Healthcare Systems in the US and UK. A Comparison

Term Paper, 2018

14 Pages, Grade: 78.00


Table of Contents


A. Country Description

B. Health System
1. Brief History of Health System
2. Description of Current Health System
2.1 Facilities
2.2 Workforce in Health System
2.3 Public/Private Health Services
2.4 Cost of Healthcare
2.5 Quality of Healthcare
2.6 Access
3. Evaluation of Healthcare System
3.1 Cost
3.2 Quality
3.3 Access
4. Emerging Health Issues

C. Conclusion




Health care delivery systems and financing structures are some of the most popular across the globe when it comes to the wellbeing of the human race. The resultant popularity is influenced by the significance of universal healthcare and the efficiency levels attributed to healthcare delivery, financing, and accessibility, among other factors (Simonet, 2015). All countries are inherently predisposed to have unique healthcare financing and delivery systems due to assorted issues such as political history, culture, economic, and demographic factors. In particular, health care in the United Kingdom and the United States has been at the centre of political, social, and cultural debate in the past few years.

A. Country Description

On the one hand, the United States of America (USA) commonly abbreviated as the US, gained its independence as a country and subsequently created and ratified its initial constitution along with the national government between 1776 and 1789. In 1789, the nationalist movements in the US repealed the Articles of Confederation in attempts to authority and mandate of the federal government’s authority in defence along with taxation with the Constitution of the USA, which is still in operational till to date (Zinn, 2015). The US is made up of 50 states and a number of territories extending into the Pacific Ocean, with a size of about 9.8 million squared kilometres. The large size is accompanied by geographic variety with an assorted types of climates across the country. It is prone to hurricanes and some of the worst known tornadoes in the world.

The US population is estimated to be at 325,719,178 people in 2017, which has quadrupled from an average of 76 million at the beginning of the 20th century. The White Americans make about 73.1% of the total population, while the African Americans are considered as the largest minority group (Zinn, 2015). Others large racial minority groups are grouped as Hispanic and Latino Americans. It is estimated that about 82% of the American population live in urban areas and suburbs. The US macroeconomic aspects are considered as capitalist mixed economy, which is enhanced by vast natural resources and extraordinary productivity, with a GDP of $16.8 trillion (Zinn, 2015). It is estimated that about 12.7% of the total population live in poverty. The transport and energy sector are highly developed, while the basic literacy is estimated to be 99%, and the education index is pegged at 0.97.

On the other hand, the United Kingdom of Great Britain and Ireland, simply referred to as the United Kingdom (UK), or Britain begun in 1707 with a political unity and collaboration of England and Scotland monarchies, while the Kingdom of Ireland was later added 1800. The modern Britain is made up of England, Scotland, Wales and the Northern Ireland, which are largely made up of islands, while its size is estimated to be 248,532 square kilometres. The UK is considered as the sixth largest economy in the globe with a GDP of $2.619 trillion, as of 2016. It has the strongest GDP across the European region (Floud et al., 2014). As of 2011, the UK population was estimated to be 63,182,000, with England recording the highest population density. The literacy level is relatively high and it is estimated to be 99% at the age of fifteen years, which is attributed to the universal public education that was established in 1890. The UK population is dominated by the White Britons, with the immigrants making up to 13% of the total population (Floud et al., 2014). It is estimated that 6.5%, an equivalent of about 3.9 million people live in what is described as persistent income poverty.

B. Health System

1. Brief History of Health System

The US healthcare system is considered as a hybrid system as it is offered my numerous organisation with unique characteristics. It is estimated that about 58% of the community hospitals are non-profit, 21% are privatised while 21% are publicly funded by the government (Osborn et al., 2016). The US is among the few member states of the OECD that fail to include healthcare as a basic human right and also does not guarantee availability of access to healthcare. The hybrid nature of the US health care system implies that different entities, private and public provider healthcare services in the country (Malhotra et al., 2015). In particular, the primary providers include health care facilities, healthcare personnel, along with medical products. The largest financier is the federal government in collaboration with the state and local authorities through special programs such as Veterans Health Administration, Medicaid, the Children’s Health Insurance Program along with Medicare (Shaheen et al., 2018). A significant portion of the American citizens who fail to qualify for the special programs enrol to private insurance programs with a range of merits and demerits. Health indicators are described as quantifiable features in a community or civilization that are used as supporting evidence characterising the wellbeing of a population. These indicators are established by the Healthy People 2020 objectives, which reflect the primary health concerns in the US (Case and Deaton, 2015). These factors include access to healthcare, mental health, injury and violence, environmental quality, physical activity, immunisation, responsible sexual behaviour, tobacco use and substance abuse along with overweight and obesity (Lorenzoni et al., 2014). Notably, the Healthy People framework is subject to modifications after every ten years based on the health status of the US population.

The UK healthcare system is a devolved function with Scotland, Northern Ireland, Wales and England having unique systems that are publicly funded and accountable to different governments within their respective jurisdictions. Voluntary provisions and private sector make a small portion of the UK healthcare system (Devaux, 2015). The National Health Service (NHS) is a common body in the UK that oversees the provision of healthcare services for free or subsidised costs to all the legal UK citizens. The UK government is the largest financial provider of healthcare services through taxation, with a record of 98.8% funding. However, specific policies are different in the four kingdoms of the Great Britain (Buescher et al., 2014). The publicly funded system is based on the notion that universal healthcare system is the right of all Britons living in the UK. The NHS was first launched in 1948, with the subsequent years seeing numerous amendments and modifications to suit the population needs. The primary health indicators are based on the NHS Health Outcome Framework, which is centred on health life expectancy between communities, improved health expectancy and reduced differences in life expectancy (Squires, 2011). Noticeably, the mortality and morbidity rates have significantly improved in the UK and the US in the 21st century, but preventable and chronic diseases remain a significant threat to the healthy populations in both nations.

2. Description of Current Health System

2.1 Facilities

The ownership of the US healthcare system is privatised, but the federal, state, and local governments have their own facilities. The US lacks a countrywide government owned health facilities that are open for the general public consumption, yet the local government owns a number of medical facilities that are opened for the general public (Jakovljevic, 2016). The healthcare systems in the UK is largely owned by devolved governments but healthcare in England is provided by the NHS. The largest NHS hospital in England is known as the Norfolk and Norwich University Hospital (Gilbert et al., 2015). Healthcare in Northern Ireland is provided through the Health and Social Care in Northern Ireland, while in Scotland and Wales by NHS. The private hospital forms a very small niche with a 2% in England.

2.2 Workforce in Health System

Most physicians are trained under the US medical education system, whereby all practitioners are required to acquire medical license within the state jurisdictional mandate. An increase of US spending on healthcare has triggered an increase of the workforce in the sector, in which one in every eight Americans work in the healthcare related field, accounting for an average of 10% of the country’s workforce (Bekelman et al., 2016). Since the UK healthcare system is largely funded by the central and devolved governments, the workforce is accountable to the NHS. It is estimated that NHS employs more than 1.3 million workers in the healthcare sector, making it the largest employer in the UK (Malhotra et al., 2015). In both instances, an increased demand for social health workers has soared due to the growing population of the senior citizens due to favourable socioeconomic factors.

2.3 Public/Private Health Services

As previously observed in the report, the US healthcare system is predominately made up of the private services providers, including the insurers and facilities and practitioners. The federal government funds healthcare facilities and the entire industry through special programs and arrangements, which makes the healthcare system a hybrid industry due to the presence of public, private, and not-for-profit collaborative efforts (Himmelstein et al., 2014). On the contrary, the UK healthcare system is largely universal, whereby healthcare is seen as an entitlement and a human right. However, there exists private healthcare providers, which forms a significantly small portion in the healthcare industry.

2.4 Cost of Healthcare

The US healthcare is considered as the most expensive system compared to other industrialised or OECD countries. The cost has significantly escalated from at the beginning of the 21st century but it is believed to have slowed as of 2011. For each dollar spent towards the healthcare services, 31% is consumed by the hospital care, which includes diagnostic, outpatient and hospital spending per visit and discharge (Squires and Anderson, 2015). Others include 21% which directed to physicians/clinical services, and 10% to pharmaceutical products, 4% to dental care, 6% is absorbed by the nursing homes, 3% to home health care settings, 3% for complementary retail products, 3% to the government’s public health initiatives. 7% of each dollar spent is directed to administrative costs, 7% to investment programs while 6% is consumed by other professions (Filardo et al., 2016). The publicly funded healthcare in the UK accounts for more than 79.5% of the total spending £ 147.1 billion. Specific expenditure differs between the major kingdoms with England recording the highest spending.

2.5 Quality of Healthcare

Compared to the UK, the quality of the US healthcare system is largely considered inefficient. This is due to heavy annual spending, the absence of universal healthcare, and poor accessibility in the midst of escalating healthcare costs (Ryan et al., 2016). However, the UK healthcare system is considered above average compared to other countries due to increased heavy spending and poor health indicators affecting the country (Himmelstein et al., 2014).

2.6 Access

The physician and hospital supply along with spending in the US entails 2.43 practicing physician per 1,000 people, while the acute care hospital beds per 1000 population 2.7. The average length of stay for acute care is 5.5 days, while the hospital discharge per 1000 population is 130 and the total health spending in 2008 was $897 (Squires, 2011). The UK total health spending was $368 in 2008. The practicing physicians per 1000 population was 2.61 and the acute hospital beds per 1,000 was 2.7. the average of length of stay for acute care 7.1 and the hospital discharges per 1000 was 136.


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Healthcare Systems in the US and UK. A Comparison
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Leonard Kahungu (Author), 2018, Healthcare Systems in the US and UK. A Comparison, Munich, GRIN Verlag,


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