Comparison of U.K and U.S Healthcare Systems



The NHS was launched in 1948. One of its core principles is to avail good healthcare to all individuals, regardless of their wealth. Statistics indicate that in every 36 hours, the NHS England handles more than 1 million patients. It covers all the services from end-of-life care, antenatal screening, emergency treatment, routine screenings and transplants (Nuwer, 2013). The NHS is renowned for its efficiency, cost-related problems, effective care, patient-centered care and coordinated care. In terms of equity, it ranked second. It has more than 1.6 million employees, and this puts it in the top five bracket of the largest workforces in the world.

Coverage is universal in the NHS, with all of U.Ks ordinary citizens being entitled to healthcare. The NHS covers various things such as services, cost-sharing, safety nets, hospitals, government and private insurance funds. With regards to services, the NHS covers rehabilitation, preventive services, learning disabilities, inpatient and outpatient, mental health care, physician services and dental care. publicly-covered services also have some level of cost-sharing arrangements (Tighe, 2014). The safety nets ensure that the public purse meets most of the costs, with special patient groups being subjected to unique measures that alleviate costs. Hospitals are directly accountable to the Department of Health because they are structured as NHS trusts. General policy matters and health legislation lie with the parliament.

The NHS undertakes various measures to safeguard quality of care. A key focus is to enhance the safety and quality of social and health care services the NHS uses various means to address quality issues. They include regulatory bodies, targets, national service frameworks and quality and outcome framework (Maskileyson, 2014). The regulatory bodies assess and monitor the quality of services that both private and public health care providers give. This involves regular investigations and assessments of all providers. The government sets targets for a range of variables so as to reflect the quality of care. Regulatory bodies are tasked with monitoring these targets.  The NST was developed in 1998 to improve certain areas of care such as diabetes, coronary, mental health and cancer. The quality and outcome framework was newly developed to measure the quality of care that GPs deliver. It serves as an incentive for improving quality.

The NHS also undertakes various measures to improve efficiency. This remains a key focus, and the NHS employs various tactics to ensure this. They include; high-level efficiency targets, benchmarking and institute for innovation and improvement. The government has undertaken measures to increase social care provision efficiency, centralize procurement and reduce costs of NHS provider. The benchmarking of NHS organizations is done against their peers’ performance, including reference costs, readmission rates and day case rates.

In order to control costs, the NHS budget is set by the government on a three-year cycle. The government also gives a capped general budget for PCTs to control costs and utilization. Each year, PCTs and NHS trusts are expected to attain financial balance. The centralized administrative system guarantees lower overhead costs (Kumar, 2014). A significant percentage of the NHS funding comes directly from taxation. In the new changes that have been enacted by the Cameron administration, 80% of the healthcare budget will be handled by the GPs. All hospitals will also be independent from the Department of Health, and should their books fail to balance, private operators will take them over. These reforms are being undertaken for ideological reasons and to save money. Some of the challenges facing the NHS include the steady increase of life expectancy, as well as the increases in chronic diseases like neurological disorders and cancer.

In the United States, healthcare is provided by various distinct organizations. The private sector owns and operates a significant percentage of the health care facilities. Statistics indicate that in the U.S, 20 % of the hospitals are for profit, 20% are owned by the government, whereas 60% are non-profit (Salzberg, 2012).  The healthcare provision in the U.S comes from programs like the Veterans Health Administration, Children’s Health Insurance Program, Medicaid and Medicare. A significant percentage of the country’s population is insured either on their own, or through the employer of a family member. The government provides the public sector employees with health insurance.

Unlike in the U.K, the life expectancy in the U.S is slightly higher at 78.4 years. Some of the challenges that the healthcare system of the country has been struggling with include lung and heart diseases, high obesity rates, homicides and teenage pregnancies (Gwee, 2009). When it comes to medical innovation, America remains a global leader, and this can be attested to by their contribution to medical innovation in the present and past centuries. The U.S health system has been dogged by various factors such as quality, right to health care, value, access, choice, fairness, cost and efficiency. This explains why the country has been trying to institute various reforms to address these concerns. The U.S healthcare system has come under harsh criticisms from some quarters who insist that the quality of care being delivered does not represent value for money as is the case in the U.K.

Healthcare providers in the country encompass medical products, healthcare facilities and health care personnel. Although the county, state and federal governments own some facilities, most of the country’s health care system lies in private hands. Compared to other countries such as the U.K, the U.S healthcare spending is regarded as the most costly. However, the quality of care remains relatively low as can be proven by infant mortality rates (Chen, 2015). The country’s healthcare spending represents about 18% percent of its GDP (Nuwer, 2013). The regulation and oversight of the U.S healthcare system is governed by involved institutions and organizations. The state and federal governments subjects the country’s healthcare system to extensive regulation to safeguard efficiency.

Unlike the U.K, the U.S healthcare system does not pay much attention to equality of care, as the system is often subjected to political interference. The U.S has moved to address these concerns by instituting certain measures of effectiveness including access to care, population health and innovation. These are meant to safeguard affordability, coverage, vulnerable populations, and the U.S workforce.

In conclusion, the U.K and U.S healthcare systems exhibit numerous similarities and differences. Although the U.S system has a better choice of health provider and modern technology, the healthcare is too costly, and this disadvantages the poor citizens (Archibald, 2013). The U.K system is praised for its equality and universality, although some critics suggest that it has long waiting times and a system that is overly-bureaucratic. The U.S system takes advantage of its insurance scheme, whereas the U.K system prides itself in its access to all. Both countries remain keen on providing the best health care to their citizens through various reforms in the sector.


Archibald, M. E., 2013. A spatial analysis of community disadvantage and access to healthcare services in the U.S.. Social Science & Medicine, 90(10), pp. 11-23.

Chen, M.-P., 2015. Bubbles in health care: Evidence from the U.S., U.K., and German stock markets. The North American Journal of Economics and Finance, 31(4), pp. 193-205.

Gwee, M. C.-E., 2009. Problem-Based Learning: A Strategic Learning System Design For The Education Of Healthcare Professionals in the 21ST Century. The Kaohsiung Journal of Medical Sciences, 25(5), pp. 231-139.

Ker, J.-I., 2014. Deploying lean in healthcare: Evaluating information technology effectiveness in U.S. hospital pharmacies. International Journal of Information Management, 34(4), pp. 556-560.

Kumar, D., 2014. Modelling Rural Healthcare Supply Chain in India using System Dynamics. Procedia Engineering, 97(12), pp. 2204-2212.

Maskileyson, D., 2014. Healthcare system and the wealth–health gradient: A comparative study of older populations in six countries. Social Science & Medicine, 119(23), pp. 18-26.

Nuwer, M. R., 2013. Chapter 23 – Public policy and healthcare systems. Handbook of Clinical Neurology, 118(45), pp. 277-287.

Salzberg, C. A., 2012. Policy initiatives for Health Information Technology: A qualitative study of U.S. expectations and Canada’s experience. International Journal of Medical Informatics, 81(10), pp. 713-722.

Seddon, J. J., 2013. Cloud computing and trans-border health data: Unpacking U.S. and EU healthcare regulation and compliance. Health Policy and Technology, 4(2), pp. 229-241.

Tighe, P. J., 2014. Geospatial analysis of Hospital Consumer Assessment of Healthcare Providers and Systems pain management experience scores in U.S. hospitals. PAIN®, 155(5), pp. 1016-1026.

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