Key Takeaways
• Portugal ranks 12th globally in healthcare, the US is 37th, per WHO.
• Portugal provides universal access and lower costs for residents and expats.
• US healthcare boasts advanced technology but faces high costs and limited access.
When comparing the healthcare systems of Portugal 🇵🇹 and the United States 🇺🇸, several areas stand out, from international rankings to the patient experience, to out-of-pocket costs faced by residents and expats. This detailed comparison will look at the most important aspects of both systems, using the latest data and real-world observations, and will help make the differences easy to understand for anyone thinking about moving to or accessing healthcare in either country.
Purpose and Scope
The main goal here is to examine the quality, cost, structure, and accessibility of healthcare in Portugal 🇵🇹 and the United States 🇺🇸. The comparison draws on global rankings, cost data, and patient feedback, focusing on common areas of interest: the overall structure of the healthcare system, how each system is rated internationally, what patients experience, and the costs people face when seeking care.
Quality Rankings and International Recognition
One clear way to see how the two countries’ systems stack up is through international rankings. The World Health Organization is the source for one of the most well-known global healthcare rankings. According to the World Health Organization, Portugal 🇵🇹 has the 12th best healthcare system in the world. In contrast, the United States 🇺🇸 sits at 37th place.
More recent rankings continue to show Portugal 🇵🇹 outperforming the United States 🇺🇸:
- Numbeo Health Care Index 2025: Portugal 🇵🇹 is ranked 23rd.
- World Health Organization 2024 ranking on healthcare access: Portugal 🇵🇹 is listed as 4th among all countries.
- Euro Health Consumer Index (2018, Europe): Portugal 🇵🇹 is ranked 13th out of all European countries, higher than the UK, Spain, Italy, and Ireland.
Portugal 🇵🇹 has also been improving over time:
– 25th place in 2012
– 20th in 2015
– 13th in 2018 (Euro Health Consumer Index)
These improvements point to ongoing efforts to increase quality and access. As reported by VisaVerge.com, these rankings matter because they combine hard data (like how many people have access to care, or how well doctors follow guidelines) with user experiences, making them trusted by many experts.
Why are these differences so large?
The reasons behind Portugal’s higher scores include a focus on making sure everyone can get care, controlling costs, and investing in basic health services. In contrast, the United States 🇺🇸 system is more focused on cutting-edge treatment and new medical equipment, but often faces challenges in making care available and affordable for all citizens.
Structure of the Healthcare Systems
Portugal 🇵🇹
Portugal 🇵🇹 uses a “hybrid” healthcare system. This means it includes both a public system, which almost everyone can use, and a private system, which offers extra choices for those who want to pay for faster service or extras.
- Public Healthcare (SNS):
- The Serviço Nacional de Saúde (SNS) is the backbone of Portugal’s system. It gives healthcare to all legal residents, including expats who have residency status.
- Most “essential” medical care is either free or requires only a small payment (called a “copay”).
- Emergency care in the public system is known for being good, but sometimes you have to wait longer than you would in private hospitals.
- Private Healthcare:
- Many expats, especially those from English-speaking countries, choose private healthcare for faster appointments and English-speaking staff.
- Even in private clinics, care is far more affordable than in the United States 🇺🇸.
United States 🇺🇸
The United States 🇺🇸 system is mostly private, with some government support for groups like the elderly (Medicare), the poor (Medicaid), and veterans.
- No universal coverage: Healthcare is mostly connected to jobs or private insurance plans.
- Out-of-pocket costs can be very high for those without insurance— sometimes causing people to avoid care.
- Government programs only help specific parts of the population.
Side-by-Side Comparison Table
| Aspect | Portugal 🇵🇹 | United States 🇺🇸 |
|---|---|---|
| System Type | Hybrid: Public SNS + Private Options | Predominantly Private + Government Programs |
| Universal Access | Yes—public system covers all residents/expats | No—depends on insurance, employer, age, income |
| WHO Global Rank | 12th | 37th |
| Public Insurance | Universal, low cost | Public aid for special cases (Medicare/Medicaid) |
| Private Insurance Monthly | $140–$550 (comprehensive, average in Portugal) | Can be $400–$1500 or more (US, varies by plan) |
| Doctor Visit (No Insurance) | $65–$145 | Typically $100–$300 or much higher |
| Doctor Visit (With Insurance) | $17.50–$20 | Copay varies, often $30–$100 |
| GP Visit, Public | Free or €5 ($6.17) | Not available |
| Hip Replacement | €4,000–€20,000 ($4,924–$24,618) | $40,000 |
| Dental Cleaning | Free (public) / €25 ($30.85) in private | $120 or more |
| Wait Times | Longer in public, very short in private | Can be long if uninsured |
| Language Access | Many English-speaking doctors in private sector | English-speaking only |
| Main Strengths | Access, affordability, basic care | Advanced equipment, medical innovation |
| Main Weaknesses | Equipment, response speed sometimes lower | Lack of universal coverage, very high costs |
Key Differences Highlighted:
– Portugal 🇵🇹 gives care to everyone, including immigrants and expats with residency.
– Patients pay much lower prices in Portugal 🇵🇹, whether using public or private healthcare.
– The United States 🇺🇸 spends more per person but scores lower on access and patient satisfaction.
Affordability and Personal Costs
Affordability is a major reason why many people, including Americans who move abroad, praise the Portuguese system. Here’s a closer look at costs:
- Doctor’s Visits: In Portugal 🇵🇹, it costs $65–$145 without insurance, but with insurance, it drops to just $17.50–$20. In the United States 🇺🇸, the average without insurance is much higher, often between $100 and $300 per visit.
- Private Insurance: In Portugal 🇵🇹, a full insurance plan costs between $140 and $550 for a whole month— less than many US plans which can cost between $400 and $1500 each month.
- Medical Procedures:
- GP visit: Portugal’s public system offers these for free or for about $6, and private care costs about $62. In the US, the same service often costs $100 or more.
- Hip replacement: Portugal 🇵🇹 private hospitals charge between about $5,000 and $25,000. The same surgery in the United States 🇺🇸 can cost $40,000.
- Dental cleaning: In Portugal 🇵🇹, free in the public health service, or about $31 in the private system. In the US, cleaning usually costs $120 or more.
- Overall Cost Satisfaction: Numbeo’s Health Care Index shows that people in Portugal 🇵🇹 report being much happier with healthcare costs, scoring 75.40 (“High”), compared to the United States 🇺🇸 at 47.19 (“Moderate”).
Patient Experience and Satisfaction
People who use the Portuguese system often comment on the personal touch:
- Doctors are described as “unhurried and take all the time they need to treat each patient fully.”
- Many healthcare workers in private clinics speak English, making things easier for expats.
- Numbeo survey scores show Portugal 🇵🇹 scores 76.79 for “Skill and competency of medical staff,” compared to 72.75 for the United States 🇺🇸.
- Portugal 🇵🇹 also scores 76.12 for “Friendliness and courtesy of staff,” higher than the US score of 74.04.
- The United States 🇺🇸 is ahead in “Equipment for modern diagnosis and treatment” (84.65 vs. 74.95) and “Responsiveness in medical institutions” (59.33 vs. 50.54), meaning US hospitals are quicker to respond in emergency situations, and often have newer machines.
Rights Granted and Who Can Access Healthcare
- Portugal 🇵🇹: The public system is built on the idea that everyone—citizens and residents, including immigrants with the right papers—can get medical care. Emergency services are never denied. Most everyday healthcare is either free or costs only a small amount. Children, pregnant women, and retirees sometimes get extra support, with many services being completely free.
United States 🇺🇸: Healthcare depends on insurance. Those who qualify for Medicare (over 65) or Medicaid (low-income) can get some care covered by the government. Most people rely on private insurance plans, which usually require you to pay a part of the bill each time you see a doctor. People without insurance sometimes decide not to see a doctor because of high prices, even if they are very sick.
Policy Goals and Historical Context
Portugal 🇵🇹 decided many years ago that healthcare is a basic right. The Serviço Nacional de Saúde was created to make sure everyone could get help, no matter their income. This policy has been kept ever since. The United States 🇺🇸 follows a different tradition, where healthcare is a mix of public and private systems, with large companies often controlling costs and access.
This difference in policy helps explain the higher rankings, greater access, and lower costs in Portugal 🇵🇹.
Trends and Patterns
Portugal 🇵🇹 has steadily moved up in healthcare rankings over the past decade. Investments in basic care, prevention, and patient-centered approaches have paid off, especially for children, the elderly, and low-income families. At the same time, the United States 🇺🇸 continues to make remarkable advances in medical technology but struggles with rising costs and lack of access for those without insurance.
Expert Views
Many international reports, including the World Health Organization’s analysis, suggest that Portugal’s mix of universal public coverage with affordable private options offers a good model for other countries. The United States 🇺🇸 approach, while leading in new technologies, is often criticized for leaving too many people uninsured or facing financial hardship due to medical bills.
VisaVerge.com’s investigation reveals that the satisfaction scores among patients—especially expats living in Portugal 🇵🇹—show that people feel both secure in their access to care and less stress about paying their bills than their peers in the United States 🇺🇸.
Case Example
Anna, an American expat living in Lisbon, shares her experience: “When I needed physical therapy, I saw a skilled doctor through Portugal’s public health system and did not have to pay a cent. Back in the United States 🇺🇸, I once paid $200 for a single session. Here, I got the care and attention I needed, without worrying about bills.”
Methodology
This comparison uses official rankings, cost data from Numbeo and various expat reports, and patient surveys. Only findings and quotes from sources listed earlier have been used. You can read more on Serviço Nacional de Saúde, the official website of Portugal’s public health system.
Summary and Key Takeaways
- Portugal 🇵🇹’s healthcare system scores far higher in most global rankings than the United States 🇺🇸.
- Costs are much lower for both basic and advanced care in Portugal, for both citizens and legal residents.
- Universal access is provided in Portugal’s public system, reducing financial stress and making healthcare more patient-focused.
- The United States 🇺🇸 offers faster response times and more advanced technology but at a much higher price, with millions lacking coverage.
- Many expats, especially from the United States 🇺🇸, prefer the Portuguese system for its balance of quality, access, and affordability.
For anyone considering a move or comparing life in these countries, Portugal’s healthcare system is often seen as a key reason to consider living there. For more information about global health rankings, visit the World Health Organization.
No matter where you choose to live, understanding how each country’s healthcare system works can help you make smart decisions that fit your needs and budget.
Learn Today
Serviço Nacional de Saúde (SNS) → Portugal’s public healthcare system, providing universal medical coverage to legal residents, citizens, and qualifying immigrants.
Copay → A fixed, out-of-pocket amount a patient pays for healthcare services, with the remainder covered by insurance or the state.
Numbeo Health Care Index → An internationally recognized ranking system that compares healthcare quality, costs, and satisfaction across countries using user-submitted data.
Universal Access → A healthcare principle where all residents, regardless of status, have the right to receive basic medical services.
Medicare/Medicaid → US government programs; Medicare covers people over 65, Medicaid assists low-income groups with healthcare costs.
This Article in a Nutshell
Portugal’s healthcare system scores higher globally compared to the US, offering universal access and far lower costs for both basic and advanced care. Patients in Portugal benefit from affordable insurance, accessible treatment, and high satisfaction. In contrast, the US leads in technology, but faces costly care and access issues impacting millions.
— By VisaVerge.com
Read more:
• Express Entry: Canada invites 500 healthcare workers for residency
• Immigrants are vital to Canada’s healthcare system
• How public healthcare works in Canada for American expats
• Healthcare and IT offer most jobs to Americans in Australia
• How American residents can join Spain’s public healthcare system
