The United States could be the best healthcare system in the world, but I believe that in its current state it is not. 45 million Americans are uninsured as well as many others who have poor insurance coverage. The great disparity between those that have coverage and those that do not causes major barriers for Americans as many postpone treatment and as a result, their illnesses worsen (www.newyorktimes.com, 2007). The large gap in access to adequate healthcare has affected the quality of life, life expectancy and quality of care across the United States. The United States healthcare system is the only developed nation that does not offer universal coverage for its citizens. England, France, Germany and many other developed nations offer their citizen’s universal coverage through tax financed systems. In comparison to the United Kingdom healthcare system, the United States system has a dispersed model of healthcare while the United Kingdom has a universal system. The United Kingdom’s healthcare system is made up of the National Health Services (NHS), which was founded in 1948. It is a single payer system that serves as universal medical coverage that is funded by taxes. Private insurance is also available and is used 12.5% of the more affluent population. The NHS organizes care through primary, secondary and tertiary care. All British residents have access to care, that primarily is serviced by local general practitioners (GPs). Resident’s access majority of their care through GPs, every resident is required to enroll with a GP and may switch to another if necessary. Secondary care is made up of specialists that can be seen after getting a referral from their GP for more serious illnesses. The tertiary level is made up of regional or national hospitals for patients with more severe illnesses (Bodenheimer & Grumbach, 2012).
The United States spends $8,233 per year on each person for healthcare. This number is two and a half times more than what other developed counties such as the United Kingdom, France and Sweden spend on healthcare per person, each year (Kane, 2012). This accounts for 17.6% of the GDP in 2010 and could increase to 19.6% by 2021 if healthcare spending does not change (The Commonwealth Fund, 2012). In comparison, the UK spends $3,433 on each person for healthcare, which is 9.6% of the counties’ GDP (Kane, 2012). The big question here is that, if the cost is twice as high as other developed countries, is the quality of care that much better as well? One measure of quality is life expectancy. Babies born in the United States have a shorter life expectancy at birth in comparison to other developed counties (Berenson & Docteur, 2009). Illnesses that could be treated or prevented are the highest cause of death amongst the United States, when compared to other developed counties (Berenson & Docteur, 2009). Obesity rates, diabetes and heart disease have been the highest in the US, in comparison to other developed nations (Institute of Medicine, 2013). Socioeconomic factors as well as behavioral aspects contribute to a largely unhealthily population. Preventative care amongst American women is high, as studies show that mammography rates are 61% versus 55% of the OECD average and 84% of women have had pap smears (Berenson & Docteur, 2009). Cancer treatment and survival rates are at the highest for breast, colon, lung, rectum and prostate in the United States (Berenson & Docteur, 2009).
In the UK, GPs are paid through capitation payments which are payments based on the number of patients on their lists. Specialists and physicians that work in hospitals are paid salaries through the NHS. In the US, physicians are paid through capitation rate contracts and negotiated fees paid through insurance companies. The UK started a pay for performance program in 2004 that rewarded bonuses to physicians who scored well in quality measures. However, many physicians have scored well and cost the NHS more money than they