The United Kingdom’s National Health Services provides universal health coverage at not cost to patients. On the other hand, in the U.S. not all people have insurance, and further insurance can be provided by public entities (e.g., Medicare, Medicaid), private and employer-provided health insurance, and other sources. Whereas the NHS system is highly centralized, the U.S. system is much more decentralized. Could these two systems have anything in common.
According to an article by Maynard, Altman and Stearns (2017), they say that the two systems may aim to have similar forms of reimbursement moving forward.
Increasingly, U.S. reform in terms of payment mechanisms is being emulated by the English. Both systems seek better measurement and management of “value,” that is, the effects of health care on the length and quality of patients’ lives. The hospital systems of both countries are attempting to integrate care function and move away from “fee for service” to bundled or incentive payments.
It looks like care value is important on both sides of the Atlantic. Measuring value as well as setting up policies to incentivize high-value care is exactly the focus of the Innovation and Value Initiative–where I serve as the Director of Research. Although IVI’s focus is largely on the U.S. market, identifying high value treatments is truly a concern for patients, physicians and payers around the globe.
Source
- Maynard, Alan, Stuart H. Altman, and Sally C. Stearns. “Redistribution and redesign in health care: An ebbing tide in England versus growing concerns in the United States.” Health Economics 26, no. 6 (2017): 687-690.
I think the systems and participants are so different it simply can’t be summed up this easily. I am married to a Scotsman. I have lived there. My daughters are nurses who just got back from visiting their neglected relatives in the antiquated NHS system. They were simply horrified. Now their neglected aunt can’t get call backs from her oncologist (you don’t get to chose your doctor). Patients there tend to totally obey the system’s rules (it’s free is the mantra….not really…an 18% VAT is added into every item you buy and the average six person, sharing a ward, no TV in the room nor phone, nor electronic beds would horrify the average American. So would the list of meds we can’t get. Our one relative was denied Zofran while on chemo. We almost sent them some, until his private doctor got it for him, but few have private insurance [How great Amazon gives it to employees there]. Doctors make sure to get it though). It feels a bit like communist indoctrination. When anything is completely government paid for you get a type of indoctrination, and yes, entitlement. But the entitlement means money blown on stupid low level ER care for broken finger nails and colds. The system is excellent at curing things that usually take care of themselves!:)
Well-intentioned? Hmmm….yes….outcome-based….not good. The vast majority of my husband’s and I’s relatives died from being morphined to death. Before becoming a statistic. So throwing comparative data at me doesn’t make sense with my loads of anecdotal. I would need a lobotomy to believe that data that the UK offers good care. In the last year not a day goes by I don’t want to fly .over and beg a relative’s doctor there to “PLEASE do something!!!” They claim they can’t. The computer won’t let them. The computer system is set up by who else…the government.