The United States and the United Kingdom have got a strikingly big difference in as far as their healthcare systems are concerned. Even though both systems are patient centered, the main difference comes in whereby in the US the healthcare system is insurance based whereas the UK healthcare system is socialized. The US healthcare system is referred o as the affordable care act where the UK one is referred to as the National Health Service. These two structures have got wide disparities as far the access to healthcare is concerned. In the US, due to the fact that healthcare is provided based on the cover that an individual has taken; it becomes easier to receive the healthcare that an individual will want (Gulliford & Morgan, 2013). The American healthcare arrangement covers the medical costs for children in the State Children’s Health Insurance Program (SCHIP) (Gulliford & Morgan, 2013). On the contrary, in the U.K, since the care provided is dependent on taxation; it translates to a lot of bureaucracies being followed before the care can be provided to the patients. The efficiency levels of the systems are also compromised in a big way. Such a situation has made access to healthcare to particular members of the society like children challenging. In fact, most parents fly their children out of the country to the United States so that they can get most advanced care services that they require. On the side of the unemployed, the US system has created an alternative healthcare system referred to as Medicaid which provides grants to states to fund insurance coverage for the jobless and the elderly. To the elderly in the United Kingdom, they are usually guaranteed of 60% of their pension which covers their healthcare costs. The unemployed individuals are usually catered for in district hospitals. The NHS system allows both the elderly and the unemployed to choose the healthcare provider that they wish to take care of them (Gaynor et al., 2012).
The fact that the United States healthcare structure is designed in a way that it is insurance based, it means that it is employers to most individuals who are responsible for funding for the medication of the employees through payment of premiums (Schoen et al., 2013). However, for the individuals not covered by such insurance schemes, their medication coverage lie squarely on either the out-of-pocket arrangement or through government-funded schemes like Medicaid, Medicare and Veterans’ Administration for the elderly. In the UK healthcare system, it is the right of every citizen to get the required coverage on medication as is provided for in the National Health Service (Harrison, 2013).. However, if an individual falls in the private insurance bracket like in the American system, the responsibility of medication coverage shifts to them (Harrison, 2013).
In the US healthcare system, for an individual to be able to get a referral to a specialist, the will be required to first of all get an approval from the primary care provider who is in charge of their treatment plans. These physicians have to determine whether the treatment regime is within their scope of practice before they approve the referral of a particular patient to a specialist (Gulliford & Morgan, 2013). Secondly, the physician’s training regarding diagnostic evaluations, self-efficacy and therapeutic interventions have to be taken into consideration before referrals are made. In the UK healthcare system, it is general practitioners who have got the primary responsibility of providing basic healthcare to patients. In a situation where the expertise of the general practitioner does not meet the needs of a particular medical regimen, he/she will then have to make a referral to a specialist in that particular field (Blumenthal & Collins, 2014).
Currently, there are debates in the United States healthcare system where the issue of the coverage of pre-existing conditions has been viewed as a situation likely to lead to increased costs, raised taxes and the displacement of the many people who have insurance covers. This realization will culminate to the private insurance sector being undermined (Gulliford & Morgan, 2013). As such, the coverage of pre-existing conditions in the United States healthcare system dwells on the pooling of high risks which acts as a way of reconciling the gap between the provisions of insurance to patients with pre-existing healthcare conditions which are expensive. Most states in the United States have got these programs which act as insurance programs that offer health benefits plans (Blumenthal & Collins, 2014). These efforts have been made possible by the signing into law of the Affordable Care Act. In the United Kingdom, due to the fact that the National Health Service is not tied to employment but rather on a free basis at the point of use, an individual won’t be denied coverage for pre-existing conditions since all the cost are taken by the federal government (Blumenthal & Collins, 2014).
Conclusively, the current healthcare system in the U.S means that the insurance and administrative costs for individuals stand at about thirty percent. These costs are this high due to the fact that a lot of money is channeled towards marketing, brokers’ fees and underwriting. However, with the current Affordable CARE Act in place, the insurance costs are likely to go down, therefore, cutting on the administrative costs for this program. in the united kingdom, however, the fact that the NHS system is funded by taxation from the citizenry, it will mean that the cost of providing care will be high, thus having tough financial implications for the patients though not directly.
References
Blumenthal, D., & Collins, S. R. (2014). Health care coverage under the Affordable Care Act—a progress report. New England Journal of Medicine,371(3), 275-281.
Gaynor, M., Propper, C., & Seiler, S. (2012). Free to choose? Reform and demand response in the English National Health Service (No. w18574). National Bureau of Economic Research.
Gillam, S. J., Siriwardena, A. N., & Steel, N. (2012). Pay-for-performance in the United Kingdom: impact of the quality and outcomes framework—a systematic review. The Annals of Family Medicine, 10(5), 461-468.
Gulliford, M., & Morgan, M. (Eds.). (2013). Access to health care. Routledge.
Harrison, S. (2013). Managing the National Health Service: Shifting the Frontier?. Springer.
Schoen, C., Osborn, R., Squires, D., & Doty, M. M. (2013). Access, affordability, and insurance complexity are often worse in the United States compared to ten other countries. Health Affairs, 32(12), 2205-2215.
