Comparison of Healthcare Systems in the US and Great Britain, Thesis of Business Accounting

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Organizational Systems and Quality Leadership Organizational Systems and Quality Leadership Task 3, SAT Western Governors University Healthcare Financing A. Country to Compare Comparing healthcare system between The United States and Great Britain. A1. Access The accessibility to healthcare services in the U.S. is based on specific measures such as insurance coverage. Insured persons have more access to better healthcare services than uninsured individuals (Pope, 2018). Most U.S. citizens have access to health insurance through employers. Most times the employer pays for a certain amount of the plan while the rest of the amount is deducted from the employee paychecks.Also access for children depends on parent's plans. The U.S. also has programs such as Mediare,Medicaid, The Child Health Insurance Program and veterans benefits for those who are unable to get coverage from employors or are unemployed.However in order to qualify for these programs there are strict guidelines that can disqualify someone who is really in need. In contrast, healthcare accessibility in Great Britain for all populations is covered by the National Health Service (NHS), financed by the department of

Organizational Systems and Quality Leadership health and general taxation (Tikkanen et al., 2018). This enhances universal accessibility to all health services for all citizens including children, unemployed and the disabled. A2A. Coverage of Medications In the U.S., medication coverage is dependent on various factors that determine patients who have access. Some of the coverage includes health plans such as employer-sponsored, health insurance, and program plans such as Medicaid and Medicare (Pope, 2018). The coverage for children is dependent on parent's plans. Great Britain, medication coverage is based on patients where the NHS covers children, elderly patients, low-income patients, pregnant women and people with cancers, persons with disabilities, and long-term health conditions (Tikkanen et al., 2018). Compared to the U.S. system, copayments for prescription drugs and transportation costs in Great Britain for patients without disabilities and those from stable livelihoods are conducted through prepayment certificates that do not have renewable costs. A2B. Referral to See a Specialist In Great Britain, a general practitioner's referral to see a specialist is booked online or by contacting the NHS. The services are covered by the NHS (Pope, 2018). In contrast, referral to see a specialist in the U.S. is covered by one's health insurance plan. Patients using Preferred Provider Organization (PPO) plans, coverage includes patient-selected provided, in and out of a network. Health Maintenance Organization (HMO) plans restrict patients to a network that is covered by health insurance. For HMO, coverage is only for patients referred by a primary healthcare physician with inclusion for copayments except for emergency referrals. PPO plans do include copayments, and patients can see specialists without referrals. Such plans do not exist in Great Britain.

Organizational Systems and Quality Leadership A2C. Coverage for Preexisting Conditions Great Britain's coverage depends on the type of policies where most cover patients with preexisting conditions between 3 to 5 years if the condition has not been managed or treated (Base, 2018). Most coverages are directed to private health institutions. Conversely, in the U.S., coverage for preexisting conditions is enhanced by insurers, provided the patient has a health insurance cover (Department of Health and Human Services, 2020). The affordable care act is a law that states health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts (Department of Health and Human Services, 2020). A3. Finance Implications for Healthcare Delivery Financing for healthcare delivery in the U.S. is through self-pay, the Federal Government, State, and employer (Pope, 2018). This implies that access to healthcare services depend on the ability to finance the required services. This results in either US citizens not getting care until a condition becomes chronic or not paying for services provided therefore causing more financial strain on hospitals,clinics etc. However with government programs such as medicare and Medicaid it has given a safety net for providers to provide services to the uninsured and in return they are compensated by the government when certain standards are met. In Great Britain, financing is supported by general taxes, the NHS, and private insurers, enhancing easier accessibility to quality services. This compares to that of the U.S. healthcare system through government involvement and differs on self-pay and employer plans. References

Organizational Systems and Quality Leadership Base, D. (2018) Coverage of preexisting conditions in the U.K. https://www.money.co.uk/health- insurance/can-you-get-health-insurance-with-pre-existing-conditions.htm Department of Health and Human Services (2020) Coverage for Preexisting conditions in the U.S. https://www.hhs.gov/answers/affordable-care-act/can-i-get-coverage-if-i-have-a- pre-existing-condition/index.html Pope, C. (2018). American healthcare system compared to NHS in the U.K. https://www.manhattan-institute.org/html/american-healthcare-and-nhs-10979.html Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton, G. (2020). Universal health coverage in the U.K. https://www.commonwealthfund.org/international-health-policy- center/countries/england