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What are the key differences between national health service (NHS) and national health insurance (NHI) systems?
For years, there was a clear contrast between NHS and NHI in terms of payment and program focus. First, the NHS was characterized as a program primarily funded by Congressional appropriations (general revenues), whereas NHI would be funded mostly by premiums paid by covered people. Second, the NHS ensured service, but the NHI just ensured reimbursement for services delivered. Differences in reaction to resource needs, changing work descriiptions and people assignments, more equal redistribution of manpower, centralized administration, and consumer participation were eventually added to these criteria. In general, NHS seemed more responsive than NHI if the goal was equity. However, in recent years, the approach to NHI has evolved in response to criticism and a growing realization of changing requirements, and plans for NHI, such as the Kennedy-Cormanbil, have begun to resemble suggestions for the NHS. In short, today’s distinction is essentially one of immediate vs long-term transformation of the medical care system into a social tool aimed at achieving equity (Tulchinsky, T. H., & Varavikova, E. A. (2020).
How do NHI and NHS systems compare with the health care system in the United States?
The United States stands out as the nation with the highest health-care spending. Systems that ration care through government provision or government insurance appear to have lower per capita costs. Waiting times in the primarily private system in the United States, on the other hand, tend to be shorter than in rationed systems, a conclusion that may be drawn both from theory and observation. Americans are more dissatisfied with their health-care system than Canadians or Germans. The major flaw in the American system, according to many, is the problem of the uninsured, which number more than 40 million individuals. While this does not imply that they go without care totally, they do consume half as much health care on average as the insured. Many Americans believe that Canada has developed a cost-effective and popular comprehensive and universal national health insurance policy. The Canadian system has cheaper prices, more services, universal access to health care without financial obstacles, and a better health status than the US system. In comparison to Americans, Canadians and Germans enjoy greater life expectancies and lower infant mortality rates.
Part of the difference in health-care costs between the US and Canada may be explained by a failure to account for Canadian hospital capital expenses, a higher proportion of elderly in the US, and more research and development spending in the US (Ridic, G., Gleason, S., & Ridic, O. 2018).
How do most countries with similar levels per capita income differ from and resemble the US with respect to provider payments, coordination of care, workforce and information technology, and health system performance?
The amount of money a country spends on healthcare is determined by its political, economic, and social factors. Wealthier countries, such as the United States, will generally spend more on healthcare than poorer countries. As a result, it’s easier to compare healthcare spending in the United States to spending in other comparatively wealthy countries, such as those with the greatest economies and GDP per capita that exceed the OECD median. In 2019, the United States spent around $11,100 per person on healthcare, making it the OECD country with the highest healthcare spend per capita. Switzerland, for example, was the second greatest spender, with almost $7,700 in healthcare costs per capita, whereas the average for wealthy OECD countries, excluding the United States, was only $5,500. These comparisons show that the US spends a disproportionate amount of money on healthcare. Higher healthcare spending might be advantageous if it leads to improved health outcomes. In the United States, however, this is not the case. Despite much higher healthcare spending, health outcomes in the United States are no better than in other industrialized countries. In certain key health measurements, such as life expectancy, infant mortality, and uncontrolled diabetes, the United States actually performs worse. A healthcare system with high expenditures and poor outcomes destabilizes our economy and jeopardizes our fiscal and economic well-being in the long run.
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