The British Health System has been one of the most successful in the world. It has been claimed as the best system in the world. The United States also has got its own health system administered through the Health Management Organizations (HMOs). The US has disagreed with this claim by the United Kingdom and as a result, several studies have been carried out to establish how best and competent the British National Health Service system is compared to system being used in the US. This paper is going to discuss this claim.
First, it will describe the National Health System of Britain, how well it is working for the British, then a comparison of the health care needs for the Britain’s population and the United States population will be made as well as other considerations that need to be assessed before it is decided whether the NHS is appropriate for the US. An argument as to whether the model may or may not be adopted will be made before a position stand and a conclusion are made. Describe the NHS 650 The NHS is the health care system in Britain which is public funded.
It provides services to any resident of the UK with most of the services being free at the of use by patients. However, eye tests, care for teeth, prescriptions and personalized health cares are charged. The system is the England’s major health care provider. It was established through an Act of Parliament in 1946. It has been paralleled by the private health care sector which serves less than 8 percent of the population. Much of the funding is from taxation of the citizens. This system is under the administration of the Department of Health. Most of the department’s budget is allocated to the NHS.
It has now been established that the NHS is the largest health service in the world and is also the fourth largest direct employer in the world (Luft, 2000, p. 17). A brief history of the NHS reveals that it was created by Clement Attlee’s Labor government in an effort to bring welfare- state reforms. Just like any other organization, the NHS has got its core principles. It is committed to ensure quality health care to every one, free services at times of need based on the client’s medical need but not based on their economic status (D H. ,2000, p. 57).
The main aims of the system is to provide global service on the basis of peoples clinical needs but not their ability to pay, to offer a comprehensive set of services, to adjust to ensure the services they offer addresses the needs and preferences of people as individuals, as families and those care for them, to offer services that address the needs of various populations, to ensure minimal errors in their work while improving the quality of their services, to value and support the professional and support staff, to utilize public funds allocated for health care to address the needs of NHS patients only, to partner with other providers of similar services to ensure seamless service to clients, to work towards having a healthy nation with minimal health inequalities, to keep the individual clients confidentiality while providing free access to information related services, performance and treatment information.
The structure of NHS in Britain begins from the Department of Health which takes care of the political issues concerning the service. Under the DH are 10 strategic health facilities (SHAs) which are in charge of all NHS operations specifically the primary care trusts in their regions. The NHS trusts are several and include Primary Care Trusts which are in charge of primary care and general public health. They have been reduced by almost half in the recent past to reduce costs and to bring services closer together. These Primary Care Trusts oversee about 29000 general practitioners and about 18000 dentists within the NHS system and also commission acute services emerging from other Trusts within the NHS and private sector.
These trusts control about 80 % of the total NHS allocated budget. Other administrative structures under the Department of Health include NHS Hospital Trusts, Ambulance Services Trusts, Direct Trusts in charge of communications, Trusts in charge of mental health as well as care trusts (HPEDIS- US,2000, p. 26). The system has the largest number of staff of about with 1. 3 million workers and nearly all medical doctors and nurses in Britain working either in the NHS or in the Trusts or NHS run hospitals. The budget for NHS in the 2008/9 fiscal year is about 94 billion and all is from government funds (Dudley, 2001, 1088). NHS working for the British
The British National Health Service has in the recent past been claiming that the way it uses its resources is one of the best and most effective systems of health care in the world. The truth about this claim has been known when it was established that the system is cost effective with a per capita expenditure of about 1,764 US dollars. The British National Health Service provides very comprehensive health service to the citizen of the United Kingdom. Some of the services in this system include admission in hospitals, outpatient services, preventive and ambulatory care services, quick response services to address cases involving accidents and other forms of emergencies, sebacute care, eye clinic services, dental care, rehabilitation of patients as well as home based health care.
The British National Health Service system allows free access to medicines and other prescriptions to populations who fall under the social category of children (those below 16 years of age), the senior citizens (above 60 years) and those with special needs like the disabled (Anderson,2001, p. 230). British National Health Service has also subsidized the cost of buying medicines and other prescriptions to an average cost of about10 US dollars to the rest of the population who lies within the remaining age bracket and social groups. The National Health Service is working very well for British in remitting dental and long term psychiatric care needs for its population. The non medical residential health care is one of the National Health Service’s programs that are run outside the system’s budget.
It is essential to note that the National Health Service system is for the service of the whole population in Britain and this is a good stance when compared to other world systems, for example in the Health Maintenance Organizations (HMOs) in United States, that serve only the members who comprise mainly the government and private sector employees (Luck,2001,p. 153). Health care needs of the US population Versus the needs of the UK population The health care needs of the United States population and that of the population of the United Kingdom can be deduced from the the mandates of the National Health system of Britain and the Health Maintenance Organizations of the United States because these two systems were set up to address the medical needs of their populations.
Kaiser Permanente based in California is the largest Health Maintenance Organization in the United States and shares every aspect with all other Health Maintenance Organizations and therefore the health care needs, the organization, administration, health care delivery and the kind of services delivered are very similar and therefore in this discussion, the health care needs of the population visiting Kaiser Permanente will be assumed to represent the health care needs of the whole population of the United States (Buisson,2001, p. 34). Before patients get treated, it is a medical requirement to meet a physician for consultation and diagnosis to establish the kind of disease or condition he or she is suffering from. Whether in the United Kingdom or in the United States, all patients have this common need.
But the way this need id addressed in the health facilities of these two countries is quite different (Barakat,Wilkinson,Suliman,2003. p. 642). First, the amount of time that patients have to spend before they make consultations is longer in the United Kingdom than in the United States. This was established following a study that was carried out to establish efficiency in service delivery in these two countries. From the study, it was shown that it takes 13 weeks for about 80 % of patients who are referred to physicians before they actually meet the physicians in the United Kingdom while the same size of patient population in the United States take only about 2 weeks before they actually meet their physicians (Richard, 2002,p. 139).
Similarly, for 90 % of patients who needs inpatient treatment have their needs met within a period of 13 weeks in the United States while the only about 41 percent of patients in need of inpatient treatment in the United Kingdom of the Great Britain can have their needs addressed within the same period of time. 90 % of the people who have been diagonalized and a surgery prescribed in the United States takes about 13 weeks before their medical needs can be met while for the same period of time only 41 % of similar population in the United Kingdom will have be treated. Also, the number of days a patient spends in waiting for his medical administration otherwise called bed days in the US are far much fewer than in the Unites Kingdom based on collected statistics that indicates that 1000 patients spends an average of 327 acute bed days in the US compared to 1000 acute bed days in Britain for the same population. (WHO, 2000, p. 27).
Concerning the insurance need of the population, competition in the US Health Management organizations (HMOs) has led to an efficient satisfaction of this need because the people can shift from one Health Management Organization to another if they are not satisfied with the way their medical insurance needs are being met. This is because most HMOs in US are not funded by the government and therefore they have to catch up and compete favorably with the market forces of supply and demand which calls for quality services when competition is tight. Whether customers are satisfied or not by the way the UK NHS addresses their insurance needs, they have limited choice since the NHS is supported by the taxes they pay to the government. This implies that the need for insurance in the National Health Service is poorly met compared to the Health Management Organizations. Both populations require cheaper access to prescribed medicines.
The National Health Service has tried to meet this need partly by exempting those with special needs, the aged (over 60 years) and the children (those under 16 years of age) while the rest of the population pay about six pounds for all prescriptions. The US Health Management Organizations have done very little in meeting this need because the population pays about five US dollars for every prescription (Sekhri, 2000, p. 834). It appears that the British population requires more long – term psychiatric care and dental health services than the United States population. This argument is based on the fact that the expanse and distribution of the health facilities and related services is determined by the immediate medical needs of the respective population.
Based on the same argument, it is likely that the United Kingdom population’s non medical health health needs necessitated the establishment of a long term care and home based health care. Since this kind of care has not been established established within the US Health Management Organizations, it is arguable that the US population do not have such health needs or else the needs are too few and thus too insignificant to necessitate provision of these services by the Health Management Organizations. Other factors to consider in determining the appropriateness of the NHS model for the US It is important to access the kind of policies that govern the administration of National Health Service whether they are compatible with the current policies in administration of Health Management Organizations.
For example, there are policies that limit the amount of hospitalization the Health Management Organizations will cover. These policies are meant to ensure that less money is spend on hospitalization so that more money can be spend on other types of care such as surgical and specialists procedures. The compatibility of National Health Service policies (which are considered lesser) to the Health Management Organizations’ policies should be considered to avoid policy conflicts in case the National Health Service system is adopted in the United States. It is essential also to consider whether National Health service will be in a position to meet the insurance needs of the United States population.
Due to competition in health care provision in the US, the US population has been used to effective ways of satisfying their health insurance needs. If National Health System is introduced in place of Health Management organizations, the US population will be forced to adopt to a less efficient system. This is a retrogressive trend in the health care provision sector and much of the population will be opposed to this new system. However, it is important to consider whether the current system in Britain provide for adjustments to make it more competitive and therefore uplift it to fit in the United States context. If such provisions are impossible, it will also be impossible to have this system in the medical and health service of the US population.
Still on the issue of insurance, about 12 % of the United Kingdom population has taken private medical insurance as a security in case they may require non emergency surgeries or they may need to access specialists quickly(HCFA, 1998, p. 36). On the other hand, very few Americans have taken this private health insurance. Much of the population rely a single health insurance which has served them efficiently. Based on this point of view, the United States government may need to consider the fate of its population when they need to access specialists or non emergency surgery because the National Health Service seems to be slow in reacting to these needs. Adopting a new health system should be aimed at improving the welfare of the US population. Any new system require the support of the population and politicians.
The government should first consider civic education to enlighten the population on the benefits of shifting the health care system from the Health Management Organizations to National Health Service system in order to win the social and political goodwill with respect to introducing the new system. Argument: The model may or may not work The introduction of the National Health Service system of Britain in place of the America’s Health Management Organizations to serve the American people may from one point of view be workable while it is totally an impossibility from another point of stand. The National health Service covers groups of populations from all socio-economic classes, but in America, Health Management Organizations mainly serve those in the mid- lower to middle socio- economic groups because the rich families go for health care options that are a little bit expensive and more flexible.
The health systems used in America, according to the US standards, are in the ‘working class’ category (Blendon, 2001, p. 37). But the population has the poor and non working people who would be happier to enjoy health care. With the support of this population and politicians who support equality and respect the opinion the minority, the adoption of the National Health Service in the US can be made a reality. The system may be supported by the population on the basis of the subsidized pharmaceutical costs. Currently, the cost of pharmaceuticals in the US is 2 percent to 60 percent higher than that of Britain and the US population admire this aspect of the National Health Service (Ayanian, 2001, p. 60).
It is also important to note that National Health Service system is set to serve the entire population while American Health Management Organizations system serve its members who majority get the membership through health plans that have been sponsored by their employers or by the government. This leaves out the unemployed population. For the government to ensure parity in health services provision to its citizens irrespective of their employment or economic status, it may require to consider the National Health Service system. Most citizens of the US require adequate dental care services, but this need has not been addressed well by the current health care system.
On the other hand, the health care system of Britain has optimized on this population need. Therefore, with the introduction of National Health Service system, it is possible a large size of the US population will embrace it. On the other hand, data sources have revealed that general practitioners who give general care to patients within the National Health Service system have a starting salary of 43 % lower than their counterparts in the US. For health care consultants serving within the US Health Management Organizations System, their starting salaries are about 115 % higher than the starting salaries of their counterparts holding the same positions within the Britain’s National Health Service System (Danzon,2000, p. 170).
If the system is adopted in the United States with its salary scale policies, it will be a major demobilization to the medical practitioners mainly due to the low salaries. This will lead to poor quality service which cannot be tolerated in the US. In short, the National Health Service system can not work in the US unless major amendments are made. If the decision of whether to adopt the National Health Service system or not were to be based on the per capita cost of medication, then the Americans will be less responsive because there will be no difference in the cost of medication per year. However, this is a generalized opinion based on national a figure.
There will be no significant change in the economic status of the US because the per capita expenditure in medication for these two countries is appropriately the same. The Britain system has also been viewed to be slower than the current system in use in the US. Conclusion It is true that the British National Health Service system is one of the best performing systems of the world but this is in respect to certain aspects like its workforce, the way it considers the poor, and diverse services. But the current system operating in America is in itself more efficient and effective and most citizens are comfortable with it. The NHS offers very little salaries to practitioners and this in America can be a risk, because it will lead to poor services.
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