11 Apr 2022


Compare United States vs England Healthcare System

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Academic level: College

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Juxtaposition between the healthcare delivery systems of the USA and England is a comparison on policy rather than capabilities because both are among the premier first world countries in the world. However, a comparison between any of them and a third world country would be different in that capacity would come into play. Policy however, sharply differs between the US and England and it is this policy difference that will mostly feature in this juxtaposition. The US has been consistent on its capitalistic policies since its declaration of independence while England transited to social democracy through the labor party after the Second World War. Political ideologies, therefore, form the main distinctions between the healthcare delivery systems of the two countries.

Health Care Policy  

England health care policy is informed by the dictates of social democracy such that the government undertakes a responsibility to cater for the basic amenities of its citizenry. These basic amenities include healthcare whereby when a resident citizen or permanent resident is unwell, the onus is on the government to cater for them. The US on the other hand, is at the extreme end of this divide. The US is strictly capitalist and the government respects individual’s rights to earn a profit. Health care is a big business in the US as government policy does not favor interference with this commercial enterprise through subsidization of healthcare (Squires & Anderson, 2015). The US government can afford universal free medical care but would not do it for political reasons. 

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Healthcare Cost

England forms part of the United Kingdom where all healthcare service costs for all permanent residents are handled by the National Health Service (NHS). English citizens domiciled at home as well as permanent residents, therefore, need not worry about any form of medical expenses whether general or specialized as healthcare is guaranteed at no cost (National Health Service, 2016). In the United States however, all health care costs are directly or indirectly borne by the individual. There is no guaranteed health care for any class of citizens in the United States except for reproductive health through Planned Parenthood. However, all hospitals; public or private require some form of payment with the only difference being subsidization for community and humanitarian hospitals (Squires & Anderson, 2015). 

Medical Insurance

In the US, medical insurance is almost a matter of life and death since a citizen’s life may depend on it in times of critical illness. The Patient Protection and Affordable Care Act (PPACA) of 2010 also called the Affordable Care Act (ACA) or simply Obamacare regulates this industry. It however, only provides for contributory insurance for all employees, hence the scope and level of insurance and by extension healthcare in the US is depended on the social class of the insured (Squires & Anderson, 2015). In England, health insurance is a matter of choice and preference as most English employers provide health insurance for their employees as part of employee benefits. In extreme contrast, some US states have declined to enforce the mandatory contributory system of the ACA (Squires & Anderson, 2015).

Medical Research 

Some of the best research facilities in the world are either in the US or owned by US agencies and companies with the average annual research budget at US$ 177 billion (Harris, 2015). The Federal government through its agencies including the Centre for Disease Control (CDC) conducts a lot of research on areas of critical interest. It also partners with many private entities, specialized hospitals, and academic institutions to conduct research (Harris, 2015). The private sectors especially for pharmaceutical companies also expend billions of US dollars annually into research.

Some of the biggest pharmaceutical companies in the world are US based. These include Johnson & Johnson and Pfizer; the largest in the world. Regulation of medical research in the US is however lax as many scandals have arisen across the globe regarding the use of humans as guinea pigs for medical experiments. Medical research in England is however, relatively smaller, less funded but very well regulated. Most research is conducted by the government through academic institutions with the associated cost subsidized by the European Union, a situation that has been jeopardized by the Britain exit poll. Generally, English medical research is a pale shadow when compared with the American version of the same.

Hospitals and Medical Facilities

In England, healthcare is not a commercial enterprise and is, therefore, mostly funded by the NHS with an annual budget of about £101.3 billion that cater for all the healthcare services. With the government providing most of the healthcare services, the private sector is not very robust. However, there are no substandard or overloaded medical facilities in the England as the government has ensured sufficiency in healthcare (National Health Service, 2016). Medical staffs are also well trained, motivated, and committed. British nurses are respected the world over for their ethics and commitment to proper service provision. Medical equipment and other facilities are also above average. 

In the other hand, due to its capitalist nature, the US has some of the best specialized hospitals in the world. From specialized medical staff to facilities and equipment, US companies have perfected medical services proviso. However, most of the leading hospitals are privately owned commercial establishments that charge exorbitant prices. In a sharp contrast, government community hospitals especially in lower class neighborhoods are normally overcrowded and overwhelmed (Squires & Anderson, 2015). The subsidization they receive from the government and well-wishers is seldom sufficient to cater for the lower class populace who are unable to pay for healthcare and normally lack insurance.


Both countries have great healthcare systems. All English residents are guaranteed above average medical care including specialized treatment at no cost. Those who can afford it can also get specialized treatment at reasonable costs. In the US, those who can afford it have access to the best medical facilities in the world at a higher cost, but the lower classes have to make do with improvised and poor healthcare facilities. It is common for the members of the lower class in the US to die because they cannot afford specialized, treatment while those who can afford medical insurance have to content with innovative healthcare arrangements that include travel to third world countries in search of cheaper medical attention. Such arrangements are both unheard of and unnecessary in England. Although the US healthcare delivery system is bigger, England provides a better system that caters for all citizens irrespective of their social class. 


Harris, R. (2015). U.S. Funding of health research stalls as other nations rev up. Retrieved from <http://www.npr.org/sections/health-shots/2015/01/13/376801357/u-s-funding-of-health-research-stalls-as-other-nations-rev-up/> 

National Health Service. (2016). The NHS in England. Choices . Retrieved from <http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx /> 

Squires, D. & Anderson, C. (2015). U.S. Health care from a global perspective . Use of services, prices, and health in 13 countries. The Commonwealth Fund. Retrieved from <http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective/> 

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StudyBounty. (2023, September 15). Compare United States vs England Healthcare System.


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