Effect of Healthcare Systems on Inequality in the UK and the US

Abstract

Objective: Healthcare systems vary among nations. From public/private partnerships to national systems, quality and equality varies. The purpose of this review is to analyze the effect that the National Health Service (NHS) in the United Kingdom (UK) has on inequality in comparison to the mixed healthcare model in the US. Materials/Methods: A review was completed using the University at Buffalo catalog and database search. A general Google search for articles regarding US healthcare costs was also done. Pubmed was also utilized. Results: The UK national healthcare system correlates with decreased inequality among all groups, while the US healthcare system exacerbates inequality. By strengthening the primary care system, the NHS has been able to efficiently care for the large majority of the UK population. The effectiveness of the NHS can also be traced to the fact that it is available to all citizens and therefore allows citizens to get care without being burdened by cost of services. The NHS was also associated with better overall performance and equity compared to the US system. While the US has made some advances in reducing healthcare inequality, medical debt and inequity in care remains a large burden for the healthcare system. The Gini index in the US before and after consideration of medical expenses remains higher than the UK and these medical expenses have also pushed citizens into poverty. Conclusion: Addressing inequality necessitates analyzing how a nation's healthcare system impacts the poor. A more centralized system that scales costs in coordination with income and a progressive tax system could help prevent and keep people from going into poverty. The UK national healthcare system has made strides in reducing inequality and providing effective care for the population, while overreliance on employer-dependent private insurance in the US can overburden those with lower incomes. While the Patient Protection and Affordable Care Act has reduced the number of people who are uninsured, it has done little to reduce inequality.