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When comparing the UK and US healthcare systems it could be said that they are at opposite ends of the spectrum. As a Brit currently living in America, I’ll give you an impression of the plusses and minuses of each system from my experience.

For those unfamiliar with the UK system, it is nationalized and offers universal coverage to all, regardless of social class or income. The National Health Service (or NHS) is funded directly from general income tax. The amount contributed to the NHS is deducted from every citizen or resident of the UK and is roughly 20% of total taxes but varies in amount depending on income level.

When I moved to the US just over six years ago, the healthcare system seemed (and still seems) incredibly complex in comparison to the UK. I have been lucky that for most of my time living in the US my healthcare was covered by an employer through private providers. What’s most confusing to me about the system is that each provider offers a myriad of different plans and coverage. Different plans offer different levels of coverage which means you still may end up paying for some services such as specialists out of pocket.

Sometimes even seemingly routine services such as a simple consultation with a doctor or bloodwork may involve an extra payment or co-payment. I actually had never heard of and didn’t know what a co-payment was before I lived in the US.

Another more negative aspect of the US healthcare system that I experienced personally was that if you ever have a period when you’re not working you normally lose your health coverage either immediately or very quickly after finishing work. Although options are available they can be extremely costly. Often the choice of private healthcare solutions available may even affect where you decide to work if you are offered a choice of jobs. It is not that unusual in the US for someone to choose a job not necessarily because it is the one, they like the best, but is instead the one that offers superior health coverage.

This would rarely happen in the UK as healthcare is not typically offered or covered as a perk by an employer which means it is not usually a factor when choosing a place to work. In the UK basically everything is covered except some prescription costs which sometimes need to be paid out of pocket.

In the US you must pay attention to and understand very clearly the health plan you select. Just because cutting-edge services are available in America doesn’t necessarily mean you have access to them. Not every health plan offers the same level of coverage or access to care as the next.

Another aspect of the US system that I found odd is that you can change your coverage once every year, but only once per year and during a very specific timeframe. This election or enrollment period can be both positive and negative, depending on your situation. On the one hand you can customize your coverage annually based on your specific needs. On the other, if you misunderstood or chose the wrong coverage you need to wait a whole year to modify it.

The advantage in the UK is that everyone has access to the same level of care. Even the unemployed receive the same basic coverage as those working full-time. This was demonstrated very recently when the UK Prime Minister, Boris Johnson was hospitalized for and recovered from COVID-19 and received the same level of care that any other tax-paying UK resident would. It is highly unlikely that the President of the US would receive the same level of healthcare as an average US worker.



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