UK and US should learn from each other on health care, Lancet paper says

The healthcare systems of the USA and the UK are often thought of as polar opposites, yet the two countries may have much to learn from each other as they both embark upon significant health reforms, according to the authors of a Health Policy paper, published in the Lancet.

Dr Jennifer Dixon, Director of the Nuffield Trust in the UK, and Professor David Blumenthal of Harvard University in the USA, point out that there are three key areas – financing, organisation, and information technology – where those responsible for driving reforms might be able to gain valuable lessons.

According to Dr Dixon, "Comparing health reforms in the USA and England seems to be an unlikely project: many people in both countries view the other as having a pariah health system that is not to be copied in any circumstance. But both countries are under pressure to get more value out of and reduce growth in expenditure to sustainable levels, and are consequently experimenting with new ways to encourage clinicians, patients, and institutions to help achieve this."*

The authors go on to analyse the key features of health care systems in the two countries, highlighting specific areas where country-specific expertise could prove relevant. For instance, they point out that the transparency and analytical rigour required to assess growth in spending in the USA could prove helpful in England, where a shortfall of £20 billion is predicted by 2015, although the calculations behind this prediction remain largely "opaque and unchallenged". Conversely, lessons learned from the UK's rollout of universal electronic health care records could prove helpful in the USA, which has struggled to create a system linking hospital inpatient and records electronically.

Professor Blumenthal adds that "The English and US health-care systems face the same imperative: to enable well-intentioned, well-trained professionals and health-care institutions to deliver, and their customers to consume, evidence-based services efficiently and effectively in the face of daunting resource constraints. Policy makers and health-care managers in both should miss no opportunity to make progress by learning from one another, and from other international examples."

The paper was written in response to the 2011 Commonwealth Fund – Nuffield Trust (US – UK) annual meeting.

More information: www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60956-8/abstract

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