Thread by @shaunjlawson

Uruguay has de facto universal healthcare Michele. Everyone who wants to be covered is covered.

The only issue is informal workers not in the system - who the government obviously want to be in the system. Tracking them down is the challenge.

https://twitter.com/michelekimball/status/1367196837447413766

All private hospitals except one - the British Hospital, which is the best and most expensive - are effectively part of the public system. All employers and employees choose a 'mutualista' (provider) and get the same coverage as someone paying privately.

Americans are always shocked when they come here and find how incredibly cheap healthcare is. In Uruguay, the concept of 'pre-existing conditions' barely exists at all. Where it does, it's only for over-70 expats.

A few more details on the system here. In Britain, the NHS being free at the point of use is, of course, covered by national insurance. Here, employees pay 4.5% of their gross income each month - the whole concept is very similar to NI, with a further 15% going on pensions.

If you're self-employed, you'll pay between 100 and 150USD a month.

There is then a very small co-payment if you're employed and need to see a doctor: about 4-5 USD; around double that if seeing a specialist.

It's a social insurance-based system, fairly similar to that in France and the Netherlands.

It is also a legal requirement for GP consultations to last at least 12 minutes. Unlike in the UK, doctors don't rush you out of the surgery in 5 seconds.

Also unlike in the UK, doctors are VERY open-minded. If they can't find what's wrong with you, they don't tell you there's therefore nothing wrong and send you away. They sit and discuss it with you. I have plenty of personal experience of that.

It's considerably easier to buy things over the counter here than in Britain (for example, asthma inhalers) - which is pragmatic and frees up space for consultations. And during the pandemic, there's been the option to have a consultation over the phone: which has worked well.

If there's any issue here, it's with prescription and drug prices - but that goes in tandem with Uruguay being a very expensive country in general.

Overall, I've been hugely impressed by the system here. And the right doesn't hold it to ransom and drain it of funds either.

Oh yes, one other thing. If you're overweight or a smoker, GPs never shame you about it. Never. They ask if you want support - by seeing a dietician/nutritionist or joining a quit smoking group - they don't judge, and they look at things holistically. Exactly as it should be.

When I saw a nutritionist, in less than a minute, she was asking me about my emotional state. Which she said had to be focused on before I'd even be ready to change my diet.

I was stunned at that. It was brilliant. And in the UK, where so many doctors get it wrong, unheard of.