Differing Global Health Services

By Dr Emma Brierley

Dr Emma Brierley examines the NHS compared to other global health services.

Health Tourism

Health systems vary greatly around the world and below we compare different countries and how the health systems work here.


The NHS was established in 1948 to ensure that everyone had access to free healthcare. It was based on three core principles:

  • that it meet the needs of everyone
  • that it be free at the point of delivery
  • that it be based on clinical need, not ability to pay

It is one of the most respected health systems in the world and is funded by tax payers and national insurance contributions.

Anyone presenting at Accident and Emergency will get emergency healthcare with no consideration of cost.

However, there are problems with the NHS. As the budget is not unlimited unfortunately not all treatments can be funded. Some of which include certain drugs such as chemotherapy drugs, cosmetic procedures and treatments such as IVF. As the population grows larger and there are more medical developments the NHS will face further difficulties on what it can fund unless more funding is given.

USA – Private Insurance

In the USA, everyone should have health insurance. In 1965, Medicare and Medicaid, public health insurance were introduced, aimed at people who have previously struggled to get insurance due to a variety of reasons, such as age or previous disabilities. It is low cost insurance.

The Patient Protection and Affordable Care Act was introduced by President Obama in 2010. It was introduced to try to enable more people to have greater access to health insurance by working with individuals, employers and the health care system.

The States has both private hospital and public hospitals. In private hospitals, payment is needed in advance of treatment or insurance details need to be given. This is different to public hospitals, which still require payment, but will see people without advance payment or insurance details. The problems with public hospitals are massive waiting lists and a very crowded environment.

If you do not have insurance, then hospitals will treat you for the emergency if its life threatening and then bill you. If you are unable to pay, they may sue you to get money back from the government. Some hospitals do write off the treatment as a charity donation, whilst others will set up payment plans. If you are taken to a private hospital and have emergency treatment, then the follow up will be in a public hospital if you are unable to pay.