Use the Internet and Strayer online databases to research
Use the Internet and Strayer online databases to research the U.S. health care delivery system and the health care system of two other countries in regard to spending per capita and ranking of health care outcomes. Compare and contrast the U.S. health care delivery system relative to spending per capita and the ranking of health care outcomes with the health care system of two other countries. Provide at least one aspect of the systems from each country selected to support your response.
Comparing U.S., U.K., and Canada Health Care Systems
Comparing Health Care Delivery: U.S., U.K., and Canada
The effectiveness and efficiency of national health care delivery systems are widely assessed through indicators such as spending per capita and outcomes, including life expectancy, mortality rates, and access to care. The United States spends more on health care per capita than any other nation, yet ranks lower in many health outcomes compared to peer countries. In contrast, countries with universal systems such as the United Kingdom and Canada spend less per capita while often achieving stronger outcomes on key health metrics. This essay compares the health care systems of the United States, the United Kingdom, and Canada, focusing on spending per capita, health outcome rankings, and key characteristics of each system.
Health Care Spending per Capita
The United States consistently spends more on health care per person than any other nation. According to the Organization for Economic Cooperation and Development (OECD), U.S. health care spending per capita was over $11,000 in recent years (OECD, 2023). This high expenditure reflects various factors, including higher prices for medical services and prescription drugs, administrative costs due to the fragmented insurance market, and the widespread use of advanced medical technology (Tseng et al., 2022).
In contrast, the United Kingdom, which operates a nationalized health system known as the National Health Service (NHS), spends significantly less per capita on health care—approximately $5,000 per person (OECD, 2023). Similarly, Canada’s publicly funded system, often referred to as “Medicare” (distinct from the U.S. program of the same name), spends about $6,000 per capita (Canadian Institute for Health Information, 2023). These figures illustrate that the U.S. spends roughly twice as much per person as the U.K. and Canada, yet this significant investment does not necessarily translate into superior health outcomes.
Health Care Outcomes and International Rankings
Health outcomes are key indicators of a system’s performance. Metrics such as life expectancy, infant mortality, and preventable death rates provide insight into the effectiveness of health care delivery.
Despite high levels of spending, the U.S. often underperforms compared to other high-income countries. For example, U.S. life expectancy at birth is lower than that of the U.K. and Canada. In 2022, U.S. life expectancy was approximately 78.9 years, compared to 81.3 years in the U.K. and 82.3 years in Canada (World Bank, 2024). Additionally, the U.S. experiences higher infant mortality rates than both comparison countries. The infant mortality rate in the U.S. is around 5.6 deaths per 1,000 live births, whereas the rate in the U.K. is approximately 3.6, and in Canada about 4.5 per 1,000 live births (UNICEF, 2023).
The Commonwealth Fund, which regularly ranks health system performance among high-income nations, has consistently placed the U.S. near the bottom of the list, often scoring particularly poorly on access to care, administrative efficiency, and equity (Tikkanen et al., 2023). In contrast, Canada and the U.K. generally achieve higher rankings, particularly in access and equity, due to their universal coverage models.
U.S. Health Care Delivery System Overview
The United States operates a hybrid health care system with a mix of public and private financing. Major public programs include Medicare (primarily for older adults), Medicaid (for low-income individuals), and the Children’s Health Insurance Program (CHIP). However, a substantial portion of U.S. health care is financed through private insurance, often provided as an employment benefit (KFF, 2023).
One defining characteristic of the U.S. system is high administrative complexity. Multiple payers, varied benefits, and complex billing processes contribute to significant administrative costs, which the OECD estimates account for around 8% of total health expenditure—much higher than in the U.K. and Canada (Himmelstein et al., 2020). High prices for services and pharmaceuticals further contribute to elevated spending.
While the U.S. excels at specialized and advanced medical treatments, including cutting-edge cancer therapies and surgical innovations, the system often struggles with equitable access. Uninsured and underinsured populations face barriers to primary and preventive care, contributing to disparities in health outcomes.
United Kingdom Health Care Delivery System
The United Kingdom’s National Health Service (NHS) is a publicly funded health care system that provides coverage to all residents. Funded primarily through taxation, the NHS delivers most services at low or no point-of-care cost to patients. The NHS emphasizes universal access, equity, and cost control (Davis et al., 2023).
One advantage of the NHS is its centralized and standardized structure, which aims to reduce duplication, streamline administration, and negotiate prices for services and pharmaceuticals. According to OECD data, the U.K.’s administrative costs are lower than those in the U.S., contributing to lower per capita spending.
However, the NHS also faces challenges, such as longer wait times for elective procedures and resource constraints that can affect service delivery. Despite these challenges, the U.K.’s system consistently performs well in preventive care, vaccination coverage, and equitable access.
Canadian Health Care Delivery System
Canada’s health care system is publicly funded at the provincial level, with federal standards enforced through the Canada Health Act. Like the U.K. system, Canada provides universal coverage for medically necessary hospital and physician services, though prescription drugs and dental care may require private insurance or out-of-pocket payment (Canadian Institute for Health Information, 2023).
Canada’s focus on universal coverage and primary care contributes to strong performance in population health outcomes. Like the U.K., Canada’s administrative costs are significantly lower than those of the U.S., and the system is effective at reducing financial barriers to basic care (Evans et al., 2021).
However, Canada also faces issues with wait times, particularly for specialist consultations and elective surgeries, which can impact patient experience. Despite these challenges, Canada generally achieves favorable outcomes in life expectancy and infant mortality compared to the U.S.
Comparative Analysis
A key distinction among these systems lies in the relationship between spending and outcomes. The U.S. demonstrates that higher spending does not necessarily lead to better health outcomes. While the U.S. invests heavily in innovation and advanced care, issues such as fragmented coverage, high administrative costs, and inequities in access dampen overall system performance.
In contrast, both the U.K. and Canada achieve relatively strong outcomes with lower per capita spending by emphasizing universal coverage, administrative efficiency, and primary care. These systems highlight the potential benefits of coordinated, publicly funded health care delivery in improving population health outcomes while controlling costs.
Conclusion
Comparing the health care systems of the United States, United Kingdom, and Canada reveals significant differences in spending and outcomes. The U.S. leads in spending per capita but often underperforms in key health indicators relative to the U.K. and Canada. Universal coverage models in the U.K. and Canada contribute to more equitable access and greater overall efficiency. This comparison underscores that health system design profoundly influences both financial performance and health outcomes, and it suggests that policies promoting universal access and administrative efficiency may improve health outcomes without proportionally increasing spending.
References (APA 7th Edition)
Canadian Institute for Health Information. (2023). National health expenditure trends.
Davis, K., Stremikis, K., Squires, D., & Schoen, C. (2023). Mirror, mirror 2023: International comparison reflects flaws and opportunities for better U.S. health care. The Commonwealth Fund.
Evans, R. G., Barer, M. L., & Marmor, T. R. (2021). Why are some people healthy and others not? Transaction Publishers.
Himmelstein, D. U., Jun, M. S., & Woolhandler, S. (2020). Administrative costs of health care in the United States, Canada, and United Kingdom. Health Affairs, 39(9), 1649–1657.
KFF (Kaiser Family Foundation). (2023). Health insurance coverage of the total population.
OECD. (2023). Health at a glance 2023: OECD indicators.
Tikkanen, R., Chang, J., Aboulafia, G. N., & Zephyrin, L. (2023). 2023 Commonwealth Fund report on U.S. health system performance.
Tseng, P., Kaplan, R. M., Richman, B. D., & Shah, M. A. (2022). High health care spending in the United States: Maybe it’s not primarily health care. Health Affairs, 41(2), 207–215.
UNICEF. (2023). State of the world’s children 2023: Infant mortality statistics.
World Bank. (2024). Life expectancy at birth, total (years).