1. Dawn Roberts, Jamie Miller, Rebecca Seymour, Cory Anderson
Healthcare USA/UK
Dawn Roberts, Jamie Miller, Rebecca Seymour, Cory Anderson
09/16/08
LIR 554

2. Presentation Overview
Models of healthcare
Description of US & UK systems
Mechanics of US & UK systems
Strengths and Weaknesses

3. Models of
Healthcare
Dawn Roberts

4. 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

5. 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

6. 3. National Health Insurance
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

7. 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

8. 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)

9. Description of Systems
Jamie Miller

10. Description of Systems
US System is notable because:
1. Numerous plans; Not universal
2. Costly
3. For-profit providers, financiers, and administrators

11. Description of Systems
Costs covered by many separate legal entities:
Private Insurance
Private out-of-pocket
Federal government
State/local governments
Other private funds

12. 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

13. Description of Systems

14. Description of SystemsUK
National Health Service (NHS)

15. Description of Systems
UK System is notable because:
1. Universal
2. Providers receive salary from Federal Government
3. Government decides on care

16. Description of Systems
Dramatic differences in health care provision
Are these reflected in actual health differences?

17. Description of Systems
Life Expectancy
United States: 78
United Kingdom: 78.7
Mortality Rate
United States: 6.4
United Kingdom: 5

18. Mechanics of Systems
Rebecca Seymour

19. US: Multiple Ways to Finance Care
Mechanics of Systems
US: Multiple Ways to Finance Care
Employer-Supported Insurance
Privately-Purchased Insurance
Government-Sponsored Insurance
The Uninsured

20. Mechanics of Systems
Uninsured
15%

21. Employer Supported Healthcare
Mechanics of Systems–
Employer Supported Healthcare
Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Point of Service (POS)
Health Savings Account (HSA)

22. Mechanics of Systems–
Employer-Supported Healthcare = 59%

23. 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

24. Mechanics of Systems– Government Sponsored = 28% Medicaid Medicare
VA Health Insurance

25. UK: One Way to Finance Care
Mechanics of Systems
UK: One Way to Finance Care
National Health Service
World’s largest health service and fourth largest employer
Publicly funded by the taxation of the general public
Separate administration in UK colonies, but reciprocity

26. 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)

27. 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

28. Strengths and Weaknesses
Cory Anderson

29. 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

30. 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

31. 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

32. 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

33. Companies with Best Healthcare Coverage
*Forbes 100 Best Companies to Work For 100% Healthcare Coverage for employees

34. FOR MORE INFORMATION: Descriptions of 5 capitalist countries’ systems:
With links to more resources:
Very cool interactive comparison by country
World Health Organization—International health
UK System
US System—Resources & Links