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The UK Health Care System VS the U.S. Health Care System

The UK Health Care System VS the U.S. Health Care System

The UK Health Care System VS the U.S. Health Care System

Abstract

The UK and the U.S. health care systems are some of the largest health care systems in the world. The systems have similar challenges such as improvement of access to health care, promotion of equity, control of cost, and variation in quality. However, the systems present some differences in structure, health outcomes, responsiveness, and delivery of healthcare. The paper compares both health care systems and uses different objective indicators to determine the most effective one. The paper concludes that the UK health care system is better in performance, health care outcome, efficiency, and safety measure. While the U.S. health care system has a high response rate and allows better access to care for those with insurance coverage, the population health as measured by life expectancy and infant mortality rates indicate that it lags behind the UK health care system. Also, the UK health care system has issues in health care delivery; therefore, both countries need to learn from each other and adapt some aspects in their system to improve the quality of care. 

The UK Health Care System VS the U.S. Health Care System

In the last few decades, the epidemic of health care system reforms has been accompanied by comparing different states. Most of these comparisons examine variations in funding and provision, differences in performance, or trends in health care reforms. A few studies have examined the differences between health care systems across borders. As a result, many health care systems struggle to maximize their health care outcome while controlling their expenditure. The U.S. and UK health care systems are some of the largest health care systems in the world; the former is the major private system in the world and the latter leads in the provision of socialized health care. Both systems are fragmented as they face common problems such as improvement of access, promotion of equity, control of cost, and variation in quality, but also possess unique differences in other areas. A comparison of the UK and U.S. health care system will allow those interested in health care development to track the systems’ performance, highlight their areas of strength and weakness, and identify factors that could accelerate or impede improvement.

The UK health care system offers socialized health care whereas the U.S. system provides an almost fully-private health care system. In the UK, the National Health Service (NHS) facilitates the health care system (Schneider, Sarnak, Squires, & Shah, 2017). The system centers on the belief that healthcare is a right for everyone and not a privilege. Notably, health care plans in the UK are not free; instead, they are paid through taxation or a single payer system, in which every individual income funds health care. The NHS ensures that every citizen in the UK has access to health care regardless of their income. Thus, every person in the country has access to health care and, as a result, the NHS ranked first among the 11 most accessible health care systems in 2014 because of the weight placed on universalism to all citizens (Schneider et al., 2017). The impact of this system is that out-of-pocket expenses are low when compared to other health care systems. 

In contrast, the U.S. health care is almost private funded, meaning that out-of-pocket expenses are high. There is no single nationwide system of insurance; instead, individuals purchased healthcare services individually in the private market place, or the government provides the service to the disadvantaged population. In addition, instead of buying insurance policies from external parties, the employer often has a private insurance plan thus assuming the risk of employee health care cost. Most employers have a managed care organization, and more than 70 percent of employees in the U.S. are covered under these organizations (Schneider et al., 2017). Public health insurance or other government-funded healthcare programs cover another percentage of the U.S. population. The dominant type of public health insurance is Medicaid and Medicare. Both insurance programs are aimed at helping the aged and disabled individuals to access healthcare. The federal government and state government administer these programs; however, a small percentage benefit from such initiatives.

 Government spending on health care in the U.S. is high when compared to that of the UK and other countries. The U.S. spends at least 17.8 percent of its gross domestic product (GDP) on health care, which is almost double of what the UK uses per person (Schneider et al., 2017). Unlike the UK health care system, out-of-money pocket money on health care determines the quality of care in the U.S. Therefore, many people are forced to take the available health care insurance coverage. In addition, only 86 percent of the population in the U.S. has access to health care through private health insurance programs provided by Medicaid and Medicare (Schneider et al., 2017). The remaining 16 percent are ineligible for such programs because of financial reasons as they depend on their financial resources or charity care. While 16 percent can access health care services, they can only do so through public health facilities, and some find it hard to access the quality of care they need. Thus, access to health care in the U.S. system is hard when compared to the UK health care system.

The U.S. and UK health care systems have excellent health outcomes. However, the UK has less variation in health outcomes than that of the U.S. Since the establishment of the NHS in the UK, health outcomes have improved substantially compared to other health care systems. For instance, life expectancy has increased from 68 to 80 years for the last 12 years, and infant mortality has reduced by 90 percent (Majeed, Allwood, Foley, & Bindman, 2018). Also, the NHS performed better in measures such as efficiency, safety, and health care access when compared to other international health care systems (Schneider et al., 2017). The commonwealth fund ranked the UK system first among the wealthiest countries in the world in areas of safety measures, person-centeredness, and access to health care. Despite these achievements, the problem in health care outcomes in various areas is prevalent. According to Majeed et al. (2018), the country lags behind the U.S. and many European countries in crucial health outcome areas such as cancer survival and child health. Besides, the average life expectancy across gender differs significantly, with men living up to 79 years. The life expectancy for women is 83 years, which, although higher than that of men, is average in Organization for Economic Cooperation and Development (OECD) countries (Majeed et al., 2018). These health care outcomes are a direct result of decreased quality of care from a socialized health care system.

The U.S. system has excellent health outcomes, which improve the quality of care and access to medical services. However, the health care system lags behind that of the UK and other developed countries. All-cause mortality rates, death amenable to health care, and premature deaths have failed to improve as quickly as those in the UK, meaning that health care gaps increase every year (Peterson-Kaiser, 2019.). The pattern of health care performance across different outcomes reveals some nuances. The U.S. healthcare system has one of the highest mortality amenable to health care, which reduced by a meager rate in the last decade. However, the U.S. performs well in-hospital mortality related to stroke or heart attack and breast cancer (Schneider et al., 2017). The primary cause of poor performance is because the U.S. has the highest per capita health expenditure and devotes a large percentage of its GDP to health care compared to the UK and other countries (Schneider et al., 2017). Moreover, fragmented health coverage may account for the poor performance of health care outcomes in the U.S. However, the U.S. federal government has taken several initiatives such as implementing the Affordable Care Act to improve its healthcare system’s performance. In addition, the government has extended insurance coverage to Americans with recent legislation thus spurring health care delivery through payment incentives to providers; nonetheless, health care outcomes are slow to change when compared to the UK health care system (Altman & Morgan, 1983).

The extent to which caregivers respond to clients and patient expectations determines the effectiveness of a health care system. Patients derive maximum satisfaction from the quality of care provided by caregivers who treat them with dignity and respect. A responsive health system can anticipate and adapt to existing health needs, and this contributes to better health outcomes (Murante, Seghieri, Vainieri, & Schäfer, 2017). The UK and U.S. health care systems have varied responsiveness to patients. The U.S. health care system ranks the highest in responsiveness. However, medical responsiveness is low for people without insurance or with limited access to health care. Many Americans have problems finding responsive caregivers if they lack private health insurance coverage. However, the UK health care system is less responsive than that of the U.S. (Murante et al., 2017). The UK health care system has tight control over funding and health resources, which leads to intangible wants and a longer waiting list even for non-essential medical care (Frayer, 2018). The health care system target is to have at least four hours of waiting time but has only achieved this objective for emergency care patients (Frayer, 2018). In contrast, the waiting time for patients in the U.S. emergency room is 58 minutes (Savva & Tezcan, 2019). In most private facilities, diagnostic testing occurs differently; therefore, it is difficult to compare the waiting time. However, it is apparent that the U.S. health care system is more responsive when compared to the UK system.

The findings reveal that the UK healthcare system is better than that of the U.S. in public spending and healthcare outcomes and performance. Whereas the NHS funds medical services at a point of use regardless of one’s income, the U.S. provision of publicly financed health care often focuses on the elderly and disabled citizens. Thus, routine health care in the UK for all people is affordable and accessible. In contrast, the majority of patients in America, especially the poor and underprivileged, are forced to pay for their health care or rely on publicly subsidized charity care, which is often hard to access. The private system allows some Americans to enjoy better access to a medical specialist; however, the out-of-pocket money is high thus expensive to the larger population. As such, life expectancy in the U.S. is low, and mortality is high than average despite the massive healthcare spending. Notably, the U.S. health care system is more diversified in production, meaning that the government and for-profit and non-profit organizations play a significant role in health care. However, millions of people in the U.S. lack health care insurance thus making the UK health care better due to its high access rate. The UK health care system has excelled in many areas such as access to health care, minimal spending, safety, and health care outcomes. However, the U.S. provides responsive and better care for the insured population. While both countries health care systems work best for the needs of its citizens, each approach faces common problems such as improvement in access, control of its expenditure, improvement in efficiency and responsiveness, promotion of equity and variation in quality. Health care needs and resources vary in the UK and the U.S. hence the nations can learn from each other and identify aspects that are worth emulating.

References

Altman, D. E., & Morgan, D. H. (1983). The role of state and local government in health. Health             Affairs, 2(4), 7-31.

Frayer, L. (2018). U.K. Hospitals Are Overburdened, but The British Love Their Universal          Health Care. Retrieved from            https://www.npr.org/sections/parallels/2018/03/07/591128836/u-k-hospitals-are-            overburdened-but-the-british-love-their-universal-health-care

Majeed, A., Allwood, D., Foley, K., & Bindman, A. (2018). Healthcare outcomes and quality in the NHS: how do we compare and how might the NHS improve?. BMJ: British Medical Journal (Online)362. doi: https://doi.org/10.1136/bmj.k3036

Murante, A. M., Seghieri, C., Vainieri, M., & Schäfer, W. L. (2017). Patient-perceived responsiveness of primary care systems across Europe and the relationship with the health expenditure and remuneration systems of primary care doctors. Social Science & Medicine186, 139-147. https://doi.org/10.1016/j.socscimed.2017.06.005

Peterson-Kaiser (2019). How does the quality of the U.S. healthcare system compare to other countries? Retrieved from https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-start

Savva, N., & Tezcan, T.  (2019, Feb 06). To Reduce Emergency Room Wait Times, Tie Them to Payments. The Harvard Business Review. https://hbr.org/2019/02/to-reduce-emergency-room-wait-times-tie-them-to-payments

Schneider, E. C., Sarnak, D. O., Squires, D., & Shah, A. (2017). Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. The Commonwealth Fund. https://interactives.commonwealthfund.org/2017/july/mirror-mirror/

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