‘Differences
in health care systems reflect different value bases in Western
societies.’
Discuss.
Value bases and cultural traditions play a very important
role in a country’s health care system and although
they are not the only factors to influence a system they are
extremely significant.
The ‘value base’ or ‘culture’ of
a country can be defined as a deep rooted and constant way
of thinking and behaving which are learned and reinforced
in the home, at school and through the media. (Wall, 1996)
Ultimately it appears that, “a society which holds
its collective obligations in high regard is likely to have
a health care system characterised by significant state intervention;
a small private sector; a preference for tax rather than insurance
funding; comprehensive coverage; and a universal entitlement
based on the notion of rights. By contrast a society steeped
in individualism will rely heavily on private enterprise and
insurance funding; be selective in its coverage, and respond
to consumer demand.” (Wall, 1996, p4)
While the UK and the US are very similar countries in many
respects, their history and values are very different and
are thus reflected in their health care systems.
In the UK care is provided mainly through the public sector,
the NHS, with a small proportion of about 10% being provided
privately. The introduction of the NHS ACT (1948) ensured
equal access to medical care for all citizens with no cost
at the point of delivery. The NHS is funded by the tax payer
and most costs will be charged directly to the state. (Lassey&Lassey&Jinks,
1997)
The health care systems of individual countries are organic
and do not come from an ‘international catalogue’.
The modern NHS is a proud British achievement and is committed
to the belief that effective health care should be provided
as a public service to all those who need it.
In contrast, health care in the US is primarily a part of
the private sector in which private entrepreneurs are free
to sell their services for a profit to those who are willing
and able to pay. The costs fall directly on the patient whose
bills are usually picked up by insurance companies to which
their client pays regular premiums. Some provision is provided
by the state for those who cannot pay, however, it is limited.
(Mechanic, 1972)
The US is a young country, renowned as ‘the land of
opportunity’, and its emphasis is on individualism,
self-help, the value of work and competition. This general
entrepreneuralism is closely linked to health care –
it is just one of many profitable businesses. (Lasseey&Lassey&Jinks,
1997)
In conclusion, it is clear that a country’s health
care system can only be understood through its history, value
base and ideology. The UK model is one built upon notions
of equality and social justice. The US system, however, represents
the free enterprise culture of the country which was founded
on individualist liberalism and a belief in less government.
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