The UK and US operate two very different healthcare systems. On one side of the Atlantic, the UK’s National Health Service (NHS) is a public-funded model that aims to ensure everyone has access to the care they need. On the other, the US system is described as a “unique hybrid” – although is perceived to be much more focused on private sector providers. But does that alter the level of care that can be expected? And how well does each system cater for its patients? 

Key differences between the two systems 

In early 2018, former President Donald Trump claimed the UK’s publicly-funded model was not working. But that was a claim quickly rebuffed by NHS England chief Simon Stevens. In fact, it seems the data tells a different story. Compare spending by the UK and US on healthcare as a proportion of GDP, and the US spends much more – while arguably serving fewer people.   

It’s one of the most fundamental differences between the two healthcare systems. And the US model is often cited as an undesirable scenario in any references to reforming the UK’s NHS. 

Other differences are maybe less obvious, but just as stark. There’s much more private sector involvement in the US healthcare system when compared to the UK. And the US system tends to rely heavily on private insurance, whereas the UK’s NHS is free at the point of access to any person who needs it. Meanwhile, it’s argued that drug approval can take more time in the US. 

Paying the cost of something going wrong 

One other area where the UK and US systems vary is in care standards. The National Institute for Health and Care Excellence (NICE) sets out guidelines, pathways, protocols, and standards for NHS treatment. The US takes a slightly different approach, but there is still an agency that seeks to hold healthcare providers to a clear and comprehensive set of recommendations. 

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Even with these frameworks in place, things can sometimes go wrong – and neither system is infallible in that respect. In 2018, it was reported that more than 250,000 individuals die each year in the US due to medical errors. Previous research put the total cost of medical liability in the US at around $55.6 billion each year too. 

In comparison, NHS England – the largest of the UK’s NHS commissioning boards – has spent more than £2.3 billion in medical negligence claims in 2019-20.  

Both are sizeable sums. But it also shows that, for all the differences between the systems of healthcare, it doesn’t necessarily make one better than the other. Ultimately, the users of UK and US healthcare providers all expect a high standard of care – and each is doing that in the specific way that each is set up to do. The prevailing difference, it seems, is purely ideological.  

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