A high-quality healthcare system is a crucial part of citizens’ welfare in any country. High-standard healthcare treatment ensures the population’s longevity, warrants low mortality rates, and the absence of complications after illnesses, guarantees quicker recovery, and establishes a high level of general health among citizens. Every country has an individual outlook on an efficient healthcare system as each state can offer divergent amounts of funding and different levels of supervision of medical professionals’ training. This paper provides the main features’ comparison of the United States and Great Britain’s healthcare systems and a discussion about the relationship between healthcare quality and one’s immigration status to highlight the healthcare system issues each country faces.
The Affordable Care Act is one of the key elements of improving the current American healthcare system. The Act was passed into law in 2010 to increase the coverage of citizens’ healthcare insurance through legislative regulations and improve the treatment’s overall quality (Silberman, 2020). Such action demonstrates the shift in the American approach to healthcare as it focuses on creating a patient-centered, affordable system. In addition, ACA prohibited medical institutions from denying citizens insurance coverage and increasing the cost of healthcare treatments due to one’s previous health history (Silberman, 2020). As a result, the ACA’s requirements provided access to quality healthcare for citizens with lower incomes and people with chronic diseases. However, not all outcomes of the ACA plan were positive. Due to the Act, taxes for companies mandated to provide insurance coverage for their employees increased drastically, as well as the prices for prescription drugs (Yu, 2020). Thus, while ACA benefited States’ healthcare system, it also inflicted some issues for the country.
Population health is a statistical tool that helps to estimate the quality level of the country’s medical treatment system. The general health evaluation of American citizens gives mixed results. According to Woolf and Schoomaker (2019), the life expectancy of the United States population has increased by approximately ten years since 1959, reaching a maximum of 78 years in 2014. The such increase demonstrates the advancement in the methods of medical care, which prevented various diseases or assisted in timely treatment. Mortality rates among American children, teens, and elders have decreased since the 1990s but increased among adults, primarily due to drug and alcohol abuse as well as a heightened suicide rate (Woolf & Schoomaker, 2019). This pattern appears to be less connected to the quality of the States’ medicine production and more indicating its substandard mental health care.
Chronic illness outcomes and hospital-related care are other factors that influence the population’s health. Woolf and Schoomaker (2019) state that in the United States: “midlife death rates increased for some chronic diseases while decreasing greatly for others” (p. 2010). While this thesis emphasizes successful drug development and therapeutic medical involvement in treating chronic diseases, it also draws attention to the need for further improvement. Due to the increase in prescription drug prices mentioned above, some people who suffer from chronic illnesses cannot afford the needed medicine, which may result in the deterioration of their health or even lethal cases. The United States hospital-related care is perceived to be high quality as it provides overall satisfactory medical treatments – for example, 51 percent of patients received the needed care the same day of the visit (Papanicolas et al., 2018). Therefore, while the United States population health may need some improvement, its general level is adequate.
The COVID-19 pandemic has greatly impacted healthcare systems worldwide, severely affecting various racial minorities. According to Andrasfay and Goldman (2021), COVID-19 was the cause of the reduction of the Unites States’ citizens’ overall life expectancy, with 1,3 years for White, 1,9 years for Black, and 3 years for Latino populations. Such statistic accentuates the deeper problem of American society – racist prejudices may result in not providing sufficient healthcare. Thus, the United States healthcare system must be reformed to accommodate citizens of various cultural backgrounds, dismiss possible biases towards racial minorities, and create a safe environment necessary for conducting medical treatment.
The analysis of the statistical data on the key elements of population health in the United States and Great Britain demonstrated some differences in citizens’ general well-being. McKee et al. (2021) indicate that in Great Britain current average life expectancy is three years longer than in The United States, with life expectancy increase in Great Britain notably slowing since 2010. This signifies that Great Britain might have a more effective system of disease prevention as well as more sufficient methods for timely illness treatment. However, in comparison to the United States, Great Britain’s infant mortality rates in poorer areas have increased from 2014 to 2017, as well as mortality among adult working people (McKee et al., 2021). Such observations may indicate insufficient funding from local authorities, leading to resource shortages in medical and social institutions in low-income neighborhoods.
The situation with the United States and Great Britain’s chronic disease outcomes and hospital-related care is quite similar. McKee et al. (2021) state that while some illnesses’ burdens decreased since 1990, others’ (diabetes, immune disorders, and disorders related to drug or alcohol abuse) mortality and complication rates have greatly increased. Both American and British governments are already considering some decisions to improve the situation: making preventive therapy accessible to all citizens, lowering prescription drug prices, and creating affordable healthcare insurance plans. Hospital-related care in Great Britain, as well as in the United States, is considered to be adequate, however, the COVID-19 pandemic has negatively affected the number of medical staff – due to excessive workload, some professionals left their jobs (McKee, 2021). Therefore, while having some differences concerning citizens’ longevity, the United States and Great Britain have similar population health situations.
The quality of a country’s healthcare system is considerably dependent on the economic resources and funding that the state is willing to invest in it. The United States is known to spend the most finances on supporting its healthcare system, as in 2016 it expanded almost 18 percent of its gross domestic product on sponsoring said system (Papanicolas et al., 2018). A high disbursement rate is also apparent in American healthcare expenditure per capita. According to Papanicolas et al. (2018), per capita dissipation on medical treatments in America is higher than in other developed countries – 1443 dollars for pharmaceuticals and 9403 dollars for mean spending. Such statistics may indicate not only the intentions of the United States government to improve the American healthcare system but also high prices for medical treatments and prescription drugs.
Other aspects of healthcare financing are spending priorities of the funds and cost-sharing of the insurance coverage. Spending priorities for healthcare economics in the United States are outpatient care (42 percent), governance and administration (8 percent), and home-based care (3 percent) as per total national spending on these functions (Papanicolas et al., 2018). Despite the Affordable Care Act, which increased the insurance coverage for American citizens, they still have to spend more on coverage than other countries’ populations. Papanicolas et al. (2018) state that the United States “has a voluntary, private employer-based and individual-based system” (p. 1027), explaining that American cost-sharing – States’ citizens’ out-of-pocket spending on their insurance coverage is at 30 percent. Thus, while ACA assisted in improving the insurance rates in the United States, some American citizens may still struggle with covering their insurance expenses.
Great Britain’s spending on its healthcare system is significantly smaller than the corresponding spending of the United States. Only 9,7 percent of the British gross domestic product is being spent on healthcare (Papanicolas et al., 2018). The difference between the respective American measure is 8,1 percent. The mean per capita healthcare expenditure in the United Kingdom is 3377 dollars – statistically lower than in most developed countries (Papanicolas et al., 2018). The contrast with per capita health spending in the United States is rather considerable – 6026 dollars. This data may indicate that Great Britain has lower prices for various medical services, which allows for moderating the budget for healthcare expenditure.
Spending priorities and the principles of cost sharing are divergent for both countries. While home-based care is important for the United Kingdom as well as the States, Great Britain also focuses on preventive care, long-term care, and medical goods (Papanicolas et al., 2018). The insurance coverage systems of the countries are very different, which results in contrasting cost-sharing statistics. Papanicolas et al. (2018) explain that in Great Britain, the insurance system is fully state-funded and automatic, which allows British citizens to have no out-of-pocket spending on its coverage. Such an approach benefits low-income citizens as they have full access to medical care services and will receive the needed help in extreme situations.
The United States is a country with a high immigration rate, which induces additional pressure on the healthcare system and calls for its further improvement. For example, Cabral and Cuevas (2020) state that while the majority of documented Mexican immigrants have permanent access to medical care, 53 percent of undocumented Mexican immigrants do not have such access. This fact may have a detrimental effect on the overall health of undocumented immigrants. According to Cabral and Cuevas (2020), “undocumented immigrants have lower odds of self-rated excellent/very good health status” (p. 874) and frequently do not receive proper diagnoses, which may lead to the development of chronic diseases or even lethal cases. Such patterns create dangerous and unhealthy conditions for undocumented immigrants’ lives and well-being.
Reasons for the mentioned patterns vary from the immigrants’ lack of legislated documents to racist prejudices of medical practitioners. While undocumented immigrants have access to emergency healthcare treatments through the Emergency Medicaid program, they cannot receive other kinds of medical services due to the absence of residency proof (Cabral & Cuevas, 2020). Such limitations exclude undocumented immigrants from preventative medical care and necessary general wellness screenings and may worsen the immigrants’ health outcomes. Another problem immigrants face while receiving medical treatments is racial bias, as practitioners often perceive them as dangerous and untrustworthy (Cabral & Cuevas, 2020). Such a model of providing healthcare to undocumented immigrants must be reformed to give the immigrants access to quality healthcare.
Therefore, it is evident that racial prejudices are one of the main factors to affect the escalation of health disparities in the United States healthcare system. Lavizzo-Mourey et al. (2021) state that the 1970s studies showed that more African Americans died from cancer than White people. It indicates a deeper problem within American society. As mentioned above, the COVID-19 pandemic negatively influenced the longevity of citizens from racial minorities more than the longevity of White Americans due to the inaccessibility of proper testing and increased risk of exposure (Andrasfay & Goldman, 2021). Racial biases toward minorities and immigrants prevent these people from receiving quality healthcare treatments, which leads to an increase in untreated chronic diseases and heightened mortality rates among these groups.
Another factor that heavily influences the increase of health disparities is insufficient insurance coverage for low-income citizens. A great number of the United States population cannot afford to pay 30 percent of out-of-pocket spending on their insurance (Papanicolas et al., 2018). It prohibits access to timely healthcare treatments and makes it difficult to receive possible needed prescription drugs or medical procedures and screenings.
However, there is a solution to the issue of health disparities in the United States. As a reaction to the COVID-19 pandemic, which exposed the inequity of the healthcare system, many health science programs refocused on recognizing the detrimental effects of racism, income, gender prejudice, and homophobia on health (Lavizzo-Mourey et al., 2021). Such affirmative action will help to reconstruct the American healthcare system and make it accessible for every citizen of the United States.
To conclude, the United States and Great Britain have similar population health situations, while having contrasting healthcare systems. In America, high prices for medical treatments lead to the absence of national health insurance, making financial spending on healthcare the largest worldwide. Britain’s budget for healthcare is almost two times smaller than the United States, yet British citizens’ longevity is higher than the longevity of Americans. Another issue of the States’ healthcare system is an inadequate attitude towards minorities due to biases or prejudices. However, currently, there are attempts to improve the situation via various training and studying programs, which will help to create a more welcoming healthcare environment for every American.
References
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Cabral, J., & Cuevas, A. G. (2020). Health inequities among latinos/hispanics: documentation status as a determinant of health. Journal of Racial and Ethnic Health Disparities, 7(5), 874-879.
Lavizzo-Mourey R. J., Besser R. E., & Williams D. R. (2021). Understanding and mitigating health inequities – past, current, and future directions. New England Journal of Medicine. 2021 May 6; 384(18), 1681-1684.
McKee, M., Dunnell, K., Anderson, M., Brayne, C., Charlesworth, A., Johnston-Webber, C., Knapp, M., McGuire, A., Newton, J. N., Taylor, D., & Watt, R. G. (2021). The changing health needs of the UK population. The Lancet, 397(10288), 1979–1991.
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Woolf, S. H., & Schoomaker, H. (2019). Life expectancy and mortality rates in the United States, 1959–2017. Journal of the American Medical Association, 322(20), 1996–2016.
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