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ANALYZING OF HEALTHCARE EXPENDITURES IN THE UNITED KINGDOM AND THE UNITED STATES OF AMERICA

Year 2019, , 89 - 116, 21.01.2020
https://doi.org/10.21441/sosyalguvence.677357

Abstract

In the light of Welfare State Literature, both the United Kingdom (UK) and the United States of America (USA) are categorized as Liberal Welfare Regime by Esping-Andersen, whose classification is widely accepted in the literature, and other researchers. But as a significant difference, whereas the UK has a universal free healthcare system contrary to typical Liberal Welfare State Regime, the US doesn’t have a universal healthcare system and furthermore, the healthcare system is mostly based on private insurance schemes. Moving from that point, health expenditures in the UK and the US has been compared and analyzed since the conditions create a significant comparing chance. This study’s main argument is based on the claim of even though the US health expenditures are about two times higher than the UK (per capita and as a rate of GDP) health system in the UK is financially more efficient than the US in terms of better public health outcomes and quality. In order to do so, the study analyzes the quantity and quality of healthcare expenditures in both countries by using literature, World Health Organization and different rating systems and furthermore both systems are discussed by 8 selected public health outcomes. The study concludes that the UK’s National Health Service (NHS) is giving better quality of service with almost two times lesser financial resources in terms of public health outcomes and some policy recommendations have been made.

References

  • AFL-CIO, (2018). http://dpeaflcio.org/programs-publications/issue-fact-sheets/the-u-s-health-care-system-an-international-perspective/ (retrieved on 05.15.2018).
  • Miller Lee J. and Lu W. (2019, February 24). These Are the World’s Healthiest Nations. Bloomberg, https://www.bloomberg.com/news/articles/2019-02-24/spain-tops-italy-as-world-s-healthiest-nation-while-u-s-slips (retrieved on 09.15.2019).
  • Bloom D. E., Canning D., Pia N. M. (2000). Demographic Change and Economic Growth in Asia. Suppl Popul Dev Rev, 2000;26:257–90.
  • Boyacıoğlu E. Z. (2012). The Importance of Health Expenditures on Sustainable Development. International Journal of Social Sciences and Humanity Studies, Vol 4, No 2, 2012 ISSN: 1309-8063 (Online) http://www.sobiad.org/eJOURNALS/journal_IJSS/arhieves/2012_2/ebru_boyacioglu.pdf
  • Çelikay F., Gümüş E. (2014). Sosyal Harcamaların Yoksulluk Üzerine Etkileri: Ampirik Bir İnceleme. Anadolu Üniversitesi Sosyal Bilimler Dergisi, Issue: 14, Number 4, pp. 127-138.
  • Esping-Andersen, G. (2006). Three Worlds of Welfare Capitalism. In C. Pierson and F.G. Castles (Eds.). The Welfare State Reader, 2nd Edition, pp. 160-174. Cambridge: Polity Press.
  • Fenger, M. (2007). Welfare Regimes in Central and Eastern Europe: Incorporating Post-Communist Countries in a Welfare Regime Typology. Contemporary Issues and Ideas in Social Sciences, August 2007 pp. 1-30.
  • Global Burden of Disease Study (2016). https://www.thelancet.com/gbd?source=post_page--------------------------- (Retireved on 09.15.2019).
  • Grimmeisen S. and Heinz R. (2004). The Changing Role of the State In Europe’s Healthcare Systems. The Second Annual Espanet Conference, University of Oxford.
  • Gökbunar, R., Özdemir H., Uğur A. (2008). Küreselleşme Kıskacındaki Refah Devletinde Sosyal Refah Harcamaları. Doğuş Üniversitesi Dergisi, Number: 9, Issue: 2, pp. 158-173.
  • Gürler Hazman, G. (2011). Türkiye’de Gelir Dağılımında Adalet ve Sosyal Güvenlik Harcamaları Arasındaki Nedensellik İlişkisi. Süleyman Demirel Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, Year: 2011, Issue: 16,Number: 1.
  • Hall, P.A. and D. Soskice (Eds). (2001). Varieties of Capitalism: The Institutional Foundations of Comparative Advantage. Oxford University Press.
  • ILO (2014). Social Protection Global Policy Trends 2010-2015: From Fiscal Consolidation To Expanding Social Protection: Key To Crisis Recovery, Inclusive Development And Social Justices, Geneva.
  • McPake, B. (2018). Crunching Health Expenditure Numbers: Important but Treacherous Terrain. The Lancet, Volume 6, Issue 2, Pe124-E125, https://doi.org/10.1016/S2214-109X(18)30007-X
  • Nghiem S. N. and Connelly L. B. (2017). Convergence and Determinants of Health Expenditures in OECD Countries Health Economics Review. 2017 7:29, DOI 10.1186/s13561-017-0164-4 NHS (2018). https://www.nhs.uk/NHSEngland/thenhs/nhshistory/Pages/NHShistory1948.aspx (Retireved on 09.13.2019).
  • Norton A., Conway T., Foster M. (2001). Social Protection Concepts and Approaches: Implications for Policy and Practise in International Development. Centre for Aid and Public Expenditure. Overseas Development Institute, London.
  • OECD (2012). Poverty Reduction and Pro-Poor Growth: The Role of Empowerment, Paris.
  • OECD (2016). Health at a Glance. Paris, https://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance_19991312 (retrieved on 09.16.2019).
  • OECD Statistics (2018). http://stats.oecd.org/ (retrieved on 04.16.2018).
  • OECD (2018a). https://data.oecd.org/healthres/health-spending.htm (retrieved on 04.15.2018).
  • OECD (2018b). https://data.oecd.org/healthstat/life-expectancy-at-birth.htm (retrieved on 04.15.2018).
  • Piabuo S. M. and Tieguhong J. C. (2017). Health Expenditure and Economic Growth, A Review of the Literature and An Analysis Between The Economic Community for Central African States (CEMAC) and Selected African Countries. Health Economics Review, 7:23, DOI 10.1186/s13561-017-0159-1
  • Schneider E. C., Sarnak D. O., Squires, D., Shah A., and Doty M. (2017), Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. The Commonwealth Fund, https://interactives.commonwealthfund.org/2017/july/mirror-mirror/ (retrieved on 08.30.2019).
  • Özdemir S. (2005). Sosyal Gelişim Düzeyleri Farklı Refah Devletlerinin Sınıflandırılması Üzerine Bir Değerlendirme. Sosyal Siyaset Konferansları Dergisi, Issue 49, Istanbul, pp. 231-266.
  • The Lancet (2018). Measuring Performance on the Healthcare Access and Quality Index for 195 Countries and Territories and Selected Subnational Locations: A Systematic Analysis from the Global Burden of Disease Study 2016. The Lancet, 391:2236–71, http://dx.doi.org/10.1016/S0140-6736(18)30994-2 (retrieved on 08.15.2019).
  • Triggle, N. (2018, May 24). 10 Charts that Show Why The NHS Is in Trouble. The BBC, http://www.bbc.com/news/health-42572110 (retrieved on 04.16.2018)
  • El Gingihy, Y., (2016, July 13). If You Think There Is No Money For NHS Funding You’d Be Right – PFI Has Sucked It Dry. The Independent, https://www.independent.co.uk/voices/nhs-funding-pfi-contracts-hospitals-debts-what-is-it-rbs-a7134881.html retrieved on 04.16.2018)
  • Syal R., (2016, November 22). NHS Financial Problems Endemic and No Longer Sustainable, Say Auditors. The Guardian, https://www.theguardian.com/society/2016/nov/22/nhs-financial-problems-endemic-and-no-longer-sustainable-national-audit-office-deficit retrieved on 04.16.2018).
  • Toprak, D. (2015). Uygulamada Ortaya Çıkan Farklı Refah Devleti Modelleri Üzerine Bir İnceleme. Süleyman Demirel Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, Issue: 21,Year: 2015/1, pp.151-175.
  • United Nations. (2018). http://www.un.org/en/universal-declaration-human-rights/ (retrieved on 04.16.2018)
  • United Nations. (2019). https://www.un.org/sustainabledevelopment/health/ (retrieved on 09.10.2019).
  • Radu, C., (2019, December 19). US News, https://www.usnews.com/news/best-countries/slideshows/countries-with-the-most-well-developed-public-health-care-system?onepage (retrieved on 09.15.2019).
  • WHO. (2000). The World Health Report. Health Systems: Improving Performance, Paris
  • WHO. (2018). Country Profiles, http://www.who.int/countries/en/#U (retrieved on 05.19.2018).
  • WHO. (2019). https://www.who.int/topics/millennium_development_goals/about/en/ (retrieved on 10.09.2019)
  • Xu, K., Saksenaa P. and Holly A. (2011). The Determinants of Health Expenditure: A Country-Level Panel Data Analysis. WHO Working Paper, https://www.who.int/health_financing/documents/report_en_11_deter-he.pdf (retrieved on 09.12.2019).
  • Zuckerman S. and McFeeters J. (2006). Recent Growth in Health Expenditures, The Commonwealth Fund, https://pdfs.semanticscholar.org/08ab/7a7d5f3a6c9fef9b9389ababd9628e6f42d4.pdf (retrieved on 09.13.2019)
  • Thornton, A. (2019, February 25 ).World Economic Forum, https://www.weforum.org/agenda/2019/02/these-are-the-world-s-healthiest-nations/ (retrieved on 09.15.2019)

BİRLEŞİK KRALLIK VE AMERİKA BİRLEŞİK DEVLETLERİNDE SAĞLIK HARCAMALARININ ANALİZİ

Year 2019, , 89 - 116, 21.01.2020
https://doi.org/10.21441/sosyalguvence.677357

Abstract

Refah Devleti literatürü kapsamında hem Birleşik Krallık (BK) hem de Amerika Birleşik Devletleri (ABD), başta literatürde sınıflandırması çokça kabul gören Esping-Andersen ve diğer araştırmacılar tarafından “Liberal Refah Devleti” olarak sınıflandırılmaktadır. Fakat iki ülke arasında önemli bir fark vardır: Birleşik Krallık’ta ücretsiz ve genel bir sağlık sigortası varken ABD’de sağlık sistemi çoğunlukla özel sigortalara dayalı olarak ve ücretli olarak yürütülmektedir. Bu noktadan hareketle bu çalışma kapsamında, iki ülkenin benzer refah sistemlerine sahip olmasının son derece önemli bir karşılaştırma imkanı vermesinden ötürü BK ve ABD’de yapılan sağlık harcamaları karşılaştırılmakta ve analiz edilmektedir. Bu çalışmanın ana argümanı, ABD’nin sağlık harcamalarının Gayri Safi Yurtiçi Hasıla içindeki oran ve kişi başına düşen harcama miktarı olarak BK’de neredeyse iki kat yüksek olmasına rağmen BK’deki sağlık sisteminin ABD’ye göre, kamu sağlığı çıktıları ve kalite açısından mali olarak daha iyi işlediği üzerine kurulmuştur. Bu çerçevede öne sürülen argümanın incelenmesi için her iki ülkedeki sağlık sistemlerinden yapılan harcamalar, literatür, Dünya Sağlık Örgütü ve bazı öteki değerlendirme sistemleri incelenerek niceliksel ve niteliksel açıdan analiz edilmiş ve bunun ötesinde seçilmiş 8 kamu sağlığı çıktısı çerçevesinde değerlendirilmiştir. Çalışmanın sonucunda BK’de Ulusal Sağlık Hizmeti (NHS) sisteminin ABD sağlık sistemine göre neredeyse iki kat az maliyetle daha kaliteli hizmet verdiği sonucuna ulaşılmış ve bazı politika önerileri yapılmıştır.

References

  • AFL-CIO, (2018). http://dpeaflcio.org/programs-publications/issue-fact-sheets/the-u-s-health-care-system-an-international-perspective/ (retrieved on 05.15.2018).
  • Miller Lee J. and Lu W. (2019, February 24). These Are the World’s Healthiest Nations. Bloomberg, https://www.bloomberg.com/news/articles/2019-02-24/spain-tops-italy-as-world-s-healthiest-nation-while-u-s-slips (retrieved on 09.15.2019).
  • Bloom D. E., Canning D., Pia N. M. (2000). Demographic Change and Economic Growth in Asia. Suppl Popul Dev Rev, 2000;26:257–90.
  • Boyacıoğlu E. Z. (2012). The Importance of Health Expenditures on Sustainable Development. International Journal of Social Sciences and Humanity Studies, Vol 4, No 2, 2012 ISSN: 1309-8063 (Online) http://www.sobiad.org/eJOURNALS/journal_IJSS/arhieves/2012_2/ebru_boyacioglu.pdf
  • Çelikay F., Gümüş E. (2014). Sosyal Harcamaların Yoksulluk Üzerine Etkileri: Ampirik Bir İnceleme. Anadolu Üniversitesi Sosyal Bilimler Dergisi, Issue: 14, Number 4, pp. 127-138.
  • Esping-Andersen, G. (2006). Three Worlds of Welfare Capitalism. In C. Pierson and F.G. Castles (Eds.). The Welfare State Reader, 2nd Edition, pp. 160-174. Cambridge: Polity Press.
  • Fenger, M. (2007). Welfare Regimes in Central and Eastern Europe: Incorporating Post-Communist Countries in a Welfare Regime Typology. Contemporary Issues and Ideas in Social Sciences, August 2007 pp. 1-30.
  • Global Burden of Disease Study (2016). https://www.thelancet.com/gbd?source=post_page--------------------------- (Retireved on 09.15.2019).
  • Grimmeisen S. and Heinz R. (2004). The Changing Role of the State In Europe’s Healthcare Systems. The Second Annual Espanet Conference, University of Oxford.
  • Gökbunar, R., Özdemir H., Uğur A. (2008). Küreselleşme Kıskacındaki Refah Devletinde Sosyal Refah Harcamaları. Doğuş Üniversitesi Dergisi, Number: 9, Issue: 2, pp. 158-173.
  • Gürler Hazman, G. (2011). Türkiye’de Gelir Dağılımında Adalet ve Sosyal Güvenlik Harcamaları Arasındaki Nedensellik İlişkisi. Süleyman Demirel Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, Year: 2011, Issue: 16,Number: 1.
  • Hall, P.A. and D. Soskice (Eds). (2001). Varieties of Capitalism: The Institutional Foundations of Comparative Advantage. Oxford University Press.
  • ILO (2014). Social Protection Global Policy Trends 2010-2015: From Fiscal Consolidation To Expanding Social Protection: Key To Crisis Recovery, Inclusive Development And Social Justices, Geneva.
  • McPake, B. (2018). Crunching Health Expenditure Numbers: Important but Treacherous Terrain. The Lancet, Volume 6, Issue 2, Pe124-E125, https://doi.org/10.1016/S2214-109X(18)30007-X
  • Nghiem S. N. and Connelly L. B. (2017). Convergence and Determinants of Health Expenditures in OECD Countries Health Economics Review. 2017 7:29, DOI 10.1186/s13561-017-0164-4 NHS (2018). https://www.nhs.uk/NHSEngland/thenhs/nhshistory/Pages/NHShistory1948.aspx (Retireved on 09.13.2019).
  • Norton A., Conway T., Foster M. (2001). Social Protection Concepts and Approaches: Implications for Policy and Practise in International Development. Centre for Aid and Public Expenditure. Overseas Development Institute, London.
  • OECD (2012). Poverty Reduction and Pro-Poor Growth: The Role of Empowerment, Paris.
  • OECD (2016). Health at a Glance. Paris, https://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance_19991312 (retrieved on 09.16.2019).
  • OECD Statistics (2018). http://stats.oecd.org/ (retrieved on 04.16.2018).
  • OECD (2018a). https://data.oecd.org/healthres/health-spending.htm (retrieved on 04.15.2018).
  • OECD (2018b). https://data.oecd.org/healthstat/life-expectancy-at-birth.htm (retrieved on 04.15.2018).
  • Piabuo S. M. and Tieguhong J. C. (2017). Health Expenditure and Economic Growth, A Review of the Literature and An Analysis Between The Economic Community for Central African States (CEMAC) and Selected African Countries. Health Economics Review, 7:23, DOI 10.1186/s13561-017-0159-1
  • Schneider E. C., Sarnak D. O., Squires, D., Shah A., and Doty M. (2017), Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. The Commonwealth Fund, https://interactives.commonwealthfund.org/2017/july/mirror-mirror/ (retrieved on 08.30.2019).
  • Özdemir S. (2005). Sosyal Gelişim Düzeyleri Farklı Refah Devletlerinin Sınıflandırılması Üzerine Bir Değerlendirme. Sosyal Siyaset Konferansları Dergisi, Issue 49, Istanbul, pp. 231-266.
  • The Lancet (2018). Measuring Performance on the Healthcare Access and Quality Index for 195 Countries and Territories and Selected Subnational Locations: A Systematic Analysis from the Global Burden of Disease Study 2016. The Lancet, 391:2236–71, http://dx.doi.org/10.1016/S0140-6736(18)30994-2 (retrieved on 08.15.2019).
  • Triggle, N. (2018, May 24). 10 Charts that Show Why The NHS Is in Trouble. The BBC, http://www.bbc.com/news/health-42572110 (retrieved on 04.16.2018)
  • El Gingihy, Y., (2016, July 13). If You Think There Is No Money For NHS Funding You’d Be Right – PFI Has Sucked It Dry. The Independent, https://www.independent.co.uk/voices/nhs-funding-pfi-contracts-hospitals-debts-what-is-it-rbs-a7134881.html retrieved on 04.16.2018)
  • Syal R., (2016, November 22). NHS Financial Problems Endemic and No Longer Sustainable, Say Auditors. The Guardian, https://www.theguardian.com/society/2016/nov/22/nhs-financial-problems-endemic-and-no-longer-sustainable-national-audit-office-deficit retrieved on 04.16.2018).
  • Toprak, D. (2015). Uygulamada Ortaya Çıkan Farklı Refah Devleti Modelleri Üzerine Bir İnceleme. Süleyman Demirel Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, Issue: 21,Year: 2015/1, pp.151-175.
  • United Nations. (2018). http://www.un.org/en/universal-declaration-human-rights/ (retrieved on 04.16.2018)
  • United Nations. (2019). https://www.un.org/sustainabledevelopment/health/ (retrieved on 09.10.2019).
  • Radu, C., (2019, December 19). US News, https://www.usnews.com/news/best-countries/slideshows/countries-with-the-most-well-developed-public-health-care-system?onepage (retrieved on 09.15.2019).
  • WHO. (2000). The World Health Report. Health Systems: Improving Performance, Paris
  • WHO. (2018). Country Profiles, http://www.who.int/countries/en/#U (retrieved on 05.19.2018).
  • WHO. (2019). https://www.who.int/topics/millennium_development_goals/about/en/ (retrieved on 10.09.2019)
  • Xu, K., Saksenaa P. and Holly A. (2011). The Determinants of Health Expenditure: A Country-Level Panel Data Analysis. WHO Working Paper, https://www.who.int/health_financing/documents/report_en_11_deter-he.pdf (retrieved on 09.12.2019).
  • Zuckerman S. and McFeeters J. (2006). Recent Growth in Health Expenditures, The Commonwealth Fund, https://pdfs.semanticscholar.org/08ab/7a7d5f3a6c9fef9b9389ababd9628e6f42d4.pdf (retrieved on 09.13.2019)
  • Thornton, A. (2019, February 25 ).World Economic Forum, https://www.weforum.org/agenda/2019/02/these-are-the-world-s-healthiest-nations/ (retrieved on 09.15.2019)
There are 38 citations in total.

Details

Primary Language English
Subjects Health Policy
Journal Section Makaleler
Authors

Eyüp Serdar Erdoğan This is me 0000-0003-3024-5335

Publication Date January 21, 2020
Published in Issue Year 2019

Cite

APA Erdoğan, E. S. (2020). ANALYZING OF HEALTHCARE EXPENDITURES IN THE UNITED KINGDOM AND THE UNITED STATES OF AMERICA. Sosyal Güvence(16), 89-116. https://doi.org/10.21441/sosyalguvence.677357