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UK: Health System Financing and Expenditures

UK: Health System Financing and Expenditures

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Current Health Expenditure Per Capita (USD) (2016): $3,958
Current Health Expenditure as Percentage of Gross Domestic Product (%) (2016): 9.8%
Domestic General Government Health Expenditure as Percentage of General Government Expenditure (%) (2016): 18.9%
Population with household expenditures on health greater than 10% of total household expenditure or income (2009-2015) (%): 1.6%
Population with household expenditures on health greater than 25% of total household expenditure or income (2009-2015) (%): 0.5%

Source: World health statistics 2019: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO.
https://apps.who.int/iris/bitstream/handle/10665/324835/9789241565707-eng.pdf
https://www.who.int/gho/publications/world_health_statistics/2019/en/


Annual household out-of-pocket payment, constant (2016) PPP, per capita (USD) (2016): $632

Source: Global Health Expenditure Database. Health expenditure series. Geneva: World Health Organization. Last accessed Nov. 15, 2019.
http://apps.who.int/nha/database/


Out-of-Pocket Spending as Share of Final Household Consumption (%) (2017): 2.4%

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.
https://www.oecd.org/health/health-systems/health-at-a-glance-19991312.htm


“Health services are mainly funded through general taxation, with the remainder coming from private medical insurance and out-of-pocket payments. In the early 2000s the United Kingdom government committed to increasing health care spending as a share of GDP to a level that corresponded with the average of the EU members at that time. Health expenditure as a share of GDP grew from 6.9% in 2000 to 9.4% in 2010, which was similar to the EU average, but below the average for the EU-15 countries. The implementation of austerity measures in 2010 following the financial crisis of 2007–2008 has meant a cut in total health expenditure in real terms in 2010 and 2011; in 2013 health spending accounted for 9.1% of GDP.

“Once administrations in Scotland, Wales and Northern Ireland and the Department of Health have their health care allocation, they distribute to their commissioners (in England and Northern Ireland) or providers (in Scotland and Wales), and to public health organizations, according to their own formulas, which all include some form of weighted capitation.

“Most services are provided free of charge at the point of use, but there are some that can involve cost-sharing (like dental care and pharmaceuticals) or direct payments (like most social care). Only England has prescription drug charges.”

Source: Cylus J, Richardson E, Findley L, Longley M, O’Neill C, Steel D. United Kingdom: Health system review. Health Systems in Transition, 2015; 17(5): 1–125.
http://www.euro.who.int/en/about-us/partners/observatory/publications/health-system-reviews-hits
http://www.euro.who.int/en/about-us/partners/observatory/publications/health-system-reviews-hits/full-list-of-country-hits/united-kingdom-hit-2015


“Historically, the U.K. has not systematically excluded benefits (it rather provides services “to such extent as [considered] necessary to meet all reasonable requirements” [14]. This means that the relatively high growth in OOP [Out-Of-Pocket spending] (2nd after the Netherlands) in 2004–2014 must be mostly ascribed to increased cost sharing requirements. Still, per capita OOP spending has been very low by international standards, with only those in France spending less. Inpatient and outpatient services are received free at point of service in most cases, but there are co-payments for prescription drugs that have been growing and amounted to £8.40 per prescription in 2016. These co-payments were capped at £104 annually in 2009 and remain the same today. Furthermore, although the co-payment maximum was lowered in 2006 (from £384 to £189), there have been regular increases since then. Similarly, there are co-payments for dental services (the amount of which varies by service). Both drug and dental co-payments have risen by 2% per year since 2005. Children and students, those age 60 and above, people with specific medical conditions and those on low-income schemes are exempted from co-payments for drugs and dental services, and are covered for vision services (which is normally not covered). Unsurprisingly, the market for VHI [Voluntary Health Insurance] is rather small. Individuals buy VHI to avoid waiting lists, have some choice over the physician they visit, and for more comfortable rooms [15].”

Source: Rice, Thomas et al. “Revisiting out-of-pocket requirements: trends in spending, financial access barriers, and policy in ten high-income countries.” BMC health services research vol. 18,1 371. 18 May. 2018, doi:10.1186/s12913-018-3185-8
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960112/


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Page last updated June 2, 2020 by Doug McVay, Senior Policy Analyst.

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