Healthcare

USA/UK
Dawn Roberts, Jamie Miller, Rebecca Seymour, Cory Anderson
09/16/08 LIR 554
 Presentation Overview

Models of healthcare
Description of US & UK systems
Mechanics of US & UK systems
Strengths and Weaknesses
Models of
Healthcare

Dawn Roberts
 Models of Healthcare

1. Beveridge Model
Provided by: Medical providers whose salaries are
paid by Government
Financed by: Federal Government, from income
taxes
Admin. by: Federal Government
Examples: England, Spain, Scandinavia, Cuba,
New Zealand, Hong Kong
 Models of Healthcare

2. Bismarck Model
Provided by: Private medical providers
Financed by: Nonprofit insurance companies,
Premiums paid by employees,
employers, government
Admin. by: Government (closely regulated)
Examples: Germany, France, Switzerland,
Belgium, Japan, Latin America
 Models of Healthcare

3. National Health Insurance

Provided by: Private medical providers
Financed by: Federal Government-run insurance
program, from taxes of all citizens
Admin. by: Federal Government
Examples: Canada, Taiwan, South Korea
 Models of Healthcare

4. Out-of-Pocket Model
Provided by: Private medical providers
Financed by: Patients, directly
Admin. by: No one; Each provider collects
Examples: Rural parts of Africa, India, China,
South America
 Models of Healthcare

US uses all of these:

1. Beveridge (VA, Military)
2. Bismarck (Employer-supported
insurance)
3. National Health Insurance (Medicare,
Medicaid)
4. Out-of-Pocket (Everyone else)
Description of
Systems

Jamie Miller
 Description of
Systems
US System is notable because:
1. Numerous plans; Not universal
2. Costly
3. For-profit providers, financiers,
and administrators
 Description of
Systems
Costs covered by many separate legal entities:
Private Insurance
Private out-of-pocket
Federal government
State/local governments
Other private funds
 Description of
Systems
More dollars spent per capita than any nation
15.2% of GDP, with projection of 19.5% by 2017
$2.26 trillion $7,439 per person, in 2007
Description of
Systems
 Description of
Systems
UK
National Health
Service (NHS)
 Description of
Systems
UK System is notable because:
1. Universal
2. Providers receive salary from
Federal Government
3. Government decides on care
 Description of
Systems
Dramatic differences in health care
provision

Are these reflected in actual health

differences?
 Description of
Systems

Life Expectancy

United States: 78
United Kingdom: 78.7

Mortality Rate

United States: 6.4

United Kingdom: 5
Mechanics of
Systems

Rebecca Seymour
 Mechanics of Systems

US: Multiple Ways to Finance Care

Employer-Supported Insurance
Privately-Purchased Insurance
Government-Sponsored Insurance
The Uninsured
 Mechanics of Systems

0
Uninsured
15%

Govt Employer
28% 59%

Private
9%
 Mechanics of Systems

Employer Supported Healthcare

Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Point of Service (POS)
Health Savings Account (HSA)
 Mechanics of Systems

Employer-Supported Healthcare = 59%

 Mechanics of Systems

Privately Purchased Insurance = 9%

Self-employed or Work for companies not
offering health benefits
Premiums based on individual health
history, age, weight, smoking status and
deductible chosen
 Mechanics of Systems

Government Sponsored = 28%

Medicaid
Medicare
VA Health Insurance
 Mechanics of Systems

UK: One Way to Finance Care

National Health Service
Worlds largest health service and fourth
largest employer
Publicly funded by the taxation of the
general public
Separate administration in UK colonies, but
reciprocity
 Mechanics of Systems

UK: One Way?

All citizens, Expats with work permits, Students
there > 6 months
Most services free
How does it work?
GPs inform hospital of a patient's condition.
Hospital judges urgency, against other patients conditions.
Urgent need is met almost immediately.
Others receive appointments. (Median wait time ~ 3 weeks)
 Mechanics of Systems

UK: Private Insurance

Currently, 12% of persons
2/3 employer-provided; 1/3 individually-
purchased
Privately insured go to NHS hospital or one
of five private hospital groups.
Average individual premium = $260/month
Strengths and
Weaknesses

Cory Anderson
 Strengths and Weaknesses

US Strengths
World-Class facilities and physicians
Relatively short wait-time for treatment
Government directly covers 27.8% of the
population through health care programs for the
elderly, disabled, military service families and
veterans, children, and some of the poor

*Information obtained from the National Institute of Health www.nih.gov/

 Strengths and Weaknesses

US Weaknesses
~47 million people without health insurance
High administrative cost
Financial problems for the under- or un-insured
Private plans have exclusions or carve outs
Disparities in access to health treatments

*Information obtained from the National Institute of Health www.nih.gov/

 Strengths and Weaknesses

UK Strengths
Universal coverage
Guaranteed treatment regardless of income level
Health care paid through taxes
Little paper work or bureaucracy

*National Health Service http://www.nhs.uk/Pages/homepage.aspx

 Strengths and Weaknesses

UK Weaknesses
Higher tax rate
Underfunding
Long waits for specialists and elective procedures
Lower quality facilities
Exclusions for new or experimental treatment

*National Health Service http://www.nhs.uk/Pages/homepage.aspx

Companies with Best
Healthcare Coverage

*Forbes 100 Best Companies to Work For

100% Healthcare Coverage for employees
 FOR MORE INFORMATION:

Descriptions of 5 capitalist countries systems:

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
With links to more resources:
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/etc/links.html
Very cool interactive comparison by country
http://www.npr.org/news/specials/healthcare/healthcare_profiles.html
World Health OrganizationInternational health
www.who.int/en/
UK System
www.nhs.uk
US SystemResources & Links
http://www.pbs.org/pov/pov2008/criticalcondition/resources.html