System A Tuition: Free Salary: $65,000 Malpractice: $650/year In this system, everyone has health insurance paid for in cooperation between individuals and their employers (or if unemployed by the government). Costs for care are negotiated between health unions and the government entities that run a public "sickness fund." These costs are paid up front by the patient and reimbursed within a month by their insurer, guaranteed. Billing is automatic. Medical records are kept electronically on encrypted, patient-carried cards that are brought to each visit giving the doctor the ability to read and add to the medical record within a central framework that is universal to all health care facilities. System B Tuition: $155,000 Salary: $350,000 Malpractice: $20,000/year Insurance is not mandatory, and patients decide how they wish to pursue coverage if at all. Most people opt for employer-assisted health insurance plans. Coverage for those not eligible for insurance through an employer must meet criteria of age or poverty to be eligible for government assistance outside of emergency care (which must be provided regardless of ability to pay). Billing is done by employees dedicated to just that, as there are many different compensations between the many different payers, and denial of claims is routine enough to merit having staff to collect on insurance claims. The medical infrastructure is second to none, but record keeping is kept in a combination of electronic and physical copies. These records can be shared between medical practices just as often as not. Tried to keep it relatively short, so don't shoot me if this isn't complete. I know it isn't.