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

Yıl 2019, Sayı: 16, 89 - 116, 21.01.2020

Eyüp Serdar Erdoğan

https://doi.org/10.21441/sosyalguvence.677357

Öz

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.

Anahtar Kelimeler

Welfare state, health, health policy, health expenditures, The United Kingdom, The United States

BİRLEŞİK KRALLIK VE AMERİKA BİRLEŞİK DEVLETLERİNDE SAĞLIK HARCAMALARININ ANALİZİ

Öz

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.

Anahtar Kelimeler

Refah devleti, sağlık, sağlık politikası, sağlık harcamaları, Birleşik Krallık, Amerika Birleşik Devletleri

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