Sarah Thomson, M.Sc., and Elias Mossialos, M.D., Ph.D.
This issue brief describes coverage, cost-sharing, and financial protection for primary care and prescription drugs in Denmark, England, France, Germany, the Netherlands, and Sweden. Very few patients report unmet need for care or find general practitioner care unaffordable. Although none of the six countries spends more than 11 percent of gross domestic product on health care, compared with 16.2 percent in the United States, they are able to provide a level of access to and financial protection for primary care and prescription drugs that far exceeds what is available in the U.S. Several have focused recently on adapting cost-sharing design to reflect value by reducing user charges for highly effective care, preventive care, accepting referral to specialist care, adhering to clinical guidelines, and enrolment in disease management programs. These innovations, and others described in the brief, could help inform U.S. policies for national health insurance reform.