The US has some of the worst health outcomes and the highest healthcare cost in comparison to other countries. As one of the most technologic and industrialized countries in the world, the US should have one of the highest life expectancies. Instead, the US is a leading country in suicide rates, chronic disease, obesity and has one of the highest rates of hospitalizations from preventable causes/avoidable deaths. In this blog, I will be comparing the health system in the U.S. with that in the United Kingdom, specifically England.
England has a governing health agency called the National Health Service that provides universal health care services for all residents. The NHS’s principle is that health coverage is a basic right that should be provided to all individuals. This universal health coverage has been accessible for residents since its creation in 1948. This service is controlled directly through the government which handles the day-to-day operations. Some of the operations include managing the budget, overseeing the clinical groups that provide the services, and setting the direction of health information technology. The government also has a hand on the ambulance services, nursing, community, health education and the quality. While, statistically, England is faring better than the US regarding healthcare systems and policies, there is still some major issues that stem from this National Health Service. I was able to interview an elder couple from the UK, whom had firsthand exposure to the National Health Service’s policies over the years.
Dave and Lynn Woodford from Chelmsford, England emigrated to the United States to pursue their business ventures and have access to its health care as well as spend time with their extended family. According to Lynn, when the National Health Service was introduced, going to the general practitioner was a personalized, great experience. Her views of the NHS over the decades had shifted from positive to negative due to multiple problems, specifically issues with the government, and excessive waiting times. During the interview, she recalled a time in her life where her sister had developed stomach issues and was told they would be put on a waiting list for three months before being seen. Three months later, the specialists had found that her excruciating stomach pain was linked to cancer. Lynn’s sister was then put on a six-month waiting list to be seen and operated on. Lynn goes on to explain that unfortunately, these waiting times are things that every family must deal with one way or another. Her husband, Dave, also recalls an experience with the NHS and his father’s previous health issues regarding misinformation between general practitioners and the specialists they are sent to. “The general practitioner had seen my father and knew of his prior health issues and his allergies to certain medications, but when he was sent to the specialist, they all laughed when we had expected them to know of his prior condition etc.….” Dave explained.
The issue that was most prevalent during the interview was the waiting times for the NHS. Generally, you would need to call two to three weeks in advance just to be seen by a general practitioner and the waiting time is applicable to over-the-counter drugs as well. The only way to bypass this waiting system is to pay a fee to have a specialist or a procedure done privately. Lynn explained that a wait time of two to three months up to even a year, can be shortened to a week’s time by paying the premium. It was very interesting to get an insight into the National Health Service from a citizen’s point of view. After interviewing these two, I asked them which health system they prefer, England or the US. Dave and Lynn both chose the US’s and even went as far as saying that they wish all their family moved here. The level of hospital care, the ability to be seen quickly and efficiently, and not be taxed heavily for it were the main reasons for their choice. Ironically, after asking a group of 20 individuals around my town in North Georgia, they prefer access to universal healthcare over the US’s current policies.
The United States does not have universal health care, rather the system is a mixture of public and private insurers. “It was estimated that almost 92% of Americans were covered by some form of health care provider, which left over 8% of the population, or around 27 million people, uninsured” (Commonwealth 2021). Instead of health coverage for all individuals, the US offers Medicaid, Medicare, and a Child Health Insurance Program (CHIP). Medicaid is offered to some low-income adults to create a health system that is affordable. Due to it not being handled by the government, Medicaid is managed by each state which have varying requirements for eligibility. Medicare is a national health insurance program that is ran by the federal government that is primarily based on age. It is used by senior Americans over the age of 65 and/or individuals who have disabilities. It Is possible to have a mix of both Medicare and Medicaid. Even with these policies, many Americans are unhappy with the health systems in place.
The United States is, in my opinion, one of the most culturally diverse countries in the world, yet there are many individuals, including myself, who have a problem with its health policies. The copayments are generally higher, and it is processed to find the right plan that supports the family or the individual. Most must choose healthcare plans that have lower monthly payments with a much higher deductible and try to stay healthy. After consulting with my family, I found that our private healthcare coverage continues to go up regardless of going to the doctor or not. I believe that there should be some sort of cap on this. I am a Hispanic American and although my family is “middle class,” we have family members that struggle to find help within these health systems. Specifically, the health options that require individuals to go through the healthcare marketplace. With some health options in the US that require the marketplace, you may not get seen by a doctor unless they happen to be “in office.”
There are many differences between the US and the UK, specifically England. While statistically, the United States fares lower than the UK in most graphical comparisons; obesity, life expectancy, chronic disease, for those who live in a country that provides universal healthcare, not everything is as it seems. Interviewing citizens of England who shed light into their health systems really helped to grasp an understanding of the bigger picture. In comparison, England’s population is 1/3 of the US’s which leads me to believe that there are steps that can be taken to help shorten the gap between the wealthy population and the low income in the United States. While full universal health care in the United States might seem like a far-fetched idea, there is much to learn from England’s National Health Service
Tikkanen, R., & Abrams, M. K. (2020, January 30). U.S. health care from a global PERSPECTIVE, 2019: Higher SPENDING, Worse OUTCOMES?: Commonwealth Fund. Retrieved February 12, 2021, from https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019
Tikkanen, R. (2020, June 05). England. Retrieved February 12, 2021, from https://www.commonwealthfund.org/international-health-policy- center/countries/england#:~:text=All%20four%20countries%20in%20the,2
Woodford, D., Woodford, L. (2021, February 09). National Health Service in England [Telephone interview].
Great article!