Universal Health Care: Mastering Health Insurance in Iceland
Iceland has become a top tourist destination because of its natural beauty and cheap airfares. The country has more than 300,000 residents or 1/1000th the population of the U.S., but its locals raved about their “universal” health care system. Here’s what they had to say:
Why is it universal? The federal Ministry of Welfare administers all health care, and the system—Sjukratryggingar Islands—is responsible for all Icelanders. There are reportedly no private clinics, hospitals, providers or insurance in the country.
How is it paid for? Health care is financed through business taxes (85%) and service fees (15%). The Ministry of Welfare sets the service fees (i.e., copays), which most Islanders pay. Many people buy discount cards to reduce their out-of-pocket costs.
Iceland doesn’t have separate systems for the elderly, poor or disabled, such as Medicare and Medicaid in the U.S., but one retiree explained that these populations pay lower fees or none at all. The country’s administrative costs are low because it has one program for all people.
Who is covered? Everyone who has been a legal resident for six months. Children are covered through their parents until they turn 18. No one can opt out of the public system, as there is no private system to use. If you aren’t covered, you pay the full cost of any care.
Young adults reported that they often work jobs or attend university in other European Economic Area countries, where they are covered thanks to governmental agreements. Upon return home, their coverage continues subject to completing the right online form.
How does it work? Individuals are required to select a general practitioner (i.e., primary care physician). One GP—a fellow runner in the Reykjavik Marathon—works in one of the country’s many clinics (“heilsugaeslustod”) and coordinates all of his patients’ medical care.
What does it cover? Traditional services include primary, specialty, emergency, maternity and mental health care, as well as hospitalization and prescriptions. Coverage also includes midwives for home deliveries and overseas hospitalization if treatment isn’t available in Iceland.
How does it compare? Iceland spends less money than the U.S. (and its people are healthier). In 2014, total expenditure on health per capita was $3,882 in Iceland and $9,403 in the U.S. Likewise, the percentage of GDP on health was 8.9 percent and 17.1 percent, respectively.
What else? Iceland and the U.S. have some of the same problems. For example, it’s difficult to attract and retain doctors in rural areas, so providers are implementing telehealth to improve access to care. Costs are also increasing, and governments are looking for ways to control them.
Our bike tour guide shared that he had left the country to work for a few years and “messed up” his online form upon return. He’s lucky not to have incurred any costs yet while he re-establishes residency and restarts the clock for eligibility. In other words, he’s Mastering Health Insurance.
Sources: 1) www.sjukra.is; 2) www.oecd.org; 3) http://apps.who.int