In the second edition of Comparative Health Policy, Blank and Bureau (2007) classify health care systems into three categories: National Health Service, Social Insurance and Private Insurance. This essay is going to compare either end of the spectrum looking at national health and private health services, namely a comparison of health care services In the united Kingdom and health care services In the United States and will attempt to draw a conclusion as to what the National Health Service can learn from private Insurance schemes In the United States.
One of the obvious differences between national health and private insurance health care systems is the way in which they are funded and this causes knock on effects throughout the whole system. In funding healthcare: alternatives to the INS (Irvine, 2003) informs us how the united Kingdom’s INS is funded, he explains that 85% of all health care provision is funded by general taxation with the addition of further taxation on the populations pay through National Insurance.
In addition to this state funding, The Office of Fair Trading (2012, p. 4) report that 15. 8% of the UK population re covered by a private health care policy. In comparison approximately 74% of the united States (US) population are covered by private Insurance, secured either through their place of work or by direct purchase (Organization For Economic Co-operation and Development, 1994) leaving 15. 4% of the US population without healthcare insurance in the year of 2008 and 16. % in 2009 retrospectively (U. S. Department of Commerce, 2010). Those who are uninsured are guaranteed free access to emergency (acute) healthcare through the Emergency Medical Treatment and Active Labor Act (IMMATERIAL In which hospitals that provide emergency department care are by law required to provide Medical Screening Examinations, stabilizing treatment and if deemed the receiving hospital agree (Assist, 2007).
As well as free access to acute services, those over the age of 65, those under the age of 65 with certain disabilities or any aged patient suffering from end-stage renal disease are eligible for Medicare Part A, which is based on the social-insurance model of healthcare systems where the patient or their spouse has paid Medicare taxes whilst working, which means that here is no need to pay a premium (Department of Health and Human Services, 2011).
Beam’s introduction of the Health Reform bill is set to change the way in which healthcare runs in the US, making it law for all Americans to carry healthcare insurance but increasing the eligibility for private healthcare by the poor through subordination for those who can not afford private healthcare as well as creating a new government administrated insurance programmer that Americans can buy into (The Senate, n. D. ). The graph below compares the budget for the INS 2012/13 with he budget for the US health care system from the year 2012/13 per person.
Having looked at the budget in both the I-J and US in the 2012-2013 period, it is worth taking the time to explore both health care systems expenditure in a similar period. As the year 2013 is not at an end at this present moment, we will look at statistics from the 2011-2012 period where both the coalition government in the UK were in power and where Beam’s Health Care Reforms were in progress (The Senate, n. D;Winter, 2010). In the 2011 to 2012 period, the National Health Service’s overall expenditure was 104. 33 Billion pounds sterling which paid for all INS activists (INS Federation, 2013) and this equates to a budget saving of 1. 67 billion pounds [where the INS budget between 2011/12 was 105. 9 billion pounds – (Kirk, 2012)] [pick] In comparison within the same period (2011-12) the American healthcare system spent $8607. 9 per capita (The World Health Organization, 1995-2011) which equates to a total of $1 where the US population 313933954 people (United States Census, 2010-2013). In the graph below you can see US Healthcare budget vs. Expenditure Organization figures we are also able to show how much private insurance impasses pay for healthcare.
Aside from finances, we also need to look at the organization of both systems in terms of service delivery. Who provides these services, how are they funded (e. G. Private or voluntary sector) and how do the public access the services they require. In The Structure of American Health Care Services Madison (1971) discusses the American approach to primary care. He explains how patients self refer to a specialist in the medical area that they are suffering issues, for example if a patient was having issues with their hip then they would visit a hip specialist.
At the time of publication on 10% of Americans used one doctor as their first port of call on any medical issue. He goes on to explain that this is why Group Medical Practices were brought in, in an attempt to place multiplicity’s into one centre allowing for greater control and overview of their patients health. As well as group practices the use of Neighborhood Health Centre allows for inter-professional working with doctors, pediatricians and nurse practitioners all under one roof (Madison, 1971). The Heeler School For Social Policy and Management state in their Foundations of
Health Care Reform (2010) that “Underlying the foundation of the delivery system’s poor performance is a lack of care coordination across the continuum of care. The complex structure of the existing delivery system acts as a barrier to accessing care and support services for patients with increasingly complex health needs who would benefit most from greater coordination and communication across the spectrum of providers. Although everyone is susceptible to poor care coordination and communication across the spectrum of providers, the elderly and the chronically ill are especially vulnerable”.