The healthcare systems in the United States and the United Kingdom represent fundamentally different approaches to healthcare financing and delivery. A key difference lies in the model of healthcare funding. The United Kingdom operates under a publicly funded system known as the National Health Service (NHS), which provides care that is free at the point of service and is funded primarily through taxation. In contrast, the United States employs a multi-payer system where healthcare is predominantly financed through private insurance, employer-sponsored coverage, and out-of-pocket payments (Tikkanen et al., 2020). This often results in significant disparities in access to care in the U.S., especially for uninsured or underinsured populations.

Another critical difference is the cost of healthcare. The United States spends significantly more on healthcare per capita compared to the UK, yet often yields poorer health outcomes such as higher infant mortality rates and lower life expectancy (Schneider et al., 2021). The administrative costs in the U.S. are notably higher due to the complexities of dealing with multiple insurance providers, which contrasts with the more streamlined administrative process in the NHS.

Advanced Practice Nurses (APNs) can play a pivotal role in advocating for health system improvements in the U.S. Through policy advocacy and involvement in political processes, APNs can support initiatives that promote universal coverage, cost control, and health equity. For instance, APNs can advocate for expanded roles in primary care, greater reimbursement parity, and telehealth legislation that broadens access to underserved areas (Brokaw et al., 2022). Engagement with professional organizations and legislative bodies can amplify the nursing voice in shaping health policy reform toward more sustainable and equitable care models.

References

Brokaw, J. J., Mahoney, S. T., Vassar, M., & Tackett, S. (2022). The role of advanced practice providers in U.S. healthcare reform: Policy implications and future directions. The Journal for Nurse Practitioners, 18(3), 215-220. https://doi.org/10.1016/j.nurpra.2021.11.007

Schneider, E. C., Shah, A., Doty, M. M., Tikkanen, R., Fields, K., & Williams, R. D. (2021). Mirror, mirror 2021: Reflecting poorly—Health care in the U.S. compared to other high-income countries. The Commonwealth Fund. https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly

Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton, G. A. (2020). International health care system profiles: United Kingdom. The Commonwealth Fund. https://www.commonwealthfund.org/international-health-policy-center/countries/united-kingdom