Harry Campos, RN
Should American citizens expect more from the nation’s health care system?
United States vs. Great Britain
Although we are far more advanced than many nations, our health care system seems to be behind the richer nations in the world. Lets compare Great Britain’s health care system to that of the United States.
Health Coverage In The 2 Systems
Coverage For Medications
The National Health Service (NHS) of Great Britain covers not only medical bills, it also covers medications the patient needs. Every resident in Great Britain gets coverage (Mossialos, Wenzl, Osborn, & Anderson, 2015). The NHS covers every British citizen; including children, those who are retired, and even those who are unemployed. Being unemployed does not mean you will go without insurance under the NHS. In the U.S. it can get a little more complicated. For those who are uninsured, get no coverage and need to pay for medications out-of-pocket, although citizens may be eligible for Medicaid which covers those with low income. For the insured, most insurance companies require a co-pay for medications. Retired citizens in the United States are eligible for Medicare, which does not cover all, but does cover most medical expenses. Children of low income families may be eligible for Children’s Health Insurance Program (Mossialos, Wenzl, Osborn, & Anderson, 2015).
Getting A Specialist Referral
Sometimes, a patient needs to see a specialist, a cardiologist for example. This may cost more to the healthcare system, so in turn the system has ways to reduce the cost. The report “2014 International Profiles of Health Care Systems” (January, 2015) describes how in Great Britain, the patient will need to see their own primary physician first and obtain a referral to see the cardiologist, if needed. In the United States, it can at times be similar. The same report mentions that at times having a “gate keeper” for the patient to see the cardiologist is true, but this depends on the coverage the patient pays for. Depending on what insurance the patient has, he or she would be able to see the cardiologist without needing a referral from their primary, but this of course will most likely cost the patient more.
Because under the NHS in Britain all citizens are covered, anyone who has a preexisting condition that may need chronic use of medications or necessary procedures are covered. The 2014 International profiles of health care systems (2015) states that there is no statute defining the extent of the NHS but describes that duty of the Secretary of Health “to take active steps to expand comprehensive coverage, in terms of both the number of people and the services or illnesses covered”. In the United States, before the Affordable Care Act (ACA), private insurance companies could deny coverage to a person due to a preexisting condition. “Under the Affordable Care Act, health insurance companies can’t refuse to cover you or charge you more just because you have a ‘pre-existing condition’ — that is, a health problem you had before the date that new health coverage starts. They also can’t charge women more than men” (U.S. Department of Health & Human Services, 2014).
Healthcare in the United States cannot be described as bad. It has been my personal Experience that it is excellent. Working in an emergency department, I see this on a daily basis. Regardless of healthcare coverage or the patient’s ability to pay, a patient having an emergency will have every test and every intervention necessary to stabilize the patient done. The downside to this is that emergency interventions in the U.S. can be very expensive and the patient will be responsible for that bill in the end, which can be tens of thousands of dollars. In Great Britain, in contrast, citizens never get a hospital bill. The Frontline film “Sick Around the World” (2008) talks about how citizens in Great Britain are not responsible for their medical bills. Instead, healthcare is paid through taxes. Another financial implication is on the health system itself. The same film states that the United States healthcare system is the most expensive healthcare system in the world. Due to the high cost of healthcare in the U.S, it is fair to assume that healthcare premiums will be high and therefore more difficult for patients to be able to afford.
The Dude Nurse
Klaus Campos, BSN-RN