American flag hanging between buildings in a U.S. city
Access Yes — public and private ERs treat regardless of ability to pay (EMTALA)
Entitlement None automatically — coverage depends entirely on your specific insurance plan
Payment You or your insurer, at U.S. market rates — the highest baseline of any country here
Worth knowing

The U.S. has public healthcare too — Medicare, Medicaid, the VA. What makes it unusual isn't private care existing, it's that there's no universal layer underneath it, and prices are astronomically higher across the board.

Colorful riverside buildings and boats in Porto, Portugal
Access Yes — anyone in Portugal has the right to be treated at a health center or hospital
Entitlement Full for citizens and registered legal residents; partial for EU visitors via EHIC; not automatic for American tourists
Payment SNS absorbs it for residents; American tourists can be billed after treatment
Worth knowing

Portugal will issue a foreigner an SNS user number the first time they show up at a public hospital. That number does not mean the bill is covered — you can be fully processed into their system and still owe money.

Colorful colonial street in Cartagena, Colombia
Access Yes — extensive public and private infrastructure, especially in major cities
Entitlement Hybrid system — formal enrollment via insurers (EPS) tied to employment or income; visitors generally outside it
Payment Formal system covers enrolled residents; cash-pay private care is common and notably affordable regardless
Worth knowing

A routine doctor's visit runs around $50 USD. Prescriptions, including ones that require a script, show up on Rappi — the same app you'd use to order dinner. No one asks for insurance at the pharmacy counter.

Hot air balloons over a pyramid near Mexico City
Access Yes — large private sector plus public institutions in every major city
Entitlement Public coverage tied to employment and enrollment status — not automatic for foreigners or visitors
Payment Many residents and nearly all visitors pay cash for private care — often still far below U.S. equivalent cost
Worth knowing

Being "uninsured" doesn't carry the same risk it does in the U.S. Private routine care is cheap enough that many people simply pay out of pocket, reserving insurance only for the catastrophic layer.