Health Legislation Reviw

The US and the UK Healthcare Systems: A Comparative Article Review

Liberty University

The US and the UK Healthcare Systems: A Comparative Article Review

Jacque Clinton (2013) in her article “US healthcare and the Affordable Care Act: why the US does not have a UK-style National Health Service” did a comparative study of the healthcare systems of the United States and the United Kingdom. The article looked into history and analyzed how it affected the evolution of the healthcare systems of the two countries. From this analysis, Clinton reviewed the 2010 Affordable Care Act (ACA) of the Obama administration.

Two theoretical frameworks were used in the study. The first was path dependency which explained past events through “switch points,” or moments that may have contributed to deviation, and “critical junctures,” or moments that led to development and reinforcement (Pierson, 2000 as cited in Clinton, 2013). The second theory was historical institutionalism wherein institutions are highlighted to explain the actions of political actors and the interactions among these institutions (Thelen, 1999 as cited in Clinton, 2013).

Clinton started with an overview of the healthcare system history of the UK. The unitary parliamentary system of the UK government, the absence of the complex checks-and-balance US system partnered with the quick advancement of the majority party’s agenda were crucial factors that made the government play an active role in the healthcare field. The initial “piece-meal” (Carrier & Kendall, 1998 as cited in Clinton, 2013) nature of the National Insurance Act of 1911 was then replaced by a universal healthcare system after World War II. Despite opposition (arguments ranging from compromising the relationship among state, insurers, and medical associations to the lack of budget brought by the War), and the almost perpetual financial crises of the system in its early years, the system proved to be popular as it expanded its coverage to the...