With the passing of healthcare legislation this week, many Americans are still wondering how exactly the nation and its citizens can afford to pay for universal healthcare. If the Washington Post is to be trusted, “the public [healthcare] systems employed by every other industrialized nation cost less and cover more than the American model.” While the thought of a public option still causes an indignant frenzy among many Americans, how are these other countries successfully implementing nationwide public healthcare systems?

An obvious comparison would be with Canada, our oft-mocked neighbor up north. Medicare is the nation’s largest government health program, and it entitles Canadian residents to receive insured health services without copayment. The system is tax-supported and comes from the revenues of Canadian provinces.  In general, healthcare in Canada is delivered by both public and private organizations, which then bill the provincial health authorities for reimbursement. Thus compared to many systems in Europe, healthcare in Canada is not nationalized since so many services are provided privately, and is only known as a public system due to its public financing. While most Canadians are in favor of this system, it has also been criticized for its long wait times and unbalanced distribution of physicians.

In France, the public health insurance program extends to all legal residents. Insurance is funded by employers and employee contributions. Also, the government deducts a hefty 20% from workers’ salaries to fund the social security system. About 75% of total health expenditures are covered by the public system, and the state is in charge of determining the types of healthcare that are reimbursed, the size and numbers of hospitals and technical equipment. However, their system is not always cost-effective, but perhaps there has not been as much of an outrage because the French have always expected universal health care as a right of citizenship.

In Asia, many countries in the region look up to Singapore for its efficient universal healthcare system. With one of the lowest birth mortality rates and highest life expectancy rates in the world, Singapore is able to create a successful program by combining compulsory savings from payroll deductions, government subsidies, and actively regulating the prices of healthcare services. While many Singaporeans have supplemental private health insurance for additional services, they are free to choose from government or private healthcare providers with almost no difference in treatment quality.  Since private and public systems are competing against each other, this helps keep prices consumer-friendly. Surprisingly, the Singapore government only spends 3% of its annual GDP on healthcare, as opposed to USA’s 16%.

There are many other countries with healthcare systems that are worth noting. For example, in Switzerland, everyone is required to purchase basic health insurance, choosing among competing private healthcare companies instead of a public option, with the government subsidizing low-income families. While we can’t expect the same results to occur by simply replicating the systems of other nations, these diverse examples show that there are many ways to approach universal healthcare without necessarily bankrupting the national government.