the differences between the British and American health care systems

The purpose of this essay was to cover healthcare financing, administration, human resources, and statistics. The discussion was limited to the healthcare systems of the United Kingdom and the United States. Furthermore, healthcare spending, population health conditions, and death rates were thoroughly discussed.

The next sections reviewed the expenditures and data of the UK and US healthcare systems. The parallels between the two regimes were also emphasized.

The United States. According to the CDC, Americans lived an average of 78.8 years, with five deaths occurring for every 1000 live births in 2015. (CDC, 2015). The major health conditions were ischemic heart disease, Alzheimer and dementia, Kidney disease, respiratory conditions, hypertension, diabetes, heart attack, obstructive pulmonary disease and lung cancer and the occurrence rates were 14.8, 9.5, 2.2, 2.0, 2.7, 2.7, 5.0, 5.8, and 6.5 percent respectively. It was noted that heart diseases accounted for 28.3 percent of the total health conditions in the US. In 2014, the healthcare expenditure was $9.403 per capita, which was equivalent to 17.1 per cent of GDP – a clear illustration that most Americans were spending close to one fifth of their total earnings on health care.

United Kingdom. In the United Kingdom, the life expectancy was 81.4 years while the mortality rate was five deaths in every 1000 live births in the year of 2015 (WHO, 2017a). The major health conditions that were affecting the UK residents were prostate cancer, obstructive pulmonary diseases, respiratory infection, Alzheimer’s, lung cancer, stroke, breast cancer, esophagus cancer, colon, and rectum cancers. The prevalence rates were 2.2, 5.0, 30.8, 6.2, 6.6, 2.3, 1.6 and 3.3 percent respectively. From the findings, it was deduced that the combined prevalence of heart-related ailments was 26.8 percent, while the respiratory illnesses accounted for 30.8 percent of the diseases. Therefore, in the UK, respiratory ailments were the most prevalent health conditions while the related heart conditions came in second. Health expenditure in the UK was $3.377 per capita for the entire population (WHO, 2017a) that was the equivalent to 9.1 percent of the GDP. Based on these statistics, it was deduced that the UK healthcare expenses were lower by over one-half when compared to the US healthcare expenses.

Comparison of Countries. Hearth related health conditions are the most prevalent ailments in the US, while respiratory diseases are more common in the UK. Besides, the US residents spent more on health care in comparison to their UK counterparts.

Healthcare Financing

The expenses associated with health care financing in the UK and the US were outlined in the following sections. The similarities and differences between the two healthcare systems were also discussed.

United States. The US healthcare system is heavily financed by private corporations and individual contributions except for the Medicare and the Medicaid schemes. In fact, according to the US National Library of Medicine (2016), it is estimated that Medicare and Medicaid constituted 17 and 16 percent of the gross healthcare expenses. Additionally, out of pocket expenses and private insurance schemes accounted for 15 and 34 percent of the cumulative expenses respectively. In total, federal and state funded healthcare schemes accounted for 45 percent of the healthcare funding while private schemes represented 55 percent of the gross health care funding (US National Library of Medicine, 2016). Most of the employers in the US have filled the gap by making partial contributions to the employees’ medical scheme.

United Kingdom. Regarding 2014, health care funding in the UK reached a high of approximately £180 billion; it was the equivalent to 10 percent of the Gross Domestic Product. Principally, healthcare in the UK is funded via national government revenues. Private funded Medicare accounts for a small fraction (3.6 percent) of the total healthcare expenditure. Among all countries in the European Union, the UK has probably the largest government funded public health system that is virtually free to all at the point of access. The revenues that are used to support the healthcare system are sourced from the individual tax that is pegged at 4.5 percent of the person’s gross earnings (Chang et al., 2012).

Comparison of Countries. From the statistics presented above, it was deduced that the healthcare system in the UK is funded by the government revenues collected through taxes and is free to all at the point of access. On the other hand, the US healthcare funding is funded by both private and federal agencies. The government funded healthcare schemes in the US exclude a large proportion of the American population based on age.

Healthcare Administration

The approach employed in healthcare administration in the UK and the US was outlined in the subsequent sections with the aim at determining which among the two is most successful.

United States. Unlike the healthcare administration in the UK, the US healthcare management is privatized and therefore the level of publicly funded health programs is rather small. It was estimated that approximately 56 percent of the patients seeking for the treatment in 2010 were financed by private insurers. A paltry 27 percent was financed by public programs (AICGS, 2017). The rest of the population did not have any form of health insurance. There are two major health insurance schemes in the US namely the Medicaid and Medicare. The Medicare program is mainly reserved for retirees, persons with disabilities or any individual who has attained the age of 65 and above. The program is funded by taxpayers, and eligible persons are prescreened by the federal government. Besides, the federal government is in charge of negotiating the insurance terms between private insurance schemes and public healthcare systems (AICGS, 2017). On the other hand, the Medicaid program features both state funded and federally funded health care insurance programs. Therefore, the Medicaid costs are catered for by the federal and state taxes. The program is spread based on the state that the patient is residing and the eligibility is dictated by federal guidelines. The top insurance quota is determined by the federal guidelines. The governments at the state level are tasked with bargaining the costs and the terms of the insurance. Besides, there is a variant of the Medicaid referred to as SCHIP (AICGS, 2017). The program aims at catering for the medical expenses of minors coming from underprivileged backgrounds. Additionally, such minors should otherwise not qualify for the program based on parental income. Therefore, considering the current approach in the US, it can be deduced that the majority of the American population rely on private insurance corporations to fund their health care needs. Sometimes the medical insurance programs are catered for by their employers as the incentive to encourage higher employee productivity.

Considering that different states have adopted different regulations for health care insurance service providers, it is impossible to generalize the features of the US healthcare administration.

United Kingdom. The National Health Service is the organization that is responsible for healthcare administration in the UK. The NHS has been in operation since its establishment in 1948. Its primary mission is to provide quality health care regardless of an individual’s social status (NHS, 2016). Until today, the NHS serves are offered free of charge to all persons residing in the UK. The current population in the UK is approximately 64.6 million. It is estimated that in every 1.5 days at least one million individuals are treated in the NHS facilities. The services offered by the range from end-of life care, emergency treatment, organ transplants, treatment for long-term ailments, screening, and antenatal services among the others.

However, the NHS has devolved healthcare funding in Wales, Scotland, and Northern Ireland to their respective governments. According to the Commonwealth Fund ratings in 2014, its services were voted for the best in comparison to other leading Commonwealth countries such as the US, Canada, and Australia. The higher ratings were attributed to the fact that the NHS has adopted a patient-centric approach and efficiency in all operations. Besides, its services encourage safe care and social equity. The NHS system currently employs close to 1.5 million persons, and therefore its workforce is comparable to the Chinese People’s Army, Walmart, and Department of Defense. In particular, the workforce comprises of community health staff, ambulance staff, nurses, and general practitioners, doctors whose population is 111,127, 18, 862, 314,966, 40,584, and 150,273 respectively (NHS, 2016). The devolved NHS operating in Northern Ireland, Wales, and Scotland employs 311,415 medical staff and support personnel.

Comparison of Countries. Based on the discussion presented in the preceding sections, it was noted that healthcare administration in the UK, is the preserve of the NHS. It provides free services to all UK residents, and it is funded by the taxpayer. In the US, the healthcare system is partly funded by the federal and state governments through various programs such as the Medicare and the Medicare (WHO, 2017c). Nonetheless, the eligibility for the schemes is limited to a particular population such as senior citizens and minors from underprivileged backgrounds. In both countries, the healthcare system is regulated by the federal or national governments.

The healthcare administration is highly devolved in the US, with private insurers taking center stage in an industry where there is little federal presence. However, just like in the UK, the medical staffs are allowed to practice only after being certified by the federal authorities.

Health Human Resources

The purpose of the current section was to present the ratio of the medical personnel to residents in the US and the UK healthcare systems were outlined in the following sub-sections.

United States. The healthcare system in the US had a physician and nurse staff ratio of 2.45 and 9.82 per 1000 residents in 2011. Moreover, there were three hospital beds available for every 1000 inhabitants (WHO, 2017b). The current ratios may be different based on the current dynamics in the healthcare industry.

United Kingdom. The physician and nurse ratio to the general population was 2.8 and 10.13 per 1000 residents in 2013 (World Bank, 2017). Additionally, the ratio of hospital beds to the population was 2.9 per 1000 inhabitants.

Comparison of Countries. From the health statistics, it was deduced that the US and the UK have similar physician and nurse ratios to the general population. Besides, the numbers of hospital beds available to the population were the same.

Conclusion: Access and Equity Issues

To conclude, it was noted that the healthcare systems in the UK and the US have striking dissimilarities. For instance, the healthcare system in the UK is managed by the NHS, and it is free to all at the point of access. Besides, it has managed to maintain a patient-centric system despite the high number of patients that seek treatment from the facilities nationwide. The UK healthcare system is funded by revenues collected from individual taxes. On the other hand, the US healthcare system is structured on capitalism, therefore it is less accessible, and it does not foster equity. The only exceptions are the Medicare and Medicaid that are funded by federal and state taxes; however, such schemes are limited to the elderly and the disabled. Therefore, the UK healthcare system is more accessible and equitably distributed compared to the US healthcare system.

References

American Institute for Contemporary German Studies (AICGS) (2017). Structure of the US health care system. Retrieved from http://www.aicgs.org/issue/structure-of-the-u-s-health-care-system/

Centers for Disease Control and Prevention (CDC) (2015). Deaths and mortality. Retrieved from https://www.cdc.gov/nchs/fastats/deaths.htm

Chang, J., et al. (2012). The UK health care system. Retrieved from http://assets.ce.columbia.edu/pdf/actu/actu-uk.pdf

National Health Service (NHS) (2016). The NHS in England. Retrieved from http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx

The World Bank (2017). Mortality rate, infant (per 1,000 live births). Retrieved from https://data.worldbank.org/indicator/SP.DYN.IMRT.IN

The World Health Organization (WHO) (2017a). The United Kingdom. Retrieved from http://www.who.int/countries/gbr/en/

The World Health Organization (WHO) (2017b). The United States of America. Retrieved from http://www.who.int/countries/usa/en/

The World Health Organization (WHO) (2017c). World Health Organization’s global health workforce statistics. Retrieved from http://www.who.int/hrh/statistics/hwfstats/en/

US National Library of Medicine (2016). Module 2 – Sources and characteristics of information relating to health care financing in the US. Retrieved from https://www.nlm.nih.gov/nichsr/edu/healthecon/02_he_intro.html