The health care system in the US and Great Britain: what barriers await immigrants?
The growing level of migration in the world causes numerous difficulties for expats. Even in countries with a large immigrant population, such as the United States and the United Kingdom, there are certain obstacles. Read more about the barriers that immigrants face in the process of receiving medical care in the United States and the United Kingdom in our article
The level of migration in the world is constantly increasing, but despite this, expats continue to encounter difficulties in receiving medical care abroad. Given that the United States and Great Britain are the world leaders in terms of the number of immigrants, we decided to investigate and compare the obstacles that migrants may face when receiving medical care in these countries.
Barriers to receiving medical care by immigrants in the USA
As of 2022, there were 44.7 million immigrants living in the United States, and experts estimate that by 2050, one in five Americans will be foreign-born.
Medical services in the United States are quite expensive, so having a health insurance policy is very critical. At the same time, the United States of America does not have a universal health insurance program. The country has a widely developed system of private health insurance and public insurance (for example, Medicare, Medicaid). However, each of the policies has certain features that create obstacles for foreigners to receive medical care.
Barrier 1 – lack of right to health insurance
Immigrants who can afford private insurance are free to do so in the US regardless of their immigration status. However, low-income expats' eligibility for public coverage depends on immigration status, the expat's age, and state of residence.
According to experts, 32% of expats who have lived in the US for less than 6 years and 41% of those who have lived in the country for more than this period have a health insurance policy financed by their employer.
At the same time, from 58 to 65% of migrants do not have health insurance in the US at all.
Until 1996, low-income legal immigrants were eligible for Medicaid coverage on the same basis as other low-income US citizens. However, after the law was amended, legal migrants lost their eligibility for Medicaid during their first five years of residence in the US, except for children and pregnant women. Such a policy made it significantly more difficult for poor foreigners to access medical care.
At the same time, many states have expanded assistance programs for expats who are registered on their territory. For example, California and New York provide Medicaid-like services to all qualified immigrants. Arkansas and Michigan do not offer public health insurance to immigrants, but they do provide prenatal care to pregnant women. However, Arizona, Colorado and Georgia have passed legislation that makes it even more difficult for immigrants to get insurance coverage.
To increase insurance coverage among immigrants, the US government provides expats with loans to purchase health insurance plans through state health insurance exchanges.
Barrier 2 – limited access to medical care
Theoretically, expats can receive medical care in the USA even if they do not have a health insurance policy. However, many studies indicate that health insurance is "a major determinant of access to health care for immigrants." Especially considering the high cost of healthcare services in the country. Due to the fact that most foreigners in the US do not have a policy, they cannot go to a medical facility for help.
Also, even if an immigrant managed to obtain a social insurance policy, many doctors do not accept such patients because of the low fee per visit.
Barriers to receiving medical care by immigrants in Great Britain
The UK health care system, known as the National Health Service or NHS for short, is funded by taxpayers and provides free care to all patients, regardless of income level. The private insurance sector is also highly developed in Great Britain. However, despite this, foreigners face certain barriers in the country when receiving medical care, in particular:
- administrative and legal barriers - 29%;
- lack of knowledge or understanding of the health care system and one's rights - 17%;
- language barrier – 14%;
- fear of being arrested – 11%.
It is important to note that anyone in the UK can register and see a GP for free. There are also no requirements for a minimum period of residence in the United Kingdom before visiting the clinic. Doctors must register everyone who lives in their territory without asking for proof of identity or residence. Urgent care and urgent care centers are also free and accessible to everyone in the UK.
In general, unlike the US health care system, where most migrants do not even have access to health insurance, expats in the UK report the following barriers:
- difficulties with making an appointment with your general practitioner on time;
- limited access to dental care;
- lack of understanding of one's rights to medical assistance in Britain;
- personal fears and obstacles.
Also, access to over-the-counter medications was often mentioned as a barrier, as prescription medications are covered by insurance while over-the-counter medications are not. This becomes a significant expense, especially for families with young children who often need children's cold and flu products.
The British and American healthcare systems have fundamental differences, which is why the barriers faced by expats in these countries differ significantly.
A comprehensive analysis showed that the obstacles to migrants obtaining insurance coverage in the USA are significant, and the conditions for providing medical care depend on the migrant's state of residence. At the same time, there are fewer barriers for immigrants to access health care in Great Britain, as everyone in the country is entitled to free treatment under the NHS.
Daria Rogova, Head of Insurance at Visit World
To move, travel or work safely in a new country, you will need health insurance. You can apply for an extended policy on our website here.
Products from Visit World for a comfortable trip:
Travel guide for 200 countries;
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Travel insurance around the world (please select the country of interest and citizenship to receive services);
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