U.S. could learn from U.K's commitment to universal care

Opinion piece in NEJM encourages envy to reform healthcare
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The United States should consider universal health coverage as a strategic advantage to improve patient care and turn to the United Kingdom for inspiration, according to an opinion piece published this week in The New England Journal of Medicine.

Authors Nick Seddon and Thomas H. Lee, M.D., believe solutions to the country's healthcare challenges may be solved by using "envy" and turning to the positive aspects of the United Kingdom's healthcare system. "Virtually every major study shows that systems that cover all citizens achieve better outcomes at lower cost," they wrote.

For example, U.S. stroke teams concentrate on providing quality care to patients who have had strokes. The stroke teams in England, Northern Ireland, Scotland and Wales do the same but also think about how to reduce strokes in a given population.

In turn, they said, the U.K. should look to America for inspiration to create choices and the competition that drives healthcare organizations to respond to patients' needs and wants.

"The best U.S. providers gain a large market share because they earn patient loyalty through great outcomes and service," the authors said. "We see no reason why universal access should conflict with choice and competition. More choice and competition would not undermine the commitment to coverage in the NHS [English National Health Service], but it might improve access and quality."

Each country has strengths and weaknesses but translating the best of each system doesn't mean inheriting the worst, the authors said. A blending of the two systems, they said, could cover everyone, offer choice and competition, blend bottom-up creativity with top-down strategy, and integrate services so patients get the right care in the right places.

"In the future, English and U.S. health care organizations could compete for patients on the basis of the integration of delivered care," they wrote.

To learn more:
- Read the opinion piece
- See the study on universal coverage (.pdf)

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