I enjoyed the PBS film “America. vs. The World.” I consider myself relatively new to learning about the U.S. healthcare system. I have learned a good bit through my graduate classes in my Master’s of Public Health, and through life experiences such as getting my first full-time job with benefits and health insurance. Growing up, I am fortunate that healthcare is not something I had to think a lot about because my needs were met. I definitely did not know much about healthcare systems of other countries growing up, and my knowledge was still minimal prior to watching this film. I felt the film was an excellent introduction to understanding the pros and cons of various healthcare systems around the world.
The film starts off in Houston, Texas to showcase the U.S. healthcare system and how certain areas, such as Houston, have widespread disparities. The film mentions that most black residents are disproportionately underinsured and die on average 20 years earlier than residents of other races in Houston. Additionally, the film mentions that about 18% of Texans did not have health insurance when the documentary was filmed. One of the most shocking statistics noted in the film was that healthcare accounts for 1/5 of U.S. national spending, but Americans die at higher rates comparatively to other countries.
The film then reviews the healthcare systems of the United Kingdom, Switzerland, Australia, and Canada as comparisons to that of the U.S. This blog post will dive deeper into the healthcare system of the United Kingdom, the National Health Service (NHS), which provides universal healthcare to all citizens of the United Kingdom.
The NHS appears to have many pros, such as total spending – the film mentions the NHS spending about half of what the U.S. spends on healthcare with generally better outcomes. Other pros include paying for a variety of services and necessary healthcare equipment, such as the in-home equipment that is featured for Liam Murphy. The United Kingdom also has the public health statistics to support the positives of their system, such as lower rates of chronic disease (i.e. hypertension, diabetes) as mentioned in the PBS film. Despite its pros, no system is perfect and the film highlights a woman needing knee replacement who has been waitlisted for over a year. It seems that non-life-threatening health issues take much more time to get care than in the U.S. The U.S. may cost more for its services, but if one has health insurance, it is highly unlikely that they will wait near that length of time. I thought it was interesting that the PBS film indicated that a healthcare system like the NHS would not be feasible in the U.S. due to the difference in political set-up. The video attributes this to Congress being up for election every two years and lots of money going to doctors and hospitals. I found an article from the National Library of Medicine that suggests additional reasons for universal healthcare being difficult in the U.S. The article groups reasons into two categories: historical-cultural and political-structural. Some of the historical-cultural explanations include Americans generally having more negative attitudes about government than people of other democratic nations. This may stem back to the absence of a traditional aristocracy in the U.S., as noted by the article. The article also notes the lack of a labor party in the U.S. due to there being no self-identified working class in the U.S., rather a self-identified middle class. Political-structural explanations include how the separation of powers are set up in the U.S., with the differences between the Senate and the House of Representative as well as the independent judiciary. It is also noted that the U.S. has some of the weakest political parties and “only rarely does the content of a party’s platform have much bearing on the health policies it follows once in office, and not since 1965 has the electoral success of one party produced a major shift in health policy – although a similar shift almost occurred in 1995 after another partisan triumph.”
Likewise, Kate Freed, I was shocked to discover that the US death rate is higher than in any other country. The high death rates in our country are surprising, considering advancements in technology and medical research. My theory is that it’s because, in other countries, everyone has access to healthcare, regardless of income level. Perhaps the United States could reduce its mortality rate if it looked at this more closely. Thank you for pointing out the pros and cons of the National Health Service (NHS) in the United Kingdom. In spite of the fact that no system is without flaws, at least preventive care is available to all. Over the course of my career, I have worked in the healthcare field for many years. In the United Kingdom, obtaining non-life-threatening elective health care takes longer than in the United States. If you have insurance, you may qualify for knee replacement, but if you don’t, you won’t. Furthermore, those with insurance that require knee replacements must meet certain requirements to schedule the procedure. Non-life-threatening procedures aren’t as easy to get approved in the United States as you might think. There is a possibility that you have health insurance, but it does not meet all of the requirements for surgery.