This article provides an overview and analysis of healthcare system structures, financing models, access, cost trends, and key health challenges across seven countries (Belgium, France, Germany, Italy, the United Kingdom, Spain, and Switzerland), leveraging open data available in each market and Milliman's local expertise.

Key highlights

• European healthcare systems share the common ambition of providing universal coverage and high-quality care, yet they differ substantially in how they are financed, organized, and accessed.
• While some countries rely primarily on tax-funded national schemes and others on social or private insurance models, all face similar pressures: growing demand for chronic disease management, widening inequalities in access, and persistent workforce and infrastructure challenges.
• At the same time, health spending continues to rise, driven by technological innovation, population aging, and the expandingburden of mental and long-term conditions—raising important questions about efficiency, affordability, and future reform.
• In all geographies, insurers are now developing services that go beyond traditional insurance coverage, leveraging innovationtooffer concrete solutions to challenges such as access to care, tailored care pathways, and preventive health measures.
• Germany, the U.K., and France spent the most on healthcare as a % of GDP (≈12%–13%) in 2021. Public funding dominates in most countries (U.K., France, Spain, Italy, Belgium, and Germany), while Switzerland relies heavily on private insurance.