The UK and US health systems represent two distinct approaches to healthcare delivery. In this review, we will explore two key differences between these systems and discuss potential opportunities for advanced practice nurses (APNs) to engage in advocacy and political interventions to improve the current health systems. To inform this discussion, we will refer to the provided resources: the US and UK Health System Comparison and the Peterson-Kaiser Health System Tracker.
First, let us consider the differences in financing between the UK and US health systems. The UK operates a National Health Service (NHS), which provides healthcare free at the point of delivery to all residents. The NHS is primarily funded through general taxation, with the National Insurance Fund playing a significant role in financing healthcare services. On the other hand, the US has a predominantly private health insurance system, with various public programs such as Medicare and Medicaid catering to specific populations. The financing of healthcare in the US relies heavily on insurance premiums paid by individuals and employers, as well as out-of-pocket expenses.
The contrasting approaches to financing in the two systems have significant implications for access to care and financial protection. The UK’s universal coverage ensures that everyone has access to necessary healthcare services without facing financial hardship. Furthermore, the absence of out-of-pocket payments for most services means that individuals are not deterred from seeking care due to cost concerns. In contrast, the US system’s reliance on private health insurance can result in coverage gaps and affordability issues. Many individuals, especially those with lower incomes or pre-existing conditions, face challenges in obtaining comprehensive coverage or may need to bear substantial out-of-pocket costs. As APNs engage in advocacy and political interventions, they can draw attention to these disparities and advocate for policies that promote equitable access to healthcare services while addressing the financial burden on individuals and families.
Secondly, let us explore the differences in the organization of healthcare delivery in the UK and the US. In the UK, the NHS serves as the primary provider of healthcare services, with a hierarchical structure encompassing primary, secondary, and tertiary care. General practitioners (GPs) act as gatekeepers and serve as the first point of contact for patients, referring them to specialist services when necessary. The NHS also employs healthcare professionals directly, including hospital staff and community healthcare workers. In contrast, the US healthcare system consists of a mix of private healthcare providers, including hospitals, physician practices, and various types of outpatient facilities. The coordination of care is often fragmented, with patients having multiple healthcare providers who may not be connected in terms of information-sharing or care coordination.
This difference in healthcare delivery has implications for the continuity and coordination of care, as well as the role of APNs in the healthcare system. In the UK, the centralized nature of the NHS allows for better communication and collaboration among healthcare providers, leading to more integrated and patient-centered care. APNs, particularly those working in primary care, can play a crucial role in coordinating care and filling gaps in healthcare service delivery. In the US, where care is more fragmented, APNs can advocate for policies that promote care coordination, such as the implementation of health information exchange systems and interdisciplinary team-based models of care. Additionally, APNs can push for the expansion of their scope of practice to improve access to primary care services, especially in underserved areas where the shortage of primary care providers is prevalent.
In conclusion, two key differences between the UK and US health systems are the financing mechanisms and the organization of healthcare delivery. The UK’s universal coverage and centralized NHS model provide accessible and integrated care, while the US system relies on private health insurance and has a fragmented delivery system. APNs can capitalize on opportunities for advocacy and political interventions to improve these systems. They can advocate for policies that promote equitable access to healthcare services and address financial barriers to care. Additionally, APNs can play a crucial role in promoting care coordination and filling gaps in service delivery, both in the UK and the US. By engaging in political and advocacy efforts, APNs can contribute to the advancement of the healthcare system and the overall well-being of individuals and communities.