This paper will compare the healthcare system of the United Kingdom, with that of the United States. The healthcare system of the United Kingdom is called the NHS (National Healthcare System), and it provides free basic healthcare to all residents within the United Kingdom, without the need for health insurance. The care is provided and managed by the central government (NHS, 2013, p. 2). This is very different to the United States system, where all individuals are expected to have private healthcare, usually linked to their employment, in order to access medical services.

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Compared to the United Kingdom, only a relatively small proportion of the United States’ spending on healthcare is on social services (Squires and Anderson, 2015). In practice, this means that within the United States, coverage for economically vulnerable groups such as children, the elderly, or the unemployed is provided by means of government subsidized health insurance such as Medicare and Medicaid, which can be limited in scope. Because there is a provision gap between the private healthcare providers and the insurers, patients may find their access to certain treatments or services are limited, delayed, or unavailable unless they can afford more expensive health insurance plans. This is also true of medications, and referrals to specialists, which may be available to some patients through insurance coverage, but not to others. The coverage of pre-existing conditions in the United States may also be variable, depending on the health insurance provider. One financial implication for patients under the U.S. system is that wealthier patients or patients working for wealthier organizations will have better access to care, services, medications, referrals, and treatment for pre-existing conditions (Department for Professional Employees, 2014, n.p.). A second implication, however, is that economically disadvantaged patients, such as the elderly or the unemployed, can – if they can prove their economic need – access necessary medications completely free of charge through appropriate insurance.

Under the United Kingdom NHS, in contrast, standard healthcare is provided which covers all basic care, referrals, medications, and treatment for pre-existing conditions. In most areas, the costs for medications for all individuals is capped at a fixed rate, and all basic care, emergency care, referrals, and treatments are available free of charge, with the costs of these services paid for by the central government and funded by UK taxes (NHS Choices, 2016, n.p.). This means that groups such as the elderly, children, and the unemployed are guaranteed access to all healthcare services, although unnecessary or more premium versions of services may not be provided and might need to be paid for privately. Because the care as well as the costs are provided by the central government, there is also no chance that a provider will recommend a treatment or drug not available to the patient thought his or her insurance; the only exception to this rule are treatment considered unnecessary to health, such as cosmetic surgery. Patients who do choose to purchase additional private health insurance may have access to more expensive drugs or treatment, but the care they receive will often be provided through the same hospitals and doctors who provide care to NHS patients (NHS Choices, 206, n.p.). Two financial implications for patients under this system are that even very poor patients will need to pay a fixed fee for medications, and also that all patients will have access to necessary health care regardless of their economic and employment status.

As can be seen from the above information, the major difference between the systems of the United States and the United Kingdom lies in the fact that the United Kingdom provides government-managed healthcare to all residents, free-of-charge, with no insurance necessary. This means that patients can always access healthcare with minimal and fixed cost implications. In the United States, however, the privatization of healthcare means that patients need to control their own access to health care, and the financial implications can be variable.

  • Department for Professional Employees (2014). “The U.S Healthcare System: An International Perspective.” Retrieved from:
  • NHS (2013, May). “Guide to the Healthcare System in England: Including the Statement of NHS Accountability.” London: UK Department of Health. Retrieved from:
  • NHS Choices (2016). “About the National Health Service (NHS).” Retrieved from:
  • Squires, D., and Anderson, C. (2015, October 8). “U.S. Healthcare from a Global Perspective.” The Commonwealth Fund. Retrieved from: