– What are the key differences between national health service (NHS) and national health insurance (NHI) systems? – How do NHI and NHS systems compare with the health care system in the United States? – How do most countries with similar levels per capita income differ from and resemble the United States with respect to provider payments, coordination of care, workforce and information technology, and health system performance? Cite at least 2 peer reviewed journal/article. Write in APA format

Abstract

National Health Service (NHS) and National Health Insurance (NHI) systems are two distinct models of healthcare delivery that differ in their organization, financing, and operation. This paper explores the key differences between these healthcare systems and compares them to the health care system in the United States. Furthermore, it analyzes how countries with similar levels of per capita income differ from and resemble the United States in terms of provider payments, coordination of care, workforce and information technology, and health system performance.

Introduction

The organization and financing of healthcare systems vary across different countries, resulting in distinct models of healthcare delivery. Two common models are the National Health Service (NHS) and National Health Insurance (NHI) systems. These systems differ in significant ways, including the way healthcare is funded, the role of the government, and the level of patient cost-sharing. This paper aims to compare and contrast NHS and NHI systems, while also examining how they compare to the health care system in the United States. Additionally, it explores the similarities and differences between the United States and other countries with similar per capita income levels in terms of provider payments, coordination of care, workforce and information technology, and health system performance.

Key Differences between NHS and NHI Systems

The NHS system, as exemplified in the United Kingdom, is a publicly funded healthcare system where the government owns the majority of healthcare facilities and provides healthcare services to all residents irrespective of their ability to pay. The government manages and finances the NHS through general taxation, with healthcare providers receiving payment directly from the government. In contrast, NHI systems, such as those in Canada and Taiwan, utilize a combination of public and private funding. These systems involve the government mandating all citizens to have health insurance coverage and providing public insurance to those who cannot afford private insurance. Alternatively, the government may provide insurance directly or contract with private insurers to provide coverage, as observed in Taiwan’s NHI system.

Another key difference between NHS and NHI systems lies in the level of patient cost-sharing. In NHS systems, patient cost-sharing is generally low since the focus is on universal access to care. The majority of services are provided free of charge at the point of service, although some fees may be charged for prescriptions or dental care. In contrast, NHI systems often involve higher levels of patient cost-sharing through deductibles, copayments, and coinsurance. These out-of-pocket expenses aim to discourage unnecessary utilization of services and manage healthcare costs more effectively.

Comparisons with the United States Healthcare System

When comparing NHS and NHI systems with the health care system in the United States, several differences become evident. The United States does not have a unified healthcare system but instead has a combination of public and private insurance coverage. The government primarily provides healthcare services to specific populations, such as veterans and the elderly, through programs like Medicare and Medicaid. However, the majority of the population obtains private health insurance coverage through their employers or the individual market.

One notable distinction between the United States and NHS or NHI systems is the lack of universal coverage. In the United States, a significant portion of the population remains uninsured or underinsured, resulting in barriers to accessing quality healthcare. This contrasts with NHS and NHI systems, which prioritize universal access to care and provide coverage for all residents.

Additionally, the United States spends significantly more on healthcare per capita compared to countries with NHS or NHI systems. Despite this higher expenditure, the United States has worse health outcomes in various measures, including life expectancy, infant mortality, and chronic disease prevalence. The fragmentation of the US healthcare system, with numerous private insurers and a lack of coordination between providers, contributes to inefficiencies and disparities in care delivery.

Similarities and Differences with Countries of Similar Income Levels

Countries with similar per capita income levels to the United States may exhibit both similarities and differences in their healthcare systems. One similarity is that these countries typically utilize a combination of public and private funding for healthcare. However, the extent of private involvement and the level of government regulation can vary.

For example, Switzerland has a system akin to an NHI model, where individuals are required to have health insurance coverage and choose from multiple private insurance providers. In contrast, Germany has a social health insurance system, where individuals must contribute to public health insurance funds based on their income. Both countries have achieved universal coverage and have demonstrated better health outcomes compared to the United States.

On the other hand, countries like the United Kingdom and Canada have NHS systems with a higher level of government involvement and ownership of healthcare facilities. These systems prioritize universal access to care and utilize tax-funded financing mechanisms. Despite some criticisms, both countries have achieved relatively high levels of patient satisfaction and better health outcomes compared to the United States.

Conclusion

NHS and NHI systems differ significantly in terms of organization, financing, and patient cost-sharing. These models contrast with the health care system in the United States, which is characterized by a mix of public and private funding with limited access to universal coverage. Countries with similar per capita income levels to the United States differ in the level of government involvement, private sector participation, and financing mechanisms. However, overall, these countries achieve better health outcomes and provide more equitable access to care compared to the United States.