In the current assignment, I will compare the healthcare systems of US and UK with respect to the following parameters:
Healthcare systems for Children
In United States, healthcare for children is provided through insurance under the program called Children's Health Insurance Program. The funds for this program areprovided by a joint effort between the state and the federal governments.In UK, NHS is in charge for providing healthcare to British citizens and healthcare and medicines is free for children up to the age of 16. Contribution is deducted from the wages of the parent. However, some firms also offer private insurance to their employees as a job benefit.
Healthcare systems for Unemployed
Unemployed people in United States are covered under the Federal-State Unemployment Insurance Program as per the Federal and State Law. Under this program, unemployed individual are entitled for insurance benefits for a maximum period of 26 weeks. However, the unemployed person must meet the State requirements regarding wages earned to qualify as unemployed (State Unemployment Insurance Benefits, 2016). Moreover, it must be determined that the unemployment is due to lack of jobs and not for other factors. In UK, unemployed people are exempt from the contributions to the NHS and enjoy a free healthcare provision under the NHS.
Healthcare systems for Retired
In United States, employees are usually covered by their employers under employer’s health insurance plan. Post retirement, i.e. reaching an age of 65, the retired people are eligible for Medicaid, which is the healthcare program of the government. However, individual still will have to pay a certain amount to stay insured.In UK, retired people enjoy free universal provision and do not have to pay anything for healthcare costs.
Coverage for Medications
In US, health plans pay the cost of certain drugs prescribed on prescriptions. However, the individual also have to share a certain co-insurance percentage to encourage patients to opt for drugs with lower cost. In the UK, there is no coverage required for medications and individuals have to pay from out of the pocket for the medication expenses. For children, unemployed and retired, medicines are free.
Requirements to get a referral to see a specialist
In US, the patient will have to get referral from the primary doctor for the plan to cover for the services offered by the referral doctor. In UK, for seeing a specialist, patients can opt for private practitioners. The contribution to private healthcare is calculated depending on parameters such as age of the person, health, medical conditions, etc. Private health insurance is offered by few employers as a part of job benefits.
Coverage for pre-existing conditions
Pre-existing conditions are medical conditions which were present before the health insurance of that person became effective. Before the introduction of Patient Protection and Affordable Care Act in 2014, some insurance policies did not cover the pre-existing conditions. These restrictions were removed in the Affordable Care Act. In UK, NHS does not raise questions about pre-existing medical conditions and the patient is treated as any other person in need of treatment.
Financial Implications for the patients with respect to healthcare delivery differences in US and UK
When a financial comparison is done, healthcare in UK scores far better than the healthcare in the US. Davis et al (2007) compared the healthcare system of United States with other developed nations and found out that it isone of the most expensive healthcare in the entire world. This is because healthcare in US is primarily driven by private sector, whereas in UK, the government takes the responsibility of providing healthcare through NHS. Hacker (1997) noted that healthcare services industry in US is inferior to other developed countries like UK, Australia or Germany. The healthcare system of UK is in the structure of universal health insurance coverage which provides many benefits to its citizens. This is despite the healthcare spending per person in US being $9,086 as compared to $3,364 in UK (Squires and Anderson, 2015). Citizens in UK enjoy the universal provision of NHS which is the primary body for providing healthcare in the UK.
References
Davis, K., Schoen, C., Schoenbaum, S. C., Doty, M. M., Holmgren, A. L., Kriss, J. L., &Shea, K. K. (2007). Mirror. Mirror on the Wall: An International Update on the Comparative Performance of American Health Care, The Commonwealth Fund.
Hacker, J. S. (1997). Market-driven health care: who wins, who loses in the transformation of America’s largest service industry. Journal of Health Politics, Policy and Law, 22(6), 1443-1448.
Squires, D and Anderson, C. (2015) U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices, and Health in 13 Countries, The Commonwealth Fund, October 2015.
