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Britain

The population of Britain is 59,511,000, bigger than any single state but smaller than the population of the American Midwest, which the latest census counts as over 64,000,000. The infant mortality rate in the United Kingdom is 5.63 per 1,000 live births, and life expectancy at birth is 74.97 years for men and 80.49 years for women. This is a little better than the US on all counts.

6.8% of Britain's per capita GDP of $21,800 goes towards health expenditures. Doing the math, this is $1482 per person per year, only 34% of what the US spends. (According to their plans, they will spend more in the near future.) Yet, the results are comparable.

Britain has had a National Health Service (NHS) since 1948. The British government is a purchaser and provider of health care and retains responsibility for legislation and general policy matters. The government decides on an annual budget for the NHS, which is administered by the NHS executive, regional, and district health authorities. The NHS is funded by general taxation and national insurance contributions and accounts for 88% of health expenditures. Complementary private insurance, which involves both for-profit and not-for-profit insurers, covers 12% of the population and accounts for 4% of health expenditures.

Physicians are paid directly by the government via salary, capitation, and fee-for-service. GP's act as gatekeepers. Private providers set their own fee-for-service rates but are not generally reimbursed by the public system. Specialists may supplement their salary by treating private patients. Hospitals are mainly semi-autonomous, self-governing public trusts that contract with groups of purchasers on a long-term basis.

The British government has announced a huge funding increase for the NHS. Specifically, it will receive 6.2% more in funding every year until 2004. Current plans to improve the system over the next five years include hiring 7,500 more specialists, 2,000 GP's and 20,000 nurses; providing 7,000 more acute beds in existing hospitals and building 100 new hospitals by 2010; demanding that GPs see a patient within 48 hours of an appointment; and finally, guaranteeing that patients wait no more than three months for their first outpatient appointment with a specialist and no more than six months after that appointment for an operation.


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