The that [is] not owned or controlled by the

The private sector is defined by Collins English Dictionary
as being “the part of a country’s economy… that is not owned or controlled by
the government”.1 In the United Kingdom, over the past few years,
there have been talks of privatising the National Health Service – a public
healthcare service that was set up in 1948. Similarly, in the United States
following the election of Donald Trump as president, there have been talks of
repealing and replacing the Affordable Care Act (more commonly known as
Obamacare) – an act that was introduced in March 2010 with the main goal of
making affordable health insurance accessible to more people.2 With
these topics recently circulating, it has led to the question: to what extent
is a private healthcare system more beneficial than a public healthcare system?
In order to come to an overall judgment for this question, this essay will look
at the impacts of the healthcare system on life expectancy, to the patient, to
the workers, and to the economy. This essay will do this by comparing the
healthcare systems of three different countries – Japan, the United Kingdom,
and the United States of America.

Before assessing each type of healthcare system, it is
important to first establish what type of healthcare system each of the
aforementioned countries have.
In Japan everyone is required to take out public health insurance (this is
known as compulsory insurance coverage). There are various difference premiums
depending on the type of scheme the resident is on. For example, employees will
typically be on a work scheme, and are required to pay 20% of their total
medical costs at the point of delivery. There is also a national health insurance
scheme that bases premiums of a variety of factors such as salary, value or
property, and number of dependants. On this scheme, members have to pay 30% of
their medical costs at the point of delivery, and the government pays the rest.
People over 70 only have to pay 10% of their costs. Medical fees that are above
a certain amount are paid in full by the government, and those who receive
government support that are uninsured and on low incomes have their fees
In the United States, however, there are upfront payments when it comes
to healthcare. This means that almost every visit to the doctor results in
‘co-pays’ for the patient and an income for the physician. Though the majority
of Americans are covered by a private insurance scheme, there are various
public healthcare programmes that mean that the government pays for many visits
to the doctor and medicine. These public healthcare programmes include
Medicare, Medicaid, and Chip.3 As well as these public healthcare
programmes, the Affordable Care Act (ACA) also helps to pay towards the medical
care if citizens. It does this by giving consumers subsidies that lower the
cost of healthcare for households between 100% and 400% of the federal poverty
level.2 Since the implementation of ACA, the percentage of people
who had no medical coverage fell to 10%.
In the United Kingdom, like Japan, there are no upfront payments when it comes
to healthcare. However, unlike Japan that operates on a compulsory
insurance coverage system, the UK operates on an automatic coverage system.
When the National Health Service (NHS) was set up in 1948, it had the aim of
being a service that was free at the point of use. However, in the early 1950s
patient charges were introduced to help fund the service – these charges were
for prescriptions, dental treatments, and spectacles. Still, the NHS receives most
of its funding from general taxation and contributions from National Insurance
(with 98.8% of its funding sourced from this and approximately 80% being
sourced from general taxation alone).4

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