Health Economics Analytical
1.0 Introduction
Health issues are many and these concerns are generally mind bogglingly difficult. Discussions over trade-offs between social harmony versus personal independence, public versus private heath care financing, public versus private provision of heath care services, and the requirement for high-quality medical care verses more basic levels portray health care arguments in every nation. Private provision of health care and private sector financing joint with anticipation of Americans for their systems receptiveness is obviously hard to control. The U.S. health care system is extremely more costly than any other in the world and costs approximately twice as much as the U.K. system (Bolnick, 2002).
In comparison to the U.S., the U.K. National Health Insurance (NHI) system is a Federal tax financed health care system. All U.K. nationals have the privilege to get their health care without direct cost to them through medical practitioners that are salaried employees of the NHI and hospitals possessed and ran by the government. The federal government budgets the amount spent on health care (Mossialos and Thomson 2001). World Health Organizations measures illustrate that the U.K. health care structure has world-class health results with little difference across its citizens and high feedback for financial fairness. However, the system relatively low in responsiveness. Besides, the financially unconstraint U.S. system is more responsive to its population needs.
2.0 Health economics analytical
2.1 National Health Service versus U.S. Private System
According to Hubpages Inc. (2010) the National Health Service in the United Kingdom was set up in July 1948 to cover everybody in the country for health care. There has been complains about adverse standards of hygiene in hospitals, the high rate of hospital related infections, unreasoned decisions to ration specific drugs or treatments, overworked staff, the difficulty of getting a non urgent doctors appointment, the limited time one gets with the medical practitioner when the patient wants to see one, meals at hospital and so on (The Spectator, 2010). Getting an initial diagnosis from a general doctor is generally easy, but the patient might wait for weeks to get lab test results, even longer to get an attention of a specialized practitioner. These accrued problems have been brought by National Health Services (NHS). On the hand, the U.S. system faces few problems and the patients are charged once the patients have seen a medical practitioner (Lyons, 2009).
The U.S. health care system is private and Americans get health medication an insurance policy which is frequently paid by their employers. On the hand, the U.K. spent the equivalent of 8.2 of gross domestic product on healthcare of which 87.5 is state financed. 15.3 of GDP was spent on health care in USA of which 45.8 percent is state funded. The NHS is free since NHS spends 100 billions per year which is approximately 20 of UK government income. The U.K. system is free at the point of use since is financed from the taxation. The NHS is socialist in nature. This is because NHS is non profit system which embraces all and the patients need is paramount and is preferred over the U.S. most expensive system (Guardian News and Media Limited, 2010) as shown in table below.
Table 2.1 How NHS Compares
CountryPer capita on health ()Doctors per 10,000 populationNurses and midwives per 10,000 populationHospital beds per 10,000 populationLife expectancy at birthUnited States671926943178U.K.2815231283980Source Guardian News and Media Limited, 2000, p.1
The NHS allows out patients to pay only 7.20 for drugs issued by the general practitioner. The updated list of exceptions is as follows. 60 years old or more, 15 years old or less, under the age of 19 years and in full time education, expectant, or had delivered a baby in the previous 12 months, a person with continuing physical disability and people get free prescriptions when the persons are on benefits when jobless on a low income, or their spouse or partner is on such benefits. The NHS does not cover all dentistry for everybody except where one is 15 years old or less, under the age of 19 years and in full time education, expectant or had delivered a baby in the previous 12 months, gets benefits for unemployment or on low income, or their spouse or partner is on such benefits and in-patient in hospital including a dental hospital. Else everybody is entitled to register as a NHS patient with a NHS dentist (Hubpages Inc. 2010).
NHS patients who do not get free dentistry are charged in three categories. These are band1 who pays 16.50 which covers an examination, x-rays, scale and polish, fissure sealing, and fluoride vanish, band2 who pays 45.60 which covers band1 plus any filling, root canal treatment, or extractions and band3 who pays 198 which covers band2, plus crowns, bridges, and dentures. For eye care, patients get free eye tests when required if the patients meet the following conditions. If the patients are 60 years old or more, 15years old or less, under the age of 19years and in full time education, blind or partially sighted, have glaucoma or diabetes, or are at risk of these, or have close relative with glaucoma, gets benefits for joblessness or on low income, or their spouse or partner is on such benefits. Appointment and tests costs approximately 17. In the U.S. low income earner or those who are jobless do not easily access medication. This is because health care in the United States is very expensive (Hubpages Inc. 2010).
In 2007 GDP U.S. had 16 and U.K. had 8.4 total spending on health. U.S and U.K. had 7,290 and 2,992 spending per person respectively. Life expectancy was in the U.S. 80years (female), 75years (male) and 81 years (female), 76years (male) in the U.K. Infant mortality rate (per 100,000 live births), in the U.S. was 6.26 deaths and 4.85 in the U.K. Money spend on healthcare coming from public funds was 45 in the U.S. and 82 in the U.K. Further more, minor changes in the health system in the U.S. were 38 while in the U.K. was 20. Fundamental changes needed in the health system in U.S. were 48 while in the U.K. were 46. 36 of the population in U.S. does not visit a doctor when ill while in the U.K. is only 4 (Jelsoft Enterprise Ltd, 2010).
According to Schoen et al. (2009) survey, over 58 of the U.S. physicians said that patients frequently have difficulty for healthcare and half of U.S. doctors spend a lot of time dealing with the limitations insurance companies put on patients. 29percent of the U.S. physicians said that their practice had provisions for getting patients after-hours care and avoided visiting a hospital emergency room as compared to Dutch, New Zealand, and U.K. medical practitioners who declared that their practices had arrangements for after-hours care. Only 46 of U.S. medical doctors use electronic medical records, compared to over 90 of doctors in U.K. Rarely are physicians given financial incentives to improve the quality of healthcare in the U.S. as compared to doctors in the U.K. (89). Patients with persistent illness need extensive time with medical practitioners, teaching about their sickness, and coaching about treatment, diet, and medication routine. Care teams composed of clinicians and nurses have been revealed to be efficient in providing care to patients with chronic conditions and in improving outcomes. The availability of such teams is prevalent in the U.K. (98), and in other as show in the figure 2.1 shown below.
Figure 2.1 Practice Has Arranged for Patients After-Hours Care to See DoctorNurse
Source Scheon et al. 2009. p. 1
2.2 Commonness of Breast Cancer
The vulnerability of breast cancer is as follows. Breast cancer is likely to emerge two times to women with a mother, sister or daughter detected with breast cancer. Though the threat rises with the number of first-degree relatives diagnosed with breast cancer, but eight out of nine breast cancers transpire in women without a family history of breast cancer (de Silva, 1996). Obesity raises the threat of postmenopausal breast cancer by up to 30percent. Women using hormone replacement therapy (HRT) have a 66percent increased danger of breast cancer. Further more, the danger of breast cancer increased by approximately a quarter in users of oral contraceptives. Drinking modest amounts of alcohol raises the risk of breast cancer by 12 percent.
In the U.K., the breast cancer screening programme operated by the NHS was pioneered in 1988 in rejoinder to proposals made by a working group chaired by Professor Sir Patrick Forrest. Currently the programme has an annual budget of 75 million and screens approximately 1.5million women per year in about 100 breast cancer screening units instituted across the U.K. Approximately 119,000 cancers have been diagnosed in women since the introduction of screening and 1400 lives saved per year in England alone. The 95 confidence interval for the cost-effectiveness of extending screening to the 40 to 49 years age group was estimated as 9,000 to infinity was saved per life (Madan and Rawdin, 2008). For older women, systematic review has identified a range of estimates for the cost per life-year saved of extending screening to age 75years or 80years of US34,000 to US88,000 in 2002 (Mandelblatt, et al. 2003). Figure 2.2 below and Table 2.2 .
Figure 2.2 Identification of women at high risk of breast cancer through the National Health Service Breast Screening Programme (NHSBSP)
Source de Silva, 1996 p.3
Table 2.2 Costs involved in screening and subsequent diagnosis
Activity200506 Cost200607 cost (05064.6)Initial two-view mammography4042Further mammography6770Ultrasound examination7478Biopsy241253Source Madan and Rawdin, 2006 p. 13
Breast cancer is currently the most common cancer in the U.K. Over 45,000 women were diagnosed with breast cancer in 2006. Yearly about 300 men are diagnosed with breast cancer. Incidence rates of breast cancer have risen by more than 50percent over the last 25years. Female breast cancer occurrence rates in the U.K. have risen by 6percent in the last 10years. 8 out of 10 breast cancers are detected in women aged 50 and over. The NHS breast cancer screening programme detects about 10,000 cases of breast cancer yearly in England. Breast cancer screening programme by the NHS saves approximately 1,400 lives yearly in England (Madan and Rawdin, 2008). Over a million women are diagnosed with breast cancer yearly worldwide. Northern and Western Europe and North America have the highest rates of breast cancer and lowest rates are reported in Northern, Eastern and Middle African countries and Asia (Cancer Research UK, 2010).
Currently more women are surviving from breast cancer than previously. Approximately 2 out of 3 women having breast cancer currently survive and live beyond 20 years. For 40years breast cancer survival rates have been improving. 5 out of 10 breast cancer patients survived the disease beyond 5years in 1970s. Now 8 out of 10 patients survive. Women from most affluent areas have higher rate of survival from breast cancer than those living in most deprived areas. The earlier the breast cancer is diagnosed, the higher the rate of survival. Women diagnosed with stage 1 breast cancer about 9 out of 10 survive the disease beyond five years. Those diagnosed with stage IV breast cancer, only 1 out of 10 survive (Cancer Research UK, 2010). Table 2.3 below.
Table 2.3 Breast Cancer in U.K.
Source Cancer Research UK, 2010 p.1
Currently beast cancer is the second most cause of death in women after lung cancer. Approximately 12,000 women and about 70 men die from breast cancer every year in the U.K. About 1,300 deaths are reported every year from breast cancer in women below 50 years. Over a half of breast cancer deaths are women aged beyond 70 years. The peak of breast cancer death rates was in late 1980s and now has fallen by about a fifth (Cancer Research UK, 2010). Figure 2.3 below.
Figure 2.3 Breast cancer death rates, females, UK, 1971-2007
Source Cancer Research UK, 2010 p.2
Conclusion
The National Health Service health care practiced in the United Kingdom is far much better than the United Stated states health care system. Though the National Health Service is faced with quality issues due medical practitioners being enticed with financial benefits to work, long wait lists, difficulty in accessing a specialist and long waits for lab result, but the health care system is cost effective. This is because the health care is financed by the government as compared to the United States health care system which is purely private and only persons with insurance cover can afford to access the health care rendering those who are jobless and vulnerable groups without an alternative. The screening Programme initiated by the National Health Service has cut on cost of diagnosis through screening and treatment of cancer. There is room for improvement in both National Health Service health care system in the U.K. and that of the U.S.