Health Care Systems in the USA GPs and NHS
By Alex Wattermann
The aim of this essay is to discuss and compare two health care systems in the USA, the GPs and NHS systems, the relation between expenditure on these systems and efficiency of them. Another aim of the essay is to compare heath care systems in different countries and find out whether the dominance of public or private spending is optimal for the society here the comparison between UK and USA health care system will be appropriate.
In the USA nowadays the Private Health Insurance system is the major provider of health care cervices. Is this situation adequate to the demands of the tax payers and is it effective for different categories of people who need medical treatment? Should the ratio between private and public sectors in health care be changed and should the organization of both systems be reformed?
Let us first of all define what is health. These can be two ways to define it:
1) Negative: the absence of disease
2) Positive: “a state of complete physical, mental and social well-being.” (World Health Organization, 1946).
Therefore we can outline two aims of health policy: to improve health and to reduce health inequalities. In terms of the first definition, the US health care system is efficient. In terms of the world-accepted definition, the second one, the US health care system is expensive and in many cases not efficient. Let us analyze the relation between costs and effectiveness in this system.
First of all let us trace the development and progress of both health care systems. The basis for current health care system was established after the World war II, when private doctors were serving most of the market. The traditional perception of health care as one of the paid services was and is still remaining the leading one. But it doesn t give the poor, elderly and disabled people, who most often need the medical treatment, the possibility to receive this treatment. In 1965, however, the Congress introduced Medicare and Medicaid programs, which were tax-funded and offered medical help for those groups of society who were not able to afford to pay for medical care. Naturally, this has caused the growth of health expenditures.
In the 1970s the government was trying to stop the growth of spending on health care and offering different measures: price controlling and regulation of medical practice. These measures, however, didn t work, as the doctors have been protecting their incomes. We can make a conclusion that the concurrence solely between GPs, private doctors etc. is not enough to maintain the balance of prices and provide the needs of consumers. In 1980s a lot of insurance companies called “Health Management Organizations” (HMOs) emerged they were not offering direct medical treatment, but were instead making contracts with private doctors and taking the insurance payment from citizens. This helped a little to reduce the growth of budget spending for medicine, but did not help to solve the problem in general, as they didn t manage to perform a constructive structural change in health care system. The NHS services remained necessary for the less protected groups of society and their financing still was growing.
The policy of both presidential candidates in 1990s included the concept of “managed care”, which meant the further development of HMOs network and the participation of the employers in it. But statistics in the beginning of 2000s has shown us that not very many employers have accepted this offer, and those who were using “managed care”, were mostly big corporations. In 2002 Maxwell and Temin published a survey of more than 500 corporations in the US and it turned out that less than 10% of the employers offered “choice or fixed dollar contribution” [7, p. 39] to their workers.
The reforms in 1990s years have been aimed to the reduction of budget costs involved into health care and stimulation of the concurrence between private doctors and NHS. In fact, they have contributed to the development of the private practice and GPs in the US and have strengthened their positions against those of the NHS workers.
Currently, the health care system funding in the USA is one of the highest in the whole world, and the ratio between GDP and health care expenditures is likely to become even higher in coming years. But there is a contradiction between these high costs and the effectiveness of the treatment provided by the system.
The reasons of this phenomenon are different: starting from the bureaucracy and great administrative spending in the NHS system, the lack of regulation of private practicing doctors, ineffective management system of public medical treatment, the tradition of “waiting lists” etc.
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Alex is a senior writer at custom essay writing service. He has 9 years of experience of freelance writing.
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