Comparative Analysis: Healthcare Systems in the US, UK, Australia

This report provides a comparative analysis of the healthcare systems in the United States, the United Kingdom, and Australia, focusing on their governance, structure, funding, and effectiveness. It highlights the differences in approaches to healthcare, with the US relying heavily on private funding and...Read More

Running head: COMPARING US, UK & AUSTRALIAN HEALTHCARE SYSTEMS
Comparing US, UK & Australian Healthcare Systems
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Assessment of a Health System
Introduction
Healthcare is an integral part of any given country. It is very important especially in
terms of ensuring that citizens have the chance to attain high-quality lives. The citizens are also
entitled to quality primary care so as to maintain their health in the best way possible. The
differences in the healthcare systems of different countries make them achieve varying outcomes
(Mossialos et al., 2016). Thus, some countries are deemed to have better healthcare systems
compared to other. The differences may be in the quality, affordability, comprehensiveness, and
timeliness. While the United States of America’s healthcare system is better funded than
Australia’s and the United Kingdom’s healthcare system is the most effective among the three,
Australia’s healthcare system is bound to improve due to the ongoing reforms including the
involvement of a participatory approach to care and the emphasis on the provision of a culturally
appropriate healthcare. The following analysis provides a comparison among the health care
systems of Australia, the United Kingdom, and the United States of America.
Governance, Structure, and Function of the Healthcare Systems
The Australian healthcare system has some level of complexities. It has many healthcare
providers and sources of funding. The various levels of government handle the governance and
responsibility of the healthcare system at both the federal levels and the states level (Wears et al.,
2015). The government of Australia is the primary funder of the healthcare of the country. It
does so by providing insurance schemes and through the provision of direct funding to territories
and states in the country (Blank, Burau & Kuhlmann, 2017). The states, on the other hand, play
the major role of providing the direct healthcare services to people. The government of Australia

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has the universal benefits scheme. Through the process, it ensures that many people have the
chance to access the various healthcare services easily.
The United Kingdom has a devolved healthcare system. Thus, it means that the four
territorial areas of the country, Northern Island, England Wales and Scotland have their own
publicly funded healthcare (Osborn et al., 2015). Their parliaments and governments finance the
healthcare systems of all the regions. Thus, while the government plays a major role in the
management of healthcare in the United Kingdom, private participation and voluntary provision
of healthcare are done in a limited capacity. The country also has the National Health Service
that aims to coordinate the healthcare system to ensure that it is running in an almost equal
manner for the all the territorial regions found within (Freund et al., 2015). The National Health
Service is also critical in assessing some of the areas of improvement that may be necessary
towards ensuring that people in the country have the chance to attain high-quality lives as a result
of the best healthcare outcomes.
The United States of America’s healthcare system is somehow unique as compared to
that of the United Kingdom and Australia. The country does not have a harmonized healthcare
system. It also does not have some level of universal coverage. Thus, a larger part of the United
States of America’s healthcare system is funded by private players. It also relies heavily on the
willingness of employers to provide insurance for their employees (Squires & Anderson, 2015).
Estimates show that as of 2014, private funds accounted for about 48% of all the healthcare
amounts. About 20% came from private businesses while about 28% came from households. The
state governments accounted for 17% spending on healthcare while the federal government
accounts for 28% (Slade et al., 2014). Although government funds some of the healthcare
services in the country, they are privately delivered. The US healthcare system aims to give

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private citizens the power to use their means to provide their funding they can manage towards
attaining proper healthcare.
Why the Three Systems are Different
The healthcare systems are different on many fronts because they have varying
approaches with the view of how they view healthcare (Powell Davies et al., 2017). While all the
three countries determine that healthcare is an important part of the lives of people, they need to
focus on different approaches, with the view of ensuring that they have the chance to identify
some of the priorities that do exist for each one of them (D’Andreamatteo et al., 2015). One of
the differences that exist between the healthcare systems of the three countries is based on the
amount of funding. The United States of America, averagely, spends more than the United
Kingdom and Australia regarding meeting the healthcare needs of the different people in the
country. It, is, therefore, deemed to spend more than twice per person as compared to the other
two countries. The United Kingdom provides better funding towards healthcare as opposed to
Australia. While in Australia, people pay between 1.5% and 2.5% of their income towards
Medicare, the National Health Service of the United Kingdom pays for the 98.8% of all the
healthcare costs of patients. The patients are only required the 1.2% of the remaining cost that is
involved in the healthcare system.

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Figure 1: Healthcare Funding OECD Countries
The figure above presents a summary of a 2017 report of the Organization for Economic
Co-operation and Development (OECD) which provides the state of health expenditure in the
year 2014 for member countries. From the data, it clear that the US allocates the highest amount
of funds on health as compared to any other member country such as the United Kingdom and
Australia. In fact, the United States of America spends almost twice the average amount of funds
that all OECD countries allocate to health financing. The United Kingdom like the US also has a
huge allocation above the average expenditure for any country in the OECD. Both the United
Kingdom and the United States of America spend way above the average. Even so, Australia’s
health financing expenditure is just slightly above average. The figure above thus provides the

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actual performance in regard to financial expenditure and the main conclusion drawn is that
Australia needs to increase its expenditure on healthcare programs for the benefit of its citizens.
The United Kingdom and Australia’s healthcare systems also vary from that of the
United States of America in that they have a definite level of universal healthcare for people. In
Australia, universal healthcare is provided by Medicaid while the National Health Service
provides universal healthcare in the United Kingdom through the different administrative areas
that are in charge (Clemens et al., 2014). Thus, as opposed to the other two countries, most of the
services are left at the hands of the private citizens contained within. The employers and other
members of the private sector are also charged with the role of ensuring that they can provide
people with the level of healthcare that they deserve, accordingly. In the United States of
America, the Medicare Medicaid is only provided for a specific group of people who include the
disabled and the aged.

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Figure 2: Universal Health Coverage OECD Countries
Figure 2 above presents the state of universal health coverage for member countries of
the Organization for Economic Co-operation and Development (OECD). The figure also
provides the levels of both public and private health insurance coverage. It is evident from the
figure that out of the OECD member countries as per 2013, the United States of America and
Greece are the only ones that do not have a universal health coverage scheme. The figure also
shows that while the UK has all health insurance as public coverage, the US has more private
healthcare insurance coverage than public healthcare insurance coverage. Therefore, the US
population spends more on private healthcare insurance than their counterparts in Australia and
the United Kingdom. Australia just like the United Kingdom has achieved universal health

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coverage. Majority of healthcare insurance schemes are public and this makes it also different
from the case of the United States of America.
Evaluation of the Effectiveness of the Three Healthcare Systems
The United Kingdom’s healthcare system is the most effective of the three. The fact that
it is left under the administration of the four administrative areas means that it creates huge ease
off the running of the funding mechanisms as well as the administration of healthcare within the
country. The National Health Service is important towards the harmonization of healthcare
across the four different regions. Thus, there is a high chance of assessing the defective areas
and, thus, having the chance to rectify them accordingly (Howick et al., 2014). The situation also
ensures that the amount of financing provided by the government is equal for all the regions. The
case of equity is, thus, imperative, because it improves upon the chances of uplifting the quality
of healthcare for the people in an almost the same manner.

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Figure 3: Overall Ranking of Healthcare Systems
The figure above presents an overall ranking of the healthcare systems of countries
including the United States of America, the United Kingdom, Australia, Netherlands, New
Zealand, Canada and Germany. Of interest in this particular study however include the rankings
of the United Kingdom, Australia and the United States of America. As per 2010, the overall
ranking indicates that the United Kingdom performed best (position 3 overall) followed by
Australia (4) and then the US (6) in terms of quality care. In terms of patient-centered care,
Australia performed best (2) followed by the US(4) and the UK (7). There was thus poor
patient-centered care in the United Kingdom as per the year 2010 as compared to the United
States of America and Australia. In terms of efficiency, the UK health system was the most
efficient (overall 1) followed by Australia’s (2) and lastly the US healthcare system which was
the last overall (7). As for equity in the provision of healthcare, the United Kingdom’s healthcare

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system performed best (position 2 overall), followed by Australia (4), and lastly the United
States of America’s healthcare system (7). It is thus clear that the United Kingdom’s healthcare
systems apparently outperforms its two counterparts in majority of the given quality measures.
Even so, the UK ranks lower than the US in terms of healthcare funding and lower than both the
US and Australia in regard to patient-centered care.
Although the healthcare system of Australia is better than that of the United States’
regarding coverage, it fails regarding capacity as it relates to the management (Duckett &
Willcox, 2015). The Medicaid has a huge responsibility regarding the administration of
healthcare as opposed to the roles that are conducted by the different territorial areas of the
country. Granted, there is a high chance that the agency may lack the opportunity to run its
operations in a way that would cover all the regions as effective. The fact that the United States
of America lacks a universal healthcare system puts it at a great disadvantage as compared to the
United Kingdom and Australia. Both countries, thus, have the chance to meet the healthcare
needs of a large scope of people found within.
Regarding funding, the United Kingdom healthcare system is also deemed to be more
effective of the three. The National Health Service in the United Kingdom accounts for 98.8% of
all the medical bills that patients may need to pay for healthcare facilities. Thus, the National
Health Service is important in ensuring that many people have the chance to gain access to the
different healthcare services at a highly subsidized cost. The patient has required a paltry
percentage of the medical costs incurred in a healthcare facility, thereby, ensuring that he has the
chance to deal with the different health problems that he may be experiencing better.

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Although the Medicaid for Australia pays for 75% of all the outpatient costs and 100% of
all the inpatient costs, people are usually made to pay for the insurance provided by the
government by about 1.5%-2.5% of their income. Thus, the healthcare costs involved for people
in Australia are considered to be quite high as compared to the ones experienced in the United
Kingdom. In the United States, most of the costs of healthcare are left at the hands of the private
sector (Nilsagård et al., 2015). Thus, individuals have a major role to play in regards to making
decisions as it relates to the amount of money they may pay for their healthcare. People also get
to spend more as they have to pay from their pockets to finance the insurance premiums.
The United Kingdom’s healthcare system is also more comprehensive as compared to the
one by Australia. For instance, where one signs up for Medicaid, he is not eligible for ambulance
transport, optometry or dentistry. Thus, almost a half of the population in Australia has the
preference to be covered by private insurance providers in a bid to have a chance to benefit from
more comprehensive healthcare (Oliver et al., 2014). Although the National Health Service may
not always pay for dental and optometry, there are situations where it may cover the services.
The situation, therefore, makes it more desirable as it may have a chance to improve upon the
ability of the people who are covered to meet some of the healthcare needs that they might be
having.
The US healthcare, on the other hand, is less appealing as people have to move towards
private insurance in their need to attain any form of cover that they might be in need for
(Papanicolas, Woskie & Jha, 2018). The situation is also worse where people are not in the form
of employment that may take over the responsibility of paying for their health insurance cover.
The US citizens face a host of chronic diseases that result from obesity, smoking, and alcoholism
just like their counterparts in the United Kingdom and Australia. Even so, leaving them the

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options of relying on private healthcare insurance may limit the use of such services by a section
of the population. While a section of this population can afford multiple private health insurance
covers, a larger proportion has lesser numbers of health insurance covers or no covers at all.
According to Papanicolas et al (2018), there is a need for a universal healthcare system in the
United States of America, much as there is still no goodwill on Obamacare by the current
Republican government led by President Donald Trump.
Proposed Reforms or Underway in the Healthcare systems
One of the proposed changes in the healthcare system of the US is to increase its
coverage. It could be attained through the government forming a national health insurance policy
that may be critical towards meeting the healthcare costs of almost all people in the country
(Papanicolas et al., 2018). Through the process, there is the chance that people may need to
spend much less on healthcare as they do today. Many people will also have the less need to rely
on private insurance to meet their healthcare needs. There is also the need for the healthcare
system for the United States of America to provide relevant care to all individuals within the
borders of the country. There should, therefore, be no unreasonable barriers in the financing,
which may impact negatively on the ability of some people to gain access to the form of care that
they may be in need for. All the stakeholders in the US healthcare system also need to work
towards the reduction of costs. Private insurance firms, therefore, need to work with the
government in the provision of an oversight action over the healthcare institutions. Granted, they
have the chance to push for the healthcare facilities to cut on the cost of healthcare they attach on
the different services they offer.
As it relates to the healthcare system of the United Kingdom, the proposed changes
would be based on increased funding of the National Health Service through mansion tax and

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income tax (Ryan et al., 2016). The increased funding for the National Health Service will be
imperative as it will ensure that people who are beneficiaries of the insurance system can benefit
from the different services that are offered by the different entities. For instance, they may
benefit from the ambulance and dental services that are not highly used under the current
insurance systems. It is also necessary to integrate the social and healthcare. The process will be
imperative towards improving the level of access of people within the different communities to
healthcare. (Ryan et al., 2016). They may also get the opportunity to get more comprehensive
healthcare that touches on many aspects other than the inpatient services.
As for Australia in line with the views of Bartlett, Butler, & Haines (2016), there is a
need for a smart and/or sustainable healthcare system for the benefit of not only the citizens but
also for the success of the healthcare operations in the country. The authors indicate that the
smart and/or sustainable healthcare system can facilitate the emergence of a highly informed
population that can make lifestyle choices that are better so that they enjoy both happy and
productive lives where there is reduced debilitating chronic disease incidence. Australians
citizens in this regard would have more control over their own individual care as well as access
to healthcare services which are more tailor-made for their needs. Further, a sustainable and
smart healthcare system as proposed can enable the Australian population to be in a position to
better harness novel services including better health care data access, eConsultations, and remote
monitoring of healthcare services for improvements, in the current wake of the digital revolution.
One of the ongoing reforms that are taking place within the Australian healthcare system
is the increase of the aspect of local decision-making within the management process (Duckett &
Willcox, 2015). The process of increasing the aspect of local participation ensures that people
within have the chance to determine the level of care that they may stand to benefit from. In any

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healthcare system that is sustainable and ready to meet the needs of its citizens, it is important to
have a participatory approach in which the communities take part in decision-making and
policymaking. Australia has diverse population including both non indigenous and indigenous
factions. The different territories in the country as well have governments that have different
priorities in regard to healthcare (Ryan et al., 2016). However, some of these priorities coincide
with the national healthcare interests in spite of varying in proportions. The various territories
and communities as represented through their delegates in the government and parliament must
be allowed to participate fully in making healthcare policies and in their implementation.
According to Australia’s Policy Coalition, there is a need for a participatory approach to
solving the issue of obesity, alcoholism, and smoking. These conditions actually predispose
Australians to chronic diseases and thus increase the cost of medication for many Australians
who cannot afford. While obesity is a lifestyle disease that globally mainly features among the
rich, today in Australia, the poorer communities are also at an increasingly higher risk of obesity
and related chronic diseases. In Australia for instance, the Aboriginal and Torres Strait Islanders
today, who have part of their population living in poverty are also at risk of obesity (Clemens et
al., 2014). Smoking and alcoholism including the use of other drugs such as ice put them at risk
of chronic diseases including cancer. There is thus need to involve such communities in their
own care. This includes using community-based approaches where community gate-keepers
provide the leeway for the healthcare system to penetrate effectively. This also emphasizes the
need for culturally appropriate healthcare in Australia as a continuing reform.
Conclusion
To sum up, Australia, the United Kingdom, and the United States of America have
various similarities and differences in regard to their individual healthcare system. More

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particularly, these countries’ healthcare systems vary in terms of health service management and
outcome of their healthcare systems. For instance, the United Kingdom and Australia have some
level of universal coverage. Each one of these countries has designed healthcare system that they
believe can meet the health needs and requirements of their vast populations. Even so, it is
evident that the already established structure, management and implementation of the health
policies are a continuous process that involves monitoring and evaluation for improvement. This
necessitates the creation of novel proposals and the implementation of the already approved ones
on healthcare. In similarity, the UK, the US and Australia’s healthcare systems aim at ensuring
that more people have the chance to access better healthcare. Differences exist as mentioned. As
for the part of the United States of America, most of the funding is provided by the private
sector. Thus, either households or employers play the role of financing the healthcare system.
One of the changes that may need to take place in the United States of America is the provision
of a wide level of healthcare coverage. The process will, therefore, be imperative in improving
the level of access for people towards healthcare. The United Kingdom needs changes in
improving the level of funding provided towards the National Health Service. The act may be
attained through improving on taxation to meet the funding gaps that may be present towards
dealing with the different problems associated in the present healthcare system. Australia, on the
other hand, needs to improve the level of decision-making at the local level towards healthcare
provision. It also needs to ensure that its community participatory approach in healthcare
provision is sustainable going forward. The federal and state governments must emphasize the
need for the sustainability in the healthcare system’s facilitation of culturally appropriate and
safe health services for Australians.

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References
Bartlett, C., Butler, S., & Haines, L. (2016). Reimagining health reform in Australia: Taking a
systems approach to health and wellness. Retrieved from
https://www.strategyand.pwc.com/reports/health-reform-australia
Blank, R., Burau, V., & Kuhlmann, E. (2017). Comparative health policy. Macmillan
International Higher Education.
Clemens, S., Begum, N., Harper, C., Whitty, J. A., & Scuffham, P. A. (2014). A comparison of
EQ-5D-3L population norms in Queensland, Australia, estimated using utility value sets
from Australia, the UK and USA. Quality of Life Research, 23(8), 2375-2381.
D’Andreamatteo, A., Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: A
comprehensive review. Health policy, 119(9), 1197-1209.
Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford
University Press.
Freund, T., Everett, C., Griffiths, P., Hudon, C., Naccarella, L., & Laurant, M. (2015). Skill mix,
roles, and remuneration in the primary care workforce: who are the healthcare
professionals in the primary care teams across the world?. International journal of
nursing studies, 52(3), 727-743.
Global health spending: how does the UK compare?. (2017). Retrieved from
https://fullfact.org/health/global-health-spending-how-does-uk-compare/
Howick, J., Cals, J. W., Jones, C., Price, C. P., Plüddemann, A., Heneghan, C., ... & Badrick, T.
(2014). Current and future use of point-of-care tests in primary care: an international
survey in Australia, Belgium, The Netherlands, the UK and the USA. BMJ open, 4(8),
e005611.

COMPARING US, UK & AUSTRALIAN HEALTHCARE SYSTEMS
17
Mossialos, E., Wenzl, M., Osborn, R., & Sarnak, D. (2016). 2015 international profiles of health
care systems. Canadian Agency for Drugs and Technologies in Health.
Nilsagård, Y., Gunn, H., Freeman, J., Hoang, P., Lord, S., Mazumder, R., & Cameron, M.
(2015). Falls in people with MS—an individual data meta-analysis from studies from
Australia, Sweden, United Kingdom and the United States. Multiple Sclerosis
Journal, 21(1), 92-100.
Oliver, K., Innvar, S., Lorenc, T., Woodman, J., & Thomas, J. (2014). A systematic review of
barriers to and facilitators of the use of evidence by policymakers. BMC health services
research, 14(1), 2.
Osborn, R., Moulds, D., Schneider, E. C., Doty, M. M., Squires, D., & Sarnak, D. O. (2015).
Primary care physicians in ten countries report challenges caring for patients with
complex health needs. Health Affairs, 34(12), 2104-2112.
Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States
and other high-income countries. Jama, 319(10), 1024-1039.
Powell Davies, G., Harris, M., Perkins, D., Roland, M., Williams, A., Larsen, K., & McDonald,
J. (2017). Coordination of care within primary health care and with other sectors: a
systematic review.
Ryan, A. M., Krinsky, S., Kontopantelis, E., & Doran, T. (2016). Long-term evidence for the
effect of pay-for-performance in primary care on mortality in the UK: a population
study. The Lancet, 388(10041), 268-274.
Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G., & Whitley, R.
(2014). Uses and abuses of recovery: implementing recovery‐oriented practices in mental
health systems. World Psychiatry, 13(1), 12-20.

COMPARING US, UK & AUSTRALIAN HEALTHCARE SYSTEMS
18
Squires, D., & Anderson, C. (2015). US health care from a global perspective: spending, use of
services, prices, and health in 13 countries. The Commonwealth Fund, 15, 1-16.
U.S. Ranks Last Among Seven Countries on Health System Performance Based on Measures of
Quality, Efficiency, Access, Equity, and Healthy Lives. (2010). Retrieved from
http://www.commonwealthfund.org/publications/press-releases/2010/jun/us-ranks-last-
among-seven-countries
Wears, R. L., Hollnagel, E., & Braithwaite, J. (Eds.). (2015). Resilient health care. Ashgate
Publishing, Ltd.