NURS11124-01 Global Health Economics Assignment Sample

Introduction

A comparative analysis of the health system of the United Kingdom (UK) with that of the United States of America (USA) will be presented in this assignment. This assignment will analyse the policies of the governments of two countries regarding the healthcare system. The elaboration of the structures and operations of the healthcare systems of the UK and USA can help to differentiate between the two systems. In every sector, financing and resourcing are vital factors. Therefore, this is important to present the comparative discussion regarding the financial structure of the healthcare system of the UK and USA. The illustration of the financial structure of the two countries will demonstrate the similarities or differences of the structure of resourcing in the field of healthcare. The performance of the healthcare system presents the health standard of the country and the analysis of the performances of the UK healthcare and USA healthcare will present a proper comparative evaluation between the two.

Background

Healthcare is a fundamental right for all humans and therefore, this is a very important part of the complete structure of a country. As highlighted by WHO International (2021), the Healthcare system of every country is to ensure quality care services to the citizens and improve their health. The Healthcare system creates social profit by fulfilling the promise of good health support to the people. On the other hand, by serving the people, the government can earn a financial profit from society. There is a well-known term NHS or National Health Service that is related to the healthcare system of the UK. After the massive destruction due to the second world war, the establishment of the NHS occurred and came into action from the 5th July or 1948. The basic purpose of establishing the NHS is to serve the citizens with equal care for any health problems and the system is controlled by the health department of the UK government. According to Commonwealth fund (2021), the people have to pay a certain part of their income to the government for the purpose of central funding by which the system is continuing. According to the report of Sir William Beveridge in 1942, the structure of the NHS was preliminary established as a part of the healthcare system regulations of the UK. Then the formation of the NHS started under the law of 1946 that is the National Health Service Act. Before the establishment of the NHS, the healthcare of the UK was maintained by some charities and the poor law that is the decisions of some welfare committees of the localities. At that time the people had to pay to the private healthcare sectors and free treatment was available in some charitable organisations.

After the establishment of the NHS in the UK, the Department of Health became responsible for maintaining an effective healthcare system that is funded by the government of the UK. Though the government arranges the funding of the healthcare system, the citizens are the taxpayers. According to DFID Health Systems Resource Centre (HSRC) (2021), the citizens are bound to pay a small amount of tax from their earnings to the government for ensuring the health services from the NHS. Therefore, the healthcare of the UK is not government-funded, rather this is a public-funded healthcare system. The Health Department maintains the strategies for the development of the health system, ensuring the funding and resourcing, evaluating the performances to keep a reputed national standard in healthcare. According to Government of UK (2021), the foreigners of the UK, who are not permanent residents of the UK, the healthcare system may charge for the treatments, but some types of treatments in some departments of the healthcare are free for all like the A & E department.

On the contrary, according to Kruk et al. (2018), during the 18th century, the healthcare providers were poorly trained, and previously the hospitals of the USA did not allow the entry of very sick people. Moreover, during the 17th and 18th century the nurses were untrained workers. As opined by the delivery of healthcare was largely dependent on the creation of effective health policies which include both governmental and private policies. According to Fiori et al. (2021), health care reform is one of the most crucial issues across the globe, and in the case of the USA, it has witnessed proposals of multiple reformations of health systems over the years. Moreover, acceptance of healthcare proposals in the USA demands the involvement of federal governments in the context of national medical care. As stated by Kruk et al. (2018), in the 20th century the health system of the USA has been influenced by progressivism which is associated with universal coverage.

The universal coverage of the USA health system was supported by a Republican presidential candidate who included a healthcare programme. According to Bittonet al. (2017), multiple healthcare proposals were introduced in 1949 along with the implementation of the social security act 1965. This act further had introduced medicare and Medicaid proposals which promoted several variations of universal healthcare systems. The Medicare and Medicaid healthcare proposals which were introduced in 1965 as the first public insurance programmes chiefly ensure the universal right to health care. Aged population over 65 with long-term disabilities was eligible under this healthcare programme which provided hospital insurance and medical insurance. Following this, in 1973 the beneficiaries under this coverage were either allowed to get facilities from medicare or Medicaid. As opined by Fiori et al. (2021), Medicaid coverage provides funding to the low-income group families in getting proper healthcare services.

Additionally, the healthcare coverage aimed to provide services to people with disabilities and blind people through private carriers. Besides the people with disabilities, this healthcare coverage also provided facilities for low-income pregnant women, infants, and children up to 18 years. According to Kruk et al. (2018), free-market healthcare plays a significant role in providing effective healthcare services to people at a reduced cost. The heightened cost of healthcare services is directly associated with lowers coverage of healthcare insurances. In this regard, free-market and third parties play a crucial role in providing high-quality services to the low-income groups of the population. As opined by Bittonet al. (2017), the reformation of the free-market system is largely associated with presenting opportunities for improving the aspect of the healthcare system. In addition to providing high-quality healthcare facilities, the reformation of the free-market USA health system is also responsible for addressing the issues of recent health systems.

Moreover, this type of health system does not involve any strict regulatory standards and requirements in order to provide benefits to the people in a high and inelastic environment. Asides from these reformations, the enactment of the Affordable Care Act 2010 also plays a significant role in making health insurance available at affordable prices to more people. Additionally, this enactment also aims to expand the Medicaid programme for adults whose income is below 138% of FPL (Bittonet al. 2017). Following this, the provision of supportive and innovative medical care services is another foremost objective of this act.

Government Policies

Government plays a vital role in the field of the basic human rights of a country and healthcare is one of the basic rights of the citizens of any country. According to the history of the UK healthcare system, the central government took responsibility for the health sector from the year 1948. After the establishment of the NHS system, the government owns different hospitals, healthcare centers and maintains the ambulance services for the patients. According to Commonwealth fund (2021), the government also looks after mental health services, district nursing, and community services. The government of the UK established the NHS trusts, which are liable for the maintenance of the NHS in different provinces of the UK.

According to Government of UK (2021), the NHS of the UK follows the Health Act of 2009 that indicates the duties of the NHS according to the constitution. The Health and Social Care Act of 2012 includes different legal steps to reduce the inequalities in the healthcare services and this Act is applicable to the Department of Health, Public Health of England, NHS of England, and Groups of Clinical Commissioning. This Act is also applicable to the local public health clinics. On the other hand, the Equality Act of 2010 indicates that all the public sectors of the UK have to maintain equality in their regular services to the people. Therefore, the same has to be maintained by the NHS. In addition, NHS (2021) highlighted that the Social Value Act of 2012 is applicable to the health sector bodies of the UK. This is to maintain the environmental, social, and economic well-being of the services. The purpose of this Act is to create social values among the health and wellbeing sectors for preventing inequalities.

According to the National Health Service Act of the UK, the NHS was established to not only serve physical healthcare but also for giving support to the patients, who are suffering from mental illness. The involvement of the government is prominent in the healthcare system of the UK so that the uniformity of the health services can be expected in the UK.

In the case of the US healthcare system, the government has no direct involvement in the healthcare system. This is an important difference with many other developed countries. The healthcare system is one of the most expensive healthcare systems of the whole world as the healthcare system is based on private health insurance companies. On the contrary, the healthcare system of the US is not that much effective according to the expense. The government of the US looks after the private sector, which provides health insurance to the citizens. According to HealthCare Government (2021), the Department of Health and Human Services (HHS) is responsible for ensuring health services to Americans. The HHS of the United States aimed to develop the quality of the health services, and reduce the costs of the healthcare services. For this, the US healthcare system follows some legislation from the year 2016. According to the Healthcare Quality Improvement Act of 1986, the supreme court of the US protects medical persons from any unprofessional conduct or harassment. Medicare is a program of the US government that indicates the establishment of medical care insurances for the senior citizens of the US. Medicaid is another program to provide insurance to low-income citizens for pursuing medical assistance. This program causes the investment of 50% of the total medical expenses of the country. According to HHS Government (2021), CHIP or Children’s Health Insurance Program is another program by the American government, where insurance is provided to families of low income for health coverage of the children. This program is based on the Act of Children’s Health Insurance Authorization that was established in the year 2009. This law is again based on the Affordable Care Act that ensures healthcare services at affordable costs to underprivileged children. The scenario of the government policies of the US indicates that the government encourages the insurance providers to provide health coverages to different categories of patients. According to HHS Government (2021), the government follows the Health Insurance Portability and Accountability Act that was established in 1996. According to this Act the Americans can carry their respective health insurance if they change their jobs. In the comparative study of the government policies in the healthcare system of the UK and US, it can be understood that the UK government makes policies that directly connect the government and the citizens. In the case of the US, the government insists the private sectors generate health coverages among the citizens that make the system expensive and least effective.

Funding and Resourcing

The history of the healthcare system of the UK indicates that the tax is taken from the citizens for the purpose of raising funds for providing health care services. On the contrary, US healthcare is based on private insurance companies that offer health coverage of different schemes. The people have to purchase different schemes for availing themselves of different kinds of healthcare. The government of the US invests a large amount in the programs of Medicare and Medicaid. As per Commonwealth fund (2021), the financial resources come from the general taxes, and payments for the hospital insurance and the premiums of the citizens. Therefore, availing of healthcare services in the US has become costly. Health insurance can generate growth according to the market value in the stock exchange. This becomes quite complex for the understanding of the Americans.

In the case of the UK healthcare infrastructure, the people have no problem understanding the funding method of the government. The citizens pay a certain amount of tax from their incomes to the government for healthcare purposes. NHS (2021) has pointed out that they have no requirements to pay any extra premiums within a certain interval regularly for the purpose of the health insurance. The NHS provides equal services to every citizen of the UK. In addition, if the people of the UK want to avail the of private healthcare facilities, they can purchase different health insurance schemes from the private insurer. In the UK, many companies provide funds to any private insurer to ensure the care for the health of the employees. Therefore, the privately funded healthcare system is available in the UK, but this is not the ultimate pattern of the care services like the US. The centralised healthcare services of the UK are not free for the citizens but run based on the tax of the citizens. The central fund for healthcare services is distributed to different provinces according to the constituencies.

According to the analysis of the comparative discussion, this can be understood that the US is based on the contribution of the government that is collected from tax of citizens, the private health insurer, and the individual citizens who have to give premiums for availing insurance. Therefore, the people of the US have more pressure than the people of the UK. According to HHS Government (2021), if the US government establishes the program CHIP for the children of unprivileged families, in those cases also the families have to give premiums to the insurer. There is no direct interaction between government organisations and the people. There can be a question as to whether the services of the NHS are better than the private healthcare sectors of the UK. The reports have declared that the services of the NHS are standard and the government provides expert medical professionals for patient care. As per Commonwealth fund (2021), the medical staff of the NHS experience a more secure job life as these is publicly funded organisations. As a result, they provide better services than that of the private sector. That is why the people of the UK have agreed to pay high taxes for the development of their medical support. The total spending of the UK in the field of healthcare services is 4653 UD dollars per capita and in the US that are 11072 US dollars per capita. From this, it can be concluded that the spending of resources is higher in the US, but the outcomes of the healthcare services are lower than the other developed countries.

Provisions and Performances

The Analysis of the policies and funding process of the UK and US medical services to the citizens, it can be extracted that the healthcare system of the UK is more focused on the equality for providing services to the citizens. As per WHO International (2021), health care is a basic human right for every person in the world. That is why the practice of providing services to the people from the side of the government is good. Though the centralised healthcare process of the UK is not free for the people, it is negotiated and maintained by the direct involvement of the Health Department of the UK. UK healthcare is public-funded, that is the healthcare is run by the central fund, which is established by the taxes of the citizens. As opined by Rowe (2021), the NHS is an independent organisation and recruit staff, arrange medical support by their own decisions. The UK government provides funds to them so that apparently, they take no money from the patients who are citizens of the UK. The NHS has to follow the government policy for equality in the health and social wellbeing of the people. Therefore, the NHS provides standard healthcare services step by step from diagnosis of the diseases and the proper care according to that. According to Military step into health NHS (2021), the NHS gets support from different charities and social organisations as this are the main centralised medical support provider in the UK. As the NHS is the public sector, that is why medical staff feel more job security than any private healthcare organisation. Therefore, the care services are better in the NHS and reports have revealed that the outcomes of the NHS are better than many other developed countries (Papanicolas et al. 2019).

In contrast with the performance of the NHS of the UK, the performance of the US healthcare system is not good, though this is the high pricing healthcare system. When the NHS of the UK not only cares for the physical health but also for the mental conditions of the patients, the US cannot reduce the hospital admissions of the patients, maternal mortality, suicide rates, depression, and many others. As per Piasecki and Dranseika, (2021), the bad reputation of the US healthcare system is due to expensive but inefficient medical support to the patients, negligence of data maintenance of the patients. In the case of the US healthcare system, the medical support of the citizens is based on their health coverage through the respective insurance and there is no involvement of the government for negotiation like the UK government. That is why people cannot be satisfied with the performance of the healthcare organisations as per the expenses they bear for it. The amount of the premium is based on the market value of the other businesses (Malani and Jaffe, 2018). Therefore, there are no fixed expenses for the healthcare matter to the citizens.

According to the system of the NHS of the UK, every citizen is under the shed of healthcare services and poor people are also under the same facilities. On the contrary, in the US healthcare policies, if any person cannot pay the premiums of the insurance, that person cannot get the facilities of the health coverages (Tumin et al. 2018). This kind of healthcare system indicates to the ethical issues that the business profit from any ill person cannot be justified and the standard of the healthcare is not that effective in spite of being expensive. On the other hand, there is not a high amount spent on medical purposes in the UK, but they maintain the national standard for healthcare services that is many times better than many high spending countries in the healthcare sectors.

Conclusion

Here the discussion is based on the comparative analysis of the healthcare systems of the UK and the US. The presentation of the historical background of the health department of the United Kingdom and the United States reveals that the systems are different in the UK and the US. Therefore, the elaboration of government policies, funding methods, and overall performances of the healthcare of the two countries give insights into the structure. This analysis becomes helpful for the development of the comparative knowledge between two kinds of medical systems. In simple words, the health department of the UK is mainly public-funded and that of the US is based on private insurance companies. According to the UK model, every citizen of the country can get healthcare support from the centralised system as this is the basic right of humans. This system is not free for the citizens, but they have to pay a certain tax by which the government negotiates with the NHS or National Health Services organisation. Therefore, the citizens can avail all types of health support from diagnosis to operations or medicines as needed. The reports have shown that this is such an efficient healthcare system that the citizens want to pay their particular tax for the healthcare to develop the system further. On the contrary, the system of the US is based on the private insurer and designing the programs for the patients of different groups through the insurance schemes. If any citizen cannot deposit the premium amount, that person cannot get medical support. This is very unethical as getting medical support for the well-being of health is the basic right for every human. Additionally, the people of the US have to pay general taxes from which the government invests in insurance.

From the overall analysis, this can be concluded that the health system of the UK is more efficient and less expensive than that of the US. The healthcare system of the US is the most expensive in the whole world, but this is quite inefficient regarding the outcome of the system. The system has failed to reduce the hospital admission rate, maternity death rate, suicide rate; whereas the NHS of the UK looks after the mental health of the people also though the UK government spends much less than the US. Therefore, on the basis of global context, the health system of the UK is much better than the health system of the US.

References

Journals

Bitton, A., Ratcliffe, H.L., Veillard, J.H., Kress, D.H., Barkley, S., Kimball, M., Secci, F., Wong, E., Basu, L., Taylor, C. and Bayona, J., 2017. Primary health care as a foundation for strengthening health systems in low-and middle-income countries. Journal of general internal medicine32(5), pp.566-571.

Fiori, K.P., Heller, C.G., Flattau, A., Harris-Hollingsworth, N.R., Parsons, A., Rinke, M.L., Chambers, E., Hodgson, S., Chodon, T. and Racine, A.D., 2021. Scaling-up social needs screening in practice: a retrospective, cross-sectional analysis of data from electronic health records from Bronx county, New York, USA. BMJ open11(9), p.e053633.

Kruk, M.E., Gage, A.D., Arsenault, C., Jordan, K., Leslie, H.H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S.V. and English, M., 2018. High-quality health systems in the Sustainable Development Goals era: time for a revolution. The Lancet global health6(11), pp.e1196-e1252.

Kruk, M.E., Gage, A.D., Joseph, N.T., Danaei, G., García-Saisó, S. and Salomon, J.A., 2018. Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. The Lancet392(10160), pp.2203-2212.

Malani, A. and Jaffe, S.P., 2018. The Welfare Implications of Health Insurance (No. w24851). National Bureau of Economic Research.

Papanicolas, I., Mossialos, E., Gundersen, A., Woskie, L. and Jha, A.K., 2019. Performance of UK National Health Service compared with other high income countries: observational study. bmj367.

Piasecki, J. and Dranseika, V., 2021. Balancing professional obligations and risks to providers in learning healthcare systems. Journal of medical ethics47(6), pp.413-416.

Rowe, S., 2021. The Structure of the NHS and How Money Flows. FFF Clinical Finance Journal2(1), pp.16-24.

Tumin, D., Menegay, M., Shrider, E.A., Nau, M. and Tumin, R., 2018. Local income inequality, individual socioeconomic status, and unmet healthcare needs in Ohio, USA. Health equity2(1), pp.37-44

Websites

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Government of UK, (2021), the-handbook-to-the-nhs-constitution-for-england, Available from: https://www.gov.uk/government/publications/supplements-to-the-nhs-constitution-for-england/the-handbook-to-the-nhs-constitution-for-england [Accessed on 1 November 2021]

HealthCare Government, (2021), department-of-health-and-human-services-hhs, Available from: https://www.healthcare.gov/glossary/department-of-health-and-human-services-hhs/ [Accessed on 2 November 2021]

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