Healthcare Systems in Crisis: A Comparative Study of the U.S. and U.K. Response to the Overdose Epidemic

Abstract

Purpose: This thesis analyzes the overdose epidemic in the U.S. and the U.K. In this comparative analysis, the paper explores the type of problem each country faces and how each healthcare system has responded to the crisis. In doing so, and discussing the similarities, differences, merits, and pitfalls, the paper critiques both the private and public healthcare system as they attempt to respond to the overdose epidemic. Methods: To gather the necessary information, this paper utilizes a qualitative approach, supplementing and bolstering its findings with existent quantitative data and studies. The qualitative data consists of six in-person, semi-structured interviews with a variety of public health officials, medical personnel, addiction specialists, and non-profit representatives both in the United States and in the United Kingdom. Additionally, field research was carried out in both countries that included visiting sites, collecting handouts, and making observations on the quality and accessibility of services. Results: The results of this study found that first, while private healthcare systems thrive in their ability to incentivize innovative care and provide quality care to parts of the population, this system is neither equitable nor efficient in providing adequate access to the population at large. Second, a public healthcare system, like the U.K.’s, does a better job of providing equitable access to its population, but falls short in its ability to incentivize new, innovative solutions to public health problems. The structure of this system is also potentially more susceptible to changes in government and administration that have ramifications in terms of policy priorities and funding. Third, while both systems provide important dimensions of care, neither has completely mastered the ability to provide full, comprehensive utilization of services to its population. This last finding suggests that there are still barriers in the social determinants of health that public and private healthcare systems need to address in order to successfully respond to public health crises. Implications: This thesis concludes with three policy recommendations: I. Increasing access to care is not a blanket solution. II. Policies and their makers must be aware of the potential for political/administration changeover. III. Country-specific history shapes country-specific policies, but nations must be willing to learn from the experiences of others and implement changes based on global discussion and information sharing.