Table 3.

Characteristics of national health systems and the distribution of health spending by countries

Country	Total health expenditure as a percent of GDP (%), 2006	Types of coveragea,b	Physicians/ 1000, 2006	GP gatekeepers c	Doctor type of paymenta,b
Austria	10.1	SHI. PHI covers 30% of population	3.6	YES	Fee-for-service
Belgium	10.3	Universal public coverage, except for self-employed. PHI covers most self-employed. Complementary PHI offered by many employers	4.0	NO	Fee-for-service
Denmark	9.5	98% of population universal coverage and copayments. Complementary PHI covers 30% of pop	3.32	YES	Fee-for-service
France	11.0	NHS covers about 75% of the total health expenditures. Half of the other 25% is covered by out of pocked payments and the other half is paid by PHI companies offering supplementary health insurance policies to individuals	3.4	YES	Fee-for-service
Germany	10.6	Almost universal health care coverage. Civil servants different insurance. Small percentage private insurance	3.5	NO	Fee-for-service
Greece	9.1	SHI. Supplementary PHI covers about 8% of pop	5.02	NO	Salary
Italy	9.0	Universal NHS coverage. Supplementary PHI covers 5–10% of pop	3.7	YES	Capitation
Netherlands	9.5a	SHI. Substitutive PHI for high incomes and self-employed	3.8	YES	Capitation
Spain	8.4	Universal NHS coverage. PHI covers about 10% of pop. Special regime with choice of public or private health care provider for civil servants	3.6	YES	Salary
Sweden	9.2	Universal coverage. PHI exists but has relatively little significance (about 1%)	3.5b	YES	Capitation
Switzerland	11.3	Mandatory private HI is the most common form of coverage and provides free choice of senior physicians in public hospitals, access to private hospitals and more comfortable accommodation	3.8	NO	Fee-for-service

Sources OECD Health Data (2009)—Frequently Requested Data;

^aBago and Jones [20];

^bVan Doorslaer et al. [36];

^cWHO (2004) Remuneration for doctors: (a) Capitation means doctors are paid as a function of the number of registered patients; (b) Salary is when doctors are employed by the state or the insurer; (c) Fee-for-service indicates doctors are paid (at least partially) on the basis of the services provided NHS National Health System, SHI Social Health Insurance, PHI Private Health Insurance

^a2004;

^b2005