What is health care like in the UK, Canada and New Zealand?


Three systems widely cited as examples of universal health care are the so-called single-payer systems in the UK, Canada and New Zealand.

These systems I would describe as “socialized”, and rely for the most part on taxation for funding. The system in Canada for instance, uses taxes to pay for health care administered by the individual provinces, and provided by a mixture of private and public hospitals and health care providers. Private health care is restricted in Canada, but is available in some provinces under publicly-funded private organizations called P3s. Private health insurance is limited in Canada but is available.

The UK’s National Health Service (NHS) similarly uses taxes but 8% of their population still utilizes private insurance to augment their national health care services. Services from the NHS are entirely free of charge for residents, and prescriptions have a nominal fee regardless of the cost of the medication. The government is the primary employer of health care professionals, and general practitioners (GPs), act as independent contractors employed by the NHS who serve as gatekeepers into the health system. A GP manages your health care and decides if you can see a specialist.

The New Zealand system is more decentralized with funding of community health boards to serve the needs of the population, primary care since 2001 has been subsidized by the government through Primary Health Organizations designed to allow broad access to primary care for a nominal fee and hospitals and other health services are funded through taxation. They also have a single payer drug service to subsidize prescription drugs and users pay a nominal fee for prescriptions.

How satisfied are patients with these systems, and what is their quality of care?

As shown previously, each of these systems costs a great deal less than that of the US system


And satisfaction with the systems is on par with what is seen in other universal systems


The main complaints against the British and Canadian systems is that of wait times. Wait times for elective procedures is excessive, and patients in the British system are known to purchase private insurance so that they can avoid long wait times, even over a year. Currently the British are trying to reduce all wait times to under 18 weeks. Wait times in New Zealand appear to be one of the lowest of universal systems. Rationing in these systems is by need and acuity rather than ability to pay, so non-emergent services tend to take the longest.

Despite these inconveniences most users of the system would prefer to have their national health care than the US system, and outcomes of ,mortality and health care-amenable diseases are far superior in these countries.

Based on the experience of the British and Canadians, it appears that having single-payer insurance without some outlet for more private spending on care may end up being more of a burden on the system. It seems that the systems that have had a mixture of public and private funding have enjoyed superior services and shorter wait times compared to the single-payer systems based entirely on taxation.