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Healthcare System Comparison

The US and the UK
by

Matthew Wolf

on 9 December 2012

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Transcript of Healthcare System Comparison

Comparing the US
and the UK Since healthcare is a hot button issue, how about we look at another system?
We're going to compare and contrast the Us Healthcare system with the United Kingdom's National Health Service (NHS). Specifically, we'll look at Basic Organization, Management and Payment systems. What are the Differences? US System The US system is operated primarily by the private sector while under the regulation of the government.
Private corporations and Non-Profits manage and operate most hospitals, clinics and treatment centers.
Very few are run publicly by the federal government, or a state, county or local municipality. Who runs it? ... ok so who pays for my treatment? Here again, it's primarily within the private sector. Since healthcare is seen as more of a privilege than a right, either one obtains private health insurance from an employer or on the open market, or they pay the "sticker price", that is they pay out of their own pocket with no assistance. This is evidenced in this chart.

They control nearly all Healthcare Centers in England, Scotland, Wales, and Northern Ireland. They control delivery, payment and regulation. With this centrality, any patient can see any doctor in the entirety of the UK. Seems to be quite the opposite of our system. Their biggest achievement is that they've made healthcare convenient by allowing you to make appointments, ask questions and get information all in the same place. They even have a phone app! The NHS is publicly funded through general taxation. The government pays the bill for your visit. It works like a very large insurance policy, as the video described. It is also the oldest single payer healthcare system in the world. “March on Selma” lays out many facts stated in countless other articles. What is of note is What are the Differences? The state-level government plays a primary regulatory role of creating and enforcing standards of practice to which the healthcare industry in that state is expected to adhere; such as licensure of medical professionals, acceptable standards for procedures, and proper documentation.

The Federal Government, because of Medicare and Medicaid, enforce similar standards that apply to those who accept funding from either of the programs. ...so what does the government do then? US System So here's a video explaining generally how the average health insurance plan works. There are public funding options as well. They are Medicare (for senior citizens and End-Stage Renal Disease Patients) and Medicaid (for the financially disadvantaged) at the federal level, and CHIP programs (for children) and state-run Medical Assistance (for the financially disadvantaged) at the state level. Though you must meet specific qualifications to obtain these. Before we look at the NHS, let's learn a little about its history. A Brief History of the NHS Created in the aftermath of the second world war, the NHS is an example of true socialized healthcare. At its core is the belief that good healthcare should be free to everyone, regardless of wealth. It is made a human right. Starting in 1948, with a budget of £437 Million, the NHS budget has grown to £106 Billion in 2012. That's only 9.6% Of GDP, compared to the US at 17.9%! But according to spending data, the US spends only sightly more public money than the UK, Today, the NHS serves over 62 million residents of the UK. It covers everything from prenatal care to routine check ups to emergency care to palliative care. It also employs 1.7 million people. Only the Chinese Army, Wal-Mart, and the Indian Railways employ more. What are the Differences? The NHS is the purest form of socialized medicine you will find. As is the nature of this structure, the central government runs the show. Who runs it? ...so how about payment? As a citizen of the United Kingdom, you pay nothing for most healthcare services. There are exceptions for dental care, optometrical care, prescriptions and some long-term care options though. Let's look at prescription costs for an example. What are the Differences? There has to be a catch.. Unfortunately all that glitters is not always gold. With the NHS as it is, the biggest difference between the systems is the waiting game.

The NHS employs a "gatekeeper" policy. meaning you must visit a primary care physician to obtain a referral to a specialist. Treatment access is controlled by medical priority, so you may end up waiting for up to 2 years to see a specialist or surgeon.

Very few policies continue to use this system in the United States. The NHS has created what they call Prescription Prepayment Certificates, or PPC's, to mitigate the cost of prescription medication. You can buy an individual prescription at a charge of £7.65, or purchase a certificate for 3 or 12 months for about £2 a week.

This entitles you to any and all medication you need for that period of time, like a season pass.

If you use a lot of medication, it would save a ton of money. Prescription Prepayment Let's Wrap It Up What seems to be the over arching theme where the two systems differ is a matter of philosophy and politics, "Whose duty is it to maintain the population's health?" The UK believes that it is the government's duty, Where the US believes that responsibility lies in the individual. The UK's Centralization makes care extremely easy to access, where the Us is extremely convoluted. But the US allows for more rapid, quality treatment. Where in the UK, you may not be able to seek treatment for a while. While we both continue to learn from each other, it just begs the question... Is either really better? Sources Cited App Review: NHS Direct. (2012). Retrieved from www.youtube.com.

Choices - Your health, your choices. (n.d.). Retrieved November 18, 2012, from http://www.nhs.uk/Pages/HomePage.aspxSultz,

Forrest, C. B. (2003). Primary care gatekeeping and referrals: effective filter or failed experiment? BMJ: British Medical Journal, 326(7391), 692–695.

Ham, C. (2005, March 12). US and UK health care: a special relationship?: Money can’t buy you satisfaction. US National Library of Medicine. Journal Database. Retrieved November 18, 2012, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC554041/

Harrell, E. (n.d.). Is Britain’s Health-Care System Really That Bad? Time. Retrieved from http:///time/health/article/0,8599,1916570,00.html

How Does Insurance Work? (2008). Retrieved from www.youtube.com

H. A., & Young, K. M. (2009). Health Care USA: Understanding Its Organization and Delivery. Sudbury, Mass.: Jones and Bartlett Publishers.WHO | Data and statistics. (n.d.). WHO. Retrieved December 9, 2012, from http://www.who.int/research/en/

The Health Spending Map of the World. (2012, June 30). The Guardian. Retrieved December 9, 2012, from http://www.guardian.co.uk/news/datablog/interactive/2012/jun/30/health-spending-map-world

Snapshots: Healthcare Costs. (2011, April). The Henry J. Kaiser Family Foundation. Retrieved from http://www.kff.org/insurance/snapshot/OECD042111.cfm


Presented by: Matthew Wolf Infact, THe UK has been taking more lessons from the US than the Us is taking from the UK, according to an article in the British Medical Journal. We see that the greatest form of funding healthcare in the US is private expenditure, Unlike our British Counterparts. Here's the tricky part. Private insurance payment differs from carrier to carrier, and even plan to plan. It's a lot of information to keep straight. Monthly premiums, out of pocket maximums, co-pays, deductibles, in-network and out of network. It's enough to make your head spin.
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