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Healthcare in the UK

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Teja Marri

on 25 July 2013

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Transcript of Healthcare in the UK

The United States uses both public and private care, but private care is more prevalent.
Those who use public health insurance are either living in poverty (Medicaid) or elderly and disabled (Medicare)
Most private health insurance is employer sponsored.
There is also private non-group insurance. This covers part of the population that is self-employed or retired. In addition, it covers some people who are unable to obtain insurance through their employer.

Number of Primary Care Physicians: 62,369
Number of Specialists: 76387
Primary Physician acts as gatekeeper. They can refer you to
specialists depending on the ailment. Wait times are a huge
negative in the case of the UK healthcare system.
The wait can be anywhere from 24 hours to 18 weeks.
Policlinics: clinics that offer more than just the care under a
GP but also care that extends to issues such as mental health,
social care, healthy living services and urgent care

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Healthcare in
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UK & USA Characteristics
*The UK uses the Beveridge model, named after William Beveridge. The government healthcare system is the British National Health Service.
*Health care is provided and financed by the government through tax payments, just like the police force or the public library.
*One major characteristic of the NHS is that it actually employs the physicians and nurses and owns most of the hospitals and clinics. There are very few private doctors, and even private doctors collect some fees from the NHS.
*The NHS pays for healthcare fees, except prescription drug coverage and dentistry.

How is healthcare delivered in the UK?
How is healthcare delivered in the US?
Outpatient Care in the United States
Outpatient Care in the United Kingdom
Hospital Care:
Hospital Care:
Different Types of
Alternative Medicine

How is healthcare delivered in the UK?

*The main pro of the NHS is that everyone has an equal opportunity for treatment regardless of socioeconomic status.
*These systems tend to have low costs per capita, because the government controls what doctors can do and what they can charge.
*The UK has a cap of 75,000 pounds per person for elderly care.
*A major disadvantage to the NHS system is that waiting lists have become so long that the NHS has started paying for people to cross into the European Union for treatment.

How is healthcare delivered in the US?
Medicare is a social insurance program that serves more than 44 million enrollees and costs 3.2% of GDP.
Medicaid is a social welfare program that serves about 40 million people and costs 2.4% of GDP
States establishes their own eligibility standards and administer their own Medicaid program, whereas Medicare is more overseen by the federal government.
Medicaid does not pay money to individuals, but sends payments to the health care providers.

How is healthcare delivered in the US?
When it comes to treating veterans, we use the Beveridge model, similar to the UK. There are special VA hospitals, and veterans get special insurance.
For Americans over the age of 65 on Medicare, we’re like Canada. For working Americans who get insurance on the job, we’re Germany.
For the 15 percent of the population who have no health insurance, the United States is like a less developed country, with access to a doctor available if you can pay the out of pocket cost or get into the ER
How does the delivery of healthcare affect the world ranking of the US vs the UK?
 The US is ranked 37th in quality of healthcare, compared to the UK which is ranked 18.
The United States is the lowest ranking developed country when it comes to quality of healthcare, yet they spend more than every other country.
Why is there such a discrepancy?
Unnecessary spending
Lack of a socialized system
Larger population in the US
Major Reason: Fee for service system
 Fee for service : We pay for all treatments separately, meaning the more treatments, the more money for doctors, insurance companies, and drug companies.
The fee for service system creates a high volume, high cost system, with very little improvement in quality.
In the US, we focus mainly on treatments for procedures, whereas the UK focuses a lot on preventative medicine, which can help decrease future costs.
The UK has caps on the amount of money insurance will pay for a treatment or procedure. Bundling payments will also cut down healthcare costs.

Types of hospitals by ownership
Public hospitals are operated by the government at the local, state, and federal levels.
- At the federal level, the US has the Department of Defense for active military members, the Indian Health Service for Native Americans, and the Veterans Health Administration for military veterans.
- At the state level, the government mainly operates psychiatric institutions.
- Local governments operate general hospitals that focus on aiding the underserved at free or reduced costs.

Private hospitals are not operated by the government. Types of private hospitals include:
- Not-for-profit hospitals reinvest profits into the hospital and community. Most are secular hospitals owned by non-religious organizations and run by a board of directors. Others are affiliated with religious groups. Non-profit hospitals are not required to pay taxes.
- For-profit hospitals are another type of private hospital. However, these are owned by corporations, and profit goes to the shareholders rather than the hospital or community. These hospitals are required to pay taxes.
- Physician-Owned hospitals are mainly for-profit, and often specialized in a single area, such as oncology or orthopedics.

The UK has a system of universal health care, run by the National Health Service (NHS). The NHS is run by trusts that are in charge of healthcare policies, immunizations, and budget. It offers free medical treatment to all residents of the UK, and is funded from taxes.

While a majority of healthcare in the UK is public and run by the NHS, there is still a notable private healthcare presence. The private sector is financed by private insurance companies and owned by private entities. Insurance contributions are dependent on age, general health, and preexisting conditions. However, there are still times when private patients will be treated in NHS hospitals rather than private hospitals due to more specialized the facilities.

Although the UK has a far greater public healthcare sector, it still holds similarities to the US in that sometimes there is no “pure” private practice. Some American private hospitals may choose to accept Medicare and Medicaid. In this sense, they are “funded” by the government. Likewise, many private practitioners in the UK will still treat patients under the NHS.
Types of hospitals by services
General hospitals offer a wide array of services, from surgery to internal medicine. Some of these hospitals are paired with medical schools as teaching hospitals. They have residency programs and train medical students and new physicians.

Specialty hospitals focus on a single area, such as children, women, or oncology. Children’s hospitals are general hospitals focused on the care of children. Psychiatric facilities focus on a variety of mental disorders.

The most common are the general hospitals, which offer treatment in a wide variety of specialties and deal with a broad range of disorders and injuries. Like the US, some hospitals are part of a teaching program and focus on the training of new physicians and nurses.

- Acute trusts manage hospitals and employ nurses, doctors, and other healthcare professionals. Some are centers for specialized care, while others are affiliated with a school and involved in medical student training. They also serve the community through clinics or people’s homes.
- Ambulance trusts are responsible for providing emergency healthcare. They provide emergency ambulatory transport to hospitals.
- Foundation trusts are not-for-profit and provide over half of NHS health services. They are not directed by the government; thus, decision making is not limited by central-government control and is instead made at the local and community level. Through a board of governors and members (made up of patients, community members, and staff), these self-governing entities have the freedom to organize their healthcare systems as well as raise money from both the private and public sectors. They are held accountable to the local community.
- Mental health trusts provide care for people with mental disorders.

The NHS includes multiple health trusts that are responsible for managing healthcare:
Number of Primary Care Physicians: 246, 090
Physicians encompassed in providing Primary care: Family Practice, Geriatrics, General Practice, General Internal Medicine, Pediatrics
Number of Specialists: About 600,000
General Practitioners (GP’s) commonly practice in a private practice either alone or with a group of GP’s. There are many GP’s that work in the hospital setting as well.
Some Specialists (Psychiatry, OB/GYN, Sports Med, Pain Management) tend to have their own practices but many of them are employed by hospitals. Many groups of physicians own their own practice

*Physicians can engage in group practice and work in a multispecialty practice or single-specialty practice

Single-specialty: Two or more doctors providing a specific type of care

Multi-specialty: Two or more doctors each providing a different medical specialty care

According to the World Health Organization (WHO), the United States ranks ____ and the United Kingdom ranks ____ in healthcare.
A) 13, 6
B) 13, 23
C) 37, 43
D) 37, 18
E) 28, 15

What is the name of the British Royal Baby?
A) William Alfred Edward
B) Alexander Leopold George
C) Edward John Alfred
D) Henry George James
E) George Alexander Louis
Physicians work together most commonly in
small practices that are funded publicly by the UK’s public healthcare system, the NHS (National Health Service).
There are some privately employed/self-employed doctors (private practices) for individuals who decide to purchase private insurance or are provided insurance by their place of work.

The US and UK both are active in providing
alternative medical practices. The societies
in both nations is very modernized therefore homeopathic, ayurvedic, accupuncture and
other services in the dynamic of natural healing
processes and procedures are being offered.
However most private US insurance companies
do not cover these costs likewise the NHS
system of the UK does not cover these costs
Complementary and Alternative Medicine
Hospice/Palliative Care
*This standard of care is for those who have been diagnosed with a terminal illness and fewer than six months of life. It is a way for a person to pass with their family by their side in a pain free way. This is usually the way some people decide to die after they have been refusing treatment for
their terminal illness.

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