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Health care spending in the UK

Friday, January 31, 2020

Vox interviewed Thomas Rice, distinguished professor of health policy and management at the UCLA Fielding School of Public Health, for a story about the economics of the U.K.’s National Health Service. 


In 2016, the Commonwealth Fund, our partners on this projectsurveyed 11 high-income countries about cost-related barriers to care. Americans were the most likely to skip needed care because of costs, with 33 percent having done so over the past year. Residents of the United Kingdom were among the least likely, with only 7 percent saying the same. The same was true, notably, of dental care; 32 percent of Americans said they skipped needed dental services due to cost, while only 11 percent of Britons did the same.

Yet in 2016, health care spending in the US equaled more than 17 percent of the country’s GDP, while the share of health spending in Britain was only 9.7 percent. Nor do health outcomes seem to be suffering. Life expectancy in Britain is higher than in the US, and on measures of “mortality amenable to health care” — which specifically track deaths that could have been prevented by medical intervention — the US performs worse than the UK.

So here, then, is the comparison: The UK spends barely half what we do, covers everyone, rarely lets cost prove a barrier for people seeking care, and boasts health outcomes better than ours.

Which raises the question: How does the UK do it?