Andorra’s healthcare system is an important factor in the high standard of living in the Principality. While low taxes, above-average wages, easy access to clean water, clean air, education and the environment are important, all of this goes to waste without proper healthcare.
Andorran healthcare system: 100 years
According to the World Health Organization, Andorra’s healthcare system was officially created on 24 September 1918 in response to a devastating influenza pandemic .
“Before 1918, the communes were solely responsible for concluding contracts with doctors and for passing the few existing laws concerning health matters. Some 12 years later these parish health boards became permanent bodies under the Health Administration Ordinance of 9 May 1931.”
Almost all traditional medical services are available in Andorra: there are 3.33 doctors per 1000 inhabitants . There are specialists in many fields throughout the country, many of whom speak at least some level of English, and all of them can be found in this comprehensive list of all health professionals and health centers available in Andorra.
However, since the country is small, not all medical services are available locally. In this situation, patients often travel to Barcelona or Toulouse for treatment.
Andorran Social Security Fund
Today, the insurance portion of Andorra’s healthcare system is known as Caixa Andorrana de Seguretat Social , or CASS for short. CASS was created as a social health insurance system in April 1968.
An estimated 92% of residents are covered by CASS. Registration is required for employees. Those who are not covered are likely to be largely passive residents who are required to have private insurance.
CASS reimburses some of the costs of medical consultations, examinations and medication costs. Hospital visits are typically covered up to 90%, and services such as dental, GP, physiotherapy, etc. are covered up to 75%. Childbirth in Andorra is 100% covered, as are accidents at work.
CASS coverage in Europe
Coverage extends not only to Andorra, but also to France, Portugal and Spain.
Caixa Andorrana de Seguretat Social must be notified before traveling. In the event of an accident, medical bills will be sent to CASS for reimbursement.
Andorra Sanitary Service
The Andorran National Health Service, Servei Andorrà d’Atenció Sanitària, is known as SAAS. SAAS was established in December 1986 and is responsible for the administration and management of all public health resources.
Since Andorran history has seen patients primarily see doctors privately, SAAS aims to bring together the private, public and voluntary sectors to create more efficient healthcare services.
Hospital Nostra Señora de Meritsell
There is only one hospital in Andorra – Hospital Nostra Senyora de Meritxell. Also known as Center Hospitalari Andorrà (CHA), it is located in Escaldes-Engordany and was founded in 1997.
The Andorran hospital employs both public and private doctors. Patients are housed in a modest but private room, often with a futon for guests.
There are approximately 2.5 beds per 1000 inhabitants.
All but the most serious emergencies are handled in Andorra. In extreme cases, patients are flown to Barcelona by helicopter.
Andorra: the best healthcare system in the world
A 2017 publication in The Lancet assessed the health systems of 195 countries and territories between 1990 and 2015. The study looked at the 32 most common causes of death from the ” global burden of disease ” and how they relate to access and quality of adequate health care.
The study resulted in the HAQ, or Health Care Access and Quality Index, a score out of 100. Andorra was found to have the best healthcare system in the world with a score of 95/100.
The top 10 results included:
- Andorra: 95
- Iceland: 94
- Switzerland: 92
- Sweden: 90
- Norway: 90
- Australia: 90
- Finland: 90
- Spain: 90
- The Netherlands: 90
- Luxembourg: 89
Life expectancy in Andorra
Although the top spot fluctuates from year to year, Andorra often takes the trophy for having the highest life expectancy in the world.
The 2010 Global Burden of Disease Study found Andorra to have the second highest life expectancy in the world with an average life expectancy of 79.8 years for men (2nd after Iceland with 80.0 years) and 85.2 years for women (2nd after Japan since 85.9).
Life expectancy according to WHO for 2012 is 83 years. According to US CIA statistics for 2017, Andorra ranks 8th with an indicator of 82.9 years.
Those who speculate about the reason for the high life expectancy in Andorra often talk about local food, grown and grazed on pastures – lots of leafy green vegetables, cows and (yes) horses that graze high in the mountains.
Hiking and skiing are an important part of the culture, along with a slower pace of life and much less stress than many other cultures.
For most residents, the air is fresh and the land is mountainous. A short walk to meet a friend often involves climbing, and almost all apartments and houses have stairs, so even the laziest Andoran will do some light exercise every day.