A comparative evaluation of the structure of primary care in the United States and the United Kingdom

Abstract

<p>The condition of the United States (US) health care system is currently at the center of national debate; and attempts to reform a flagging system are underway (Rutenberg &amp; Calmes, 2009; Stolberg &amp; Herszenhorn, 2010). The American health care system is in distress. An estimated 43.8 to 46.3 million individuals in the US are uninsured (Centers for Disease Control and Prevention [CDC], 2009; DeNavas-Walt, Proctor, &amp; Smith, 2008; U.S. Census Bureau, 2008). The majority of health coverage in the US is provided through employer-based insurance (Blumenthal, 2006; Congressional Budget Office [CBO,] 2007); but with the current economic crisis and a resulting rise in unemployment rates, concerns over existing health care coverage are escalating (Blumenthal, 2006; Brown, 2008; Sessions &amp; Detsky, 2009). The cost of health care in the US is nearly twice as much as other developed countries, and costs continue to rise faster than personal incomes and the economy (CBO, 2007; Commonwealth Fund, 2008; Marmot &amp; Bell, 2009). Health care spending currently exceeds $2 trillion dollars a year or 16.2 percent of the Gross Domestic Product (GDP) (Centers for Medicaid and Medicare Services [CMS], 2007). Furthermore, the US remains the only industrialized country in the world that fails to provide universal health care for its residents (Davis et al., 2007; McIntosh, 2002).</p>