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Doctors of Nursing Practice and Universal Health Care

Universal health care is a broadly debated topic, particularly in the United States. With the nation’s high costs of treatments despite the massive government expenditures, the prospect of care that is accessible to all inhabitants of the country, regardless of their social and economic status, sounds highly appealing. Moreover, examples of developed nations that have developed successful universal healthcare systems exist and are often used as models for a proposed U.S. reform. Doctors of Nursing Practice should understand the advantages and disadvantages of universal health care when applied in practice to advocate for the change or against it. To that end, this paper will analyze the system and evaluate the health outcomes of the United Kingdom compared with the U.S. to reach a conclusion.

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The U.K. uses a single-payer approach where healthcare is administered via a government agency called the National Health Service. It provides a variety of healthcare services to residents of the nation without charging them, as it is funded from taxation instead. Daire et al. (2019) provide the Commonwealth Fund’s statistics of developed countries, in which the United Kingdom ranks highly in all aspects except for patient outcomes, where it is second last above the United States. As they are arguably the essential aspect of a healthcare system, this discrepancy warrants additional investigation. There are likely some flaws in the U.K. system that hinder its performance and should be considered for the U.S.’s case.

As the government manages healthcare in the United Kingdom, it has an extensive and centralized administration workforce. Welch (2018) highlights confusion among both patients and workers due to the large number of services involved, long waiting times, and inefficiency. Like many long-lived public organizations, the NHS has developed a significant bureaucratic burden due to numerous reorganizations, which makes operations slow and raises costs. Moreover, according to the Organisation for Economic Co-operation and Development (2017), the numbers of doctors and nurses in the nation are inadequate, which creates long waiting times and unmet needs regardless of socioeconomic status. Rather than eliminate the lack of access, the NHS distributes it evenly.

Overall, the U.K. does not appear to perform meaningfully better than the U.S. in terms of the outcomes of its healthcare. As such, the author cannot recommend its adoption in the United States, as they do not see an opportunity for meaningful improvement. The U.S. is a much larger nation than the U.K., and the administrative burdens are likely to increase proportionally. Moreover, it has the same nurse and doctor shortage issues, which can lead to a lack of capacity. As such, the author will look for another option, as they consider health care reform essential. Improvements are necessary, and if universal health care is unlikely to provide them, another option has to be found.

Regardless of the shape that the U.S. healthcare system ultimately takes, the author’s primary task as a nursing leader remains the same. It is to ensure that the patients receive the highest possible standard of care, which can be guaranteed through a patient-centric care model. To that end, the author will advocate for improved access to care, whether through reduced costs, enhanced access to insurance, or other measures. However, they will also consider the implications and potential issues of such policies to avoid unintended consequences. Short-term gains do not justify the emergence of long-term systemic problems that arise from fundamental flaws in the method.


Daire, J., Yates, C., & Robinson, S. (2019). International health care systems. In E. Willis, L. Reynolds, & T. Rudge (Eds.), Understanding the Australian health care system (4th ed.) (pp. 53-70). Elsevier Health Sciences.

Organization for Economic Co-operation and Development. (2017). State of health in the EU United Kingdom: Country health profile 2017. (2017). OECD Publishing.

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Welch, E. (2018). The NHS at 70: A living history. Pen & Sword Books.

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