AFAIU in general you pay for stuff like private rooms or such.
AFAIU in general you pay for stuff like private rooms or such.
I can confirm this is the case for both Italy and Spain.
But I have to say that sometimes, even if the National Health Service does provide for free[1] a given cure or analysis (or assistance to birth), in some cases they may be not fast enough (not for the actual delivery, but for some exams/tests) and there are private services (hospitals, diagnostic clinics, etc.) where sometimes you need to go, paying out cash (or - it is now becoming more common - having a dedicated insurance).
In my experience these - though not actually "cheap" - are anyway a fraction of the costs they I have seen mentioned about the US.
While the average income in Italy and Spain is lower than the US, the cost of these services is proportionally much, much lower.
A problem - common enough - has been in recent years the increase in the number of Ceasarian sections, even when there wasn't any need for it, allegedly (but it has not been actually proven) to increase the reimburse to the hospital by the NHS (SSN in italian) or by the insurance company, or to limit the legal responsibility of the doctor in case of complications.
[1] Actually almost for free, there is a complicated system where depending on your income level you may pay a part of the cost.
In some other European countries (e.g. the PIIGS) with the budget cuts, all social care/benefits have worsened dramatically.
I feel like government is still not the right institution to make purchasing decisions, but until we make one, it's unbeatable.
But, this might also be cultural. People who come to the US are usually willing to take high risks and carry with that a certain sense of irritation with those who don't, and I feel like that might be where a lot of our national culture carries with it this sort of perspective.
I could of course be super wrong, but I think if we could erase the concept of "fairness" in this area, we might make more progress in actually helping real people with real problems
Streets are clean, local transport works (busses, trams, local-trains), education is world-leading, healthcare is great, etc, etc.
I'm sure there are people scamming money off the top, corruption is universal, but I can't begrudge paying taxes when the country seems to be so well run.
(I'm a foreigner, I suspect I wouldn't know if it were badly run!)
For the rich, basically. NHS is free, but has its issues with inconsistent service and long(!) wait times.
Private is hit and miss, but significantly faster and significantly(!) more expensive. Hence the insurance.