Comparative Analysis of Health Insurance Systems in the UK and USA.

Comparative Analysis of Health Insurance Systems in the UK and USA

A common assumption is that trade-offs between universal coverage and timely access to specialized care are inevitable. But the UK and other countries with high-performing healthcare systems provide examples of how this is not necessarily the case.

While both the US and UK are working to decrease wasteful spending, more can be done. A comparative analysis of their insurance systems can offer important lessons for reform.

The UK’s National Health Service

The UK has a national system called the NHS, or National Health Service, that is available to everyone permanently living in the country. Most people use the NHS, but some take out private insurance for quicker access to specialists.

The NHS is funded primarily by taxes, and most services are free at the point of use for those who are permanent residents in the country. The NHS covers things like physical therapy, and it subsidizes prescription drugs. It does not, however, cover alternative care.

Generally, Britons hold the NHS in high regard. In fact, in our global survey of views on health systems, the NHS received the highest net favorability of any system. That said, the system is under strain. During the coronavirus pandemic, the UK government had to quickly free up thousands of beds by postponing nonemergency procedures and buying space in private hospitals. It also had to deal with a large number of people needing urgent care.

The US’s Affordable Care Act

The Affordable Care Act is the sweeping health insurance reform signed into law by President Obama in 2010. Also known as ‘Obamacare’, it has significantly reduced the number of uninsured Americans and seen enrollment in marketplace plans reach record levels.

However, it has not eliminated health disparities or increased financial fairness, and some argue that it undermines the freedom of small businesses by requiring them to provide their employees with health coverage or pay a penalty. The ACA also includes subsidies to help individuals afford their premiums and a temporary reinsurance program to cover high-risk patients.

A major challenge for the US is overcoming the political obstacles that stand in the way of implementing a national health system, such as the ongoing legal challenges and attempts at repeal. In addition, creating a national health system requires a fundamental shift in the way healthcare is funded. This could involve moving away from a private risk-based financing model towards a more public tax financed system, such as that in England.

The US’s Private Health Insurance System

The US uses a hybrid system of public and private insurance. The majority of Americans get their health coverage through private insurers and the government’s Medicare program.

Americans’ opinions about the US’s healthcare system have grown mildly more positive over the past decade, but they still rank it below Canada (+23), Germany (+19) and the UK (+13). They also give it a lower net score than China (+6).

The US’s private system imposes cost-sharing on patients and requires them to sign up for specific networks of doctors and hospitals that limit their choice of providers. These network limitations can lead to disrupted continuity of care and surprise medical bills for enrollees. They also raise premiums. As a result, many people get supplemental private insurance to cover gaps in benefits. This creates a “two-tier” healthcare system that reduces access to affordable care for some people. It is also expensive for employers and individuals to offer private insurance, which can limit competition in the marketplace.

The UK’s Public Health System

The UK has one of the world’s largest government-run healthcare systems, known as the National Health Service. It is free at the point of use for all permanent residents and largely funded through taxes. Expats can also purchase private healthcare insurance for shorter wait times and access to better facilities, such as the GeoBlue Xplorer plan, which provides coverage in over 180 countries worldwide.

Despite the recent stresses on the NHS, the majority of Britons still hold a positive view of their system. They’re nearly twice as likely to call it the best or among the best, compared to Americans. Many employers are bringing in private healthcare insurance plans to help their employees with the high cost of treatment, especially for those who require long-term care. This is largely due to increasing waiting times for NHS services, which can cause them to take time off work. This can be costly for businesses and reduce employee productivity.

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