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Lecture 5 Tracey Lynn Koehlmoos, PhD, MHA HSCI 609 Comparative International Health Systems
No society can legitimately call itself civilized if a sick person is denied medical aid because of a lack of means.
Aneurin Bevan Minister of Health 1946
Private Market
12% of Britons have Supplementary Insurance--an employment perk Doctors & hospitals treat both public and private patients Private insurance pays for dental, vision, some prescription drugs (although 80% of all prescription drug payments are waived due to age, pregnancy, youth, poverty)
Economic Factors
Revenues
83% NHS funding from taxes 13% from employer-employee contributions 4% User fees
Expenditures
NHS accounts for 88% of health expenditures Private Insurance (SI) 4% of expenditures ~3/4 of NHS budget goes to workforce salaries 1/10th of NHS budget goes for drugs
Management
Central authority for national health planning, budgeting and legislation. Distribution of funds and delegation of planning to Strategic Health Authorities Administration (streamlined compared to previous set-ups) is vital to success of the new systememphasis on strategic planning, evaluation, budgeting and internal market competition.
Hospitals
More than 2000 public or NHS trust hospitals About 300 private/surgical procedure facilities
Compared to US
Single payer system Surgeries and new technologies underused New efforts to decrease UK waiting times All access system US, 44 million uninsured, no access Tremendous cost control and access but a definite lack of quality compared to US
Summary
National Health Service Centralized, publicly financed system Cradle-to-Grave care (except LTC!) for all citizens Largest employer in Europe