disregarding cost, they still gain benefit by healthier employees who are less often on sick leave. 🤷
Of course, if a super rich person is sick and the best possible survival rate with infinite money is 98% (where a working class person might have an average survival rate of 30%) and a country with waiting times (for example, idk, Sweden) has an average survival rate of 80% or even 60%, the rich person probably wants to be in the States lol. 😅 Of course it would also be interesting to look at the hypothetical frequency of this illness by income, if the rich person is also generally able to access more preventative care.
But "best healthcare quality" for society and for an individual is not the same and it is important to weigh up both, if you aren't just picking a country to move to, and that's probably not enough to make the decision anyway 😬 I guess, if you are a resource rich individual, Australia is a good choice, having relatively extensive private healthcare alongside public healthcare.
Logical_Maximum_9481@reddit (OP)
Actually yes spot on this is just an individual perspective, there are a lot of post about the most accessible healthcare, so I recognize this post might not be relevant for others but as I've mentioned on the other comments you can't really have it all like the best healthcare wit the super cheapest one (I'm considering the tax on here for the universal healthcare countries since it is not really free since it is paid on the tax by the citizens though it's just more convenient since it's not hectic on paying huge amounts at an emergency),But back to the topic I just want to know the experience on the quality of care by an individual not the accessibility which is community based. Since in case our life is already on the edge we will do all means just to survive including pouring anything we have.
Anyway thanks for the Insight on my question, appreciate it mate 👍
RaspJur@reddit
france
aloha_spaceman@reddit
The U.S. is mentioned several times in the thread. As a person who has lived and experienced healthcare, including for some pretty serious stuff, I’d suggest that the U.S. is less concerned generally with wellness and more concerned about illness care. I mean this not so much as a philosophical statement but as a long-term driver of outcomes. In Spain, for example, it seems that their focus on wellness reduces demand for some more serious illness. For example, heart disease seems to be less an issue (despite a lot of smokers).
funkychicken8@reddit
I have had quite a lot of experiences now in Australia unfortunately with myself, husband and 2 kids. I have been super impressed by the quality and standards here. All of it has been either little or no out of pocket.