As Americans, we frequently find ourselves comparing our country to our ally, the United Kingdom. As you step into the world of healthcare and allied health careers, you may wonder how our system in the United States measures up to the United Kingdom's. Take a look into the two healthcare systems in this comprehensive guide.
Health Policy: The British National Healthcare Service
In many ways, the healthcare system in the UK is hard to comprehend for most Americans. The British National Healthcare System is a social insurance system that operates on the belief that healthcare is a right, not a privilege.
The system of social insurance has many similarities to Social Security and Medicare in the US. In the most basic terms, everyone pays in and everyone gets treatment. The NHS is a publicly funded and administered system.
How It’s Paid For
Health plans are not actually free
in the UK, but the percentage of an individual’s income that goes to their care is equal across the board. The British system is free at the point of access, but paid for through taxation
. You may be wondering how much this amounts to. In 2008, the tax was approximately 9% of a citizen’s gross income. You might say “ouch,” but remember, no one gets turned away for treatment.
Availability and Standards of Care
NHS standards are set forth by the National Institute for Health and Care Excellence (NICE)
. NICE has worked out guidelines and standards for a variety of ailments. For instance, asthma patients who are seen at emergency or after hours care must be seen within the next two days by their primary healthcare provider. Another example is a target wait time for the ER. The goal is for 95% of patients to be in seen within four hours
Availability of care is one of the biggest healthcare concerns, regardless of the country you live in. Currently, the UK is experiencing a shortage of general practitioners (GPs). This shortage has led to many patients waiting from one week to up to three weeks to see their GP. The NHS estimates that in many larger areas of the UK, the number of GPs required is up to twice as many as the number of GPs currently practicing.
At times, long waits have also been noted for non-emergency visits to specialists as well. Jim Edwards, a writer at the Business Insider, noted that he waited six weeks to see a specialist. In contrast, the average citizen waits about two weeks for routine diagnostic tests such as MRIs, CT scans and electrocardiograms. This wait time is probably longer than many Americans are used to.
Health Policy: Private Healthcare in the US
If you live in the US, you know this system well and likely don’t need much explanation here. The big difference is that the healthcare system is structured more like a privilege than a basic right. Here, we all pay into health plans or pay out of our own pocket for our own care.
For the most part, healthcare is private, though Medicare and Medicaid provide services to certain segments of the population. To compare, in the US, healthcare workers and health facilities operate privately, whereas in the UK, facilities operate publicly and workers are public employees.
How It's Paid For
Here in the US, it’s typical for employers and insured individuals to pay a portion of the cost. There are government subsidies for some patients, but for the most part, this is still the case.
Some estimates show the average American spends about 5% of their gross income on medical costs, including premiums, co-pays and costs that are not covered, but this number varies, since everyone is responsible for their own healthcare costs.
While private insurance or Medicare or Medicaid cover many of the costs, our system does leave gaps. Not all procedures and services are covered, and coverage can vary from company to company.
Availability of Care
Getting care when you need it is universally important. Speedy care in the emergency room is essential. The UK healthcare system target is to have a patient wait time of four hours or less for 95% of its patients.
Currently, they’ve achieved this wait time for approximately 85% of emergency care patients. By comparison, 95% of visitors to the ER are seen within three hours of arrival. The average wait time for emergency and accident care in a US emergency room is 58 minutes.
American emergency room wait times may not be bad, but when it comes to seeing a primary care physician, you may be waiting longer than you’d like. A 2014 Merritt Hawkins study
surveying average wait times for new patient appointments found that someone looking to see a primary care physician could wait anywhere from five to 66 days, and the average was about 19.5 days.
If you want to see a cardiologist, the average wait is 16.8 days, and for dermatologists, you’ll be waiting 28.8 days. Unfortunately, wait times for diagnostic testing are not readily available, so this is difficult to compare. Traditionally, most diagnostic testing is done through private facilities in a variety of types of institutions, so wait times can vary drastically between a standalone facility and a hospital. The number of machines and technicians in a given region also impact how long you may wait.
Standards of Care
Though the US doesn’t utilize care guidelines in the same manner that the NHS does, there are still definitive standards of care and care recommendations. These clinical guidelines are set forth by the Agency for Healthcare Research and Quality (AHRQ)
They define standards for areas like diagnostic testing, pharmaceuticals and treatment of diseases. And though there are guidelines, healthcare insurance companies are sometimes free to choose what they will pay for, with a few legal exceptions.
Health Professions Career Outlook
It’s clear that both the UK and US have an ever-growing need for healthcare workers. Demand is high in both countries and additional vacancies are anticipated. Many health professions need more workers, including allied health professionals, doctors and nurses. In the US, the aging baby boomer population will continue to bolster the need for all types of positions within the healthcare field.
Career Outlook in the UK
The NHS currently lists over 14,000 jobs available
in a variety of areas. The website indicates that about 20,000 vacancies are advertised every month on the site. Close to 1,500 of these are listed under allied health, which includes physiotherapists, radiographers and occupational therapists, to name a few.
The British Association of Occupational Therapists and College of Occupational Therapists cites a growing need for more people to join the profession, though exact statistics are unavailable.
As European citizens, British healthcare workers can easily move to other countries on the Old Continent. The healthcare system in different EU states is pretty similar. On top of this, some countries are very welcoming to British expats.
Career Outlook in the US
Allied healthcare jobs continue to grow, as well as primary care and a variety of other medical positions in the US. We’re all concerned about career viability and growth, so one of the top questions on your mind may be which health careers have the best outlook
The Bureau of Labor Statistics cites personal care aides, home health aides, diagnostic medical sonographers, occupational therapy assistants and aides, genetic counselors, physical therapy assistants and aides, and physician assistants among rapidly-growing jobs.
Many of these positions are experiencing upwards of 40% growth over a ten-year period. Most notably, personal care aides and home health aides top the list with 49% and 48% growth respectively. Diagnostic medical sonographers come in at a very respectable 46% rate of growth.
Growth is one thing, but you also want a great job. Many health professions rank highly on the US News & World Report 100 Best Jobs list. The top two on the list are dentists and nurse practitioners. Physician, dental hygienist, physical therapist, registered nurse and physician assistant are all in the top 10.
If you’re considering allied health careers in the US, check out these New Jersey hospitals to launch & nurture your career. They’re great places for people just starting out in the field.