healthcare usa/uk

LIR 55409/16/08

HealthcareUSA/UK

Dawn Roberts, Jamie Miller, Rebecca Seymour, Cory Anderson

Presentation Overview

• Models of healthcare • Description of US & UK systems• Mechanics of US & UK systems• Strengths and Weaknesses

Models of Healthcare

Dawn Roberts


1. Beveridge Model• Provided by: Medical providers whose salaries

are paid by Government• Financed by: Federal Government, from income

taxes• Admin. by: Federal Government• Examples: England, Spain, Scandinavia,

Cuba, New Zealand, Hong Kong


2. Bismarck Model• Provided by: Private medical providers• Financed by: Nonprofit insurance companies,

Premiums paid by employees, employers, government

• Admin. by: Government (closely regulated)• Examples: Germany, France, Switzerland,

Belgium, Japan, Latin America


3. National Health Insurance• Provided by: Private medical providers• Financed by: Federal Government-run insurance

program, from taxes of all citizens• Admin. by: Federal Government• Examples: Canada, Taiwan, South Korea


4. Out-of-Pocket Model• Provided by: Private medical providers• Financed by: Patients, directly• Admin. by: No one; Each provider collects• Examples: Rural parts of Africa, India, China,

South America


US uses all of these:1. Beveridge (VA, Military)2. Bismarck (Employer-supported

insurance)3. National Health Insurance (Medicare,

Medicaid)4. Out-of-Pocket (Everyone else)

Description of Systems

Jamie Miller


US System is notable because:1. Numerous plans; Not universal2. Costly3. For-profit providers, financiers,

and administrators


Costs covered by many separate legal entities:Private Insurance Private out-of-pocket Federal government State/local governments Other private funds


• More dollars spent per capita than any nation • 15.2% of GDP, with projection of 19.5% by 2017• $2.26 trillion → $7,439 per person, in 2007


UKNational Health

Service (NHS)


UK System is notable because:1. Universal 2. Providers receive salary from

Federal Government3. Government decides on care


Dramatic differences in health care provision

Are these reflected in actual health differences?


Life Expectancy

United States: 78United Kingdom: 78.7

Mortality Rate

United States: 6.4United Kingdom: 5

Mechanics of Systems

Rebecca Seymour


US: Multiple Ways to Finance Care• Employer-Supported Insurance• Privately-Purchased Insurance• Government-Sponsored Insurance• The Uninsured

Private9%

Govt28%

0

Employer59%

Uninsured 15%


Mechanics of Systems–

Employer Supported Healthcare • Health Maintenance Organization (HMO) • Preferred Provider Organization (PPO)• Point of Service (POS)• Health Savings Account (HSA)


Employer-Supported Healthcare = 59%

0%

20%

40%

60%

80%

100%

HMO PPO POS H SA

Employment Supported Healthcare 2007


Privately Purchased Insurance = 9%• Self-employed or Work for companies not

offering health benefits • Premiums based on individual health

history, age, weight, smoking status and deductible chosen


Government Sponsored = 28%• Medicaid • Medicare• VA Health Insurance


UK: One Way to Finance Care• National Health Service• World’s largest health service and fourth

largest employer• Publicly funded by the taxation of the

general public• Separate administration in UK colonies, but

reciprocity


UK: One Way?• All citizens, Expats with work permits, Students

there > 6 months• Most services free• How does it work?

• GPs inform hospital of a patient's condition. • Hospital judges urgency, against other patients’ conditions. • Urgent need is met almost immediately.• Others receive appointments. (Median wait time ~ 3 weeks)


UK: Private Insurance• Currently, 12% of persons• 2/3 employer-provided; 1/3 individually-

purchased• Privately insured go to NHS hospital or one

of five private hospital groups. • Average individual premium = $260/month

Strengths and Weaknesses

Cory Anderson


US Strengths• World-Class facilities and physicians• Relatively short wait-time for treatment • Government directly covers 27.8% of the population

through health care programs for the elderly, disabled, military service families and veterans, children, and some of the poor

*Information obtained from the National Institute of Health www.nih.gov/


US Weaknesses• ~47 million people without health insurance• High administrative cost• Financial problems for the under- or un-insured• Private plans have exclusions or “carve outs”• Disparities in access to health treatments

*Information obtained from the National Institute of Health www.nih.gov/


UK Strengths• Universal coverage • Guaranteed treatment regardless of income level• Health care paid through taxes• Little paper work or bureaucracy

*National Health Service http://www.nhs.uk/Pages/homepage.aspx


UK Weaknesses• Higher tax rate • Underfunding • Long waits for specialists and elective procedures • Lower quality facilities• Exclusions for new or experimental treatment

*National Health Service http://www.nhs.uk/Pages/homepage.aspx

Companies with Best Healthcare Coverage

*Forbes 100 Best Companies to Work For 100% Healthcare Coverage for employees

FOR MORE INFORMATION:

Descriptions of 5 capitalist countries’ systems:http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/With links to more resources:http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/etc/links.htmlVery cool interactive comparison by countryhttp://www.npr.org/news/specials/healthcare/healthcare_profiles.htmlWorld Health Organization—International healthwww.who.int/en/UK Systemwww.nhs.ukUS System—Resources & Linkshttp://www.pbs.org/pov/pov2008/criticalcondition/resources.html

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/etc/links.html

http://www.npr.org/news/specials/healthcare/healthcare_profiles.html

http://www.who.int/en/

http://www.nhs.uk/

http://www.pbs.org/pov/pov2008/criticalcondition/resources.html

healthcare usa/uk

Documents

mechanics of systems

mechanics of systemsuk

health benefits premiums

health care provision

actual health differences

federal governmentexamples

individual health history

private funds