Health Care Policy – Discussion Week 3: Comparing the UK and US Health Systems and the Advocacy Role of Advanced Practice Nurses
University course context: This discussion prompt aligns with MSN-level health policy coursework that examines how the United Kingdom’s National Health Service and the United States’ hybrid public-private insurance model each shape access, equity, and outcomes, while asking advanced practice registered nurses to identify concrete political and advocacy interventions that can push the American system toward better population health.
A thesis-level summary: Two foundational differences separate the UK and US health systems: the UK guarantees universal coverage through tax-funded national provision while the US relies on a patchwork of private insurance, Medicare, and Medicaid that leaves millions uninsured or underinsured; and the UK constrains spending through centralized budgeting while the US tolerates far higher per-capita costs with uneven returns in life expectancy and equity.
Assignment
Review both resources provided below in addition to the assigned readings for this week and reflect on 2 key differences between the UK and US Health systems. That comparison matters because the structural choices each country made decades ago continue to shape who gets care, how quickly they receive it, and how much they pay at the point of service. What are key opportunities related to advocacy and politics interventions that can be done by advanced practice nurses to improve our current health system? Advanced practice registered nurses sit at the intersection of clinical expertise and policy impact, which makes their advocacy role both practical and urgent.
Please refer to the resources identified below for details regarding UK Health System.
- US and UK Health System Comparison – https://www.youtube.com/watch?v=R4Y0TKiwNgo
- Peterson-Kaiser Health System Tracker – https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/
Please be sure to adhere to the following when posting your weekly discussions:
- A minimum of 2 paragraphs is required for all posts
- All discussion posts must be minimum 250 words, references must be cited in APA format 7th Edition, and must include minimum of 2 different scholarly resources published within the past 5 years.
Sample Answer Excerpts for Study and Reference
Structural Divergence in Financing and Coverage
The most consequential difference between the UK and US health systems is how each finances care. The UK’s National Health Service operates on general taxation and delivers care free at the point of use, which produces near-universal coverage and eliminates direct billing for most services (KFF, 2025). The US instead depends on a voluntary private insurance market supplemented by Medicare for adults over 65 and Medicaid for low-income populations, and roughly 8.3% of Americans still lacked any health insurance in 2025 (CDC, 2025). That coverage gap translates into delayed care, medical debt, and preventable hospitalizations, particularly among working-age adults in states that did not expand Medicaid.
Spending patterns diverge just as sharply. The United States spent approximately 17.2% of its GDP on healthcare in 2025, compared with roughly 11.1% in the UK, yet Americans live shorter lives on average and report more barriers to accessing care (Peterson-KFF Health System Tracker, 2025). Higher spending has not translated into better population outcomes. The US does outperform peer nations on certain clinical measures, such as 30-day mortality after heart attacks, but those gains sit alongside persistent failures in maternal mortality, where the US rate of 18.6 deaths per 100,000 live births dwarfs the peer-country average of 5.1 (Peterson-KFF Health System Tracker, 2025).
The UK system faces its own pressures, including sustained access failures and eroding public satisfaction despite universal coverage (Waitzberg et al., 2025). Waits for elective procedures and emergency care have grown, and workforce shortages strain the NHS’s ability to deliver timely services. Neither system offers a clean template. The comparison instead reveals a set of trade-offs: the UK accepts longer waits in exchange for financial protection, while the US accepts financial risk and inequity in exchange for faster access for those who can pay.
Advocacy Pathways for Advanced Practice Nurses
Advanced practice registered nurses can influence health policy through several concrete channels. One high-impact pathway involves joining and actively participating in professional nursing organizations, which pool resources and amplify nursing voices in legislative settings (Benton et al., 2020). Membership alone is not enough. Research suggests that mentorship, structured advocacy training, and direct engagement with legislators are the mechanisms that convert membership into policy influence (Kung & Rudner Lugo, 2015).
Another opportunity lies in addressing the political efficacy gap that keeps many APRNs on the sidelines. A 2026 quality improvement project in Texas found that APRNs scored high on internal political efficacy but low on external efficacy, meaning they believed in their own skills but doubted whether policymakers would listen (Rogers et al., 2026). Targeted interventions such as policy toolkits, webinars, and direct legislator contact templates narrowed that gap and increased advocacy behavior. Similar interventions could be replicated in other states with restrictive practice environments.
APRNs can also leverage the profession’s high public trust. Nurses have ranked as the most trusted profession for 22 consecutive years in Gallup’s Honesty and Ethics poll, which gives them unusual credibility when they testify before legislative committees or speak with media (Brenan & Jones, 2024). State-level campaigns to expand full practice authority have succeeded in 27 states and the District of Columbia, and APRNs in the remaining states can study those successful campaigns to replicate their coalition-building and messaging strategies (Medscape, 2025).
Coalition building across nursing specialties and with allied health professions expands reach further. When APRNs partner with physician assistants, public health associations, and patient advocacy groups, they present a united front that legislators find harder to dismiss as narrow professional self-interest. The 2025 AANP coalition letter supporting the Improving Care and Access to Nurses Act, signed by more than 260 organizations, illustrates how broad alliances can move federal legislation forward (AANP, 2025).
Reference
American Association of Nurse Practitioners. (2025). More than 260 organizations show their support for the Improving Care and Access to Nurses Act. https://www.aanp.org
Benton, D. C., Watkins, M. J., Beasley, C. J., Ferguson, S. L., & Holloway, A. (2020). Evidence-based policy: Nursing’s role in health policy development. International Nursing Review, 67(2), 150–158. https://doi.org/10.1111/inr.12570
Brenan, M., & Jones, J. M. (2024). Nurses retain top honesty and ethics rating in U.S. Gallup. https://news.gallup.com/poll/611528/nurses-retain-top-honesty-ethics-rating.aspx
Centers for Disease Control and Prevention. (2025). Health insurance coverage: Early release of estimates from the National Health Interview Survey, 2025. https://www.cdc.gov/nchs/nhis.htm
KFF. (2025). International comparison of health systems. https://www.kff.org/global-health-policy/health-policy-101-international-comparison-of-health-systems/
Kung, Y. M., & Rudner Lugo, N. (2015). Political advocacy and practice barriers: A survey of Florida APRNs. Journal of the American Association of Nurse Practitioners, 27(3), 145–151. https://doi.org/10.1002/2327-6924.12156
Medscape. (2025). Nurses can close gaps in clinical care delivery. https://www.medscape.com
Peterson-KFF Health System Tracker. (2025). How does the quality of the U.S. health system compare to other countries? https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/
Rogers, C., et al. (2026). Mobilizing change: Strengthening advocacy among Texas advanced practice registered nurses. The Journal for Nurse Practitioners, 22(6), 105821. https://doi.org/10.1016/j.nurpra.2026.105821
Waitzberg, R., et al. (2025). Accountability, autonomy, equity, and trust in selected healthcare systems: A comparative analysis. Israel Journal of Health Policy Research, 14(71). https://doi.org/10.1186/s13584-025-00736-x
Research, Writing, Citation and Referencing Guide
When drafting your discussion post, lead with a clear thesis that names your two key differences before you elaborate. Instructors in health policy courses typically reward evidence-based comparison over opinion, so anchor each claim to a verifiable source. Use APA 7th Edition formatting for both in-text citations and the reference list, and confirm that your scholarly sources were published within the past five years. The Peterson-KFF Health System Tracker and KFF’s international comparison pages are reliable, frequently updated data sources that you can cite alongside peer-reviewed journal articles. If you reference a YouTube video, cite it in APA format with the uploader as author and the date of posting. Keep paragraphs to five or six sentences so your argument stays readable. Avoid sweeping claims about which system is “better”; instead, point to specific outcome measures and acknowledge the trade-offs each system accepts.
Frequently Asked Question
Can advanced practice nurses realistically influence federal health policy without running for office?
Yes. Legislative testimony, coalition membership, professional organization advocacy, and direct outreach to representatives are all effective and documented pathways. Rogers et al. (2026) found that a structured advocacy toolkit increased APRN engagement in Texas without requiring any participant to hold elected office. The AANP’s 2025 coalition letter demonstrates that professional organizations aggregate individual voices into a collective signal that legislators take seriously. Most policy change happens through sustained, incremental pressure rather than dramatic single actions.
Why This Matters in Practice
Health policy decisions determine whether patients can access a nurse practitioner without a supervising physician’s signature, whether telehealth visits are reimbursed at parity with in-person care, and whether rural clinics can hire the providers they need. APRNs who understand the UK-US comparison can identify which structural features of the NHS, such as centralized budgeting and universal coverage, offer useful lessons for US reform efforts. They can also recognize where the US system’s faster access for insured patients represents a genuine strength worth preserving. Advocacy is not an abstract civic duty; it directly shapes the conditions under which APRNs practice and patients receive care.
Alternative Formatting of Paragraphs
Financing and Coverage
The UK finances healthcare through general taxation and delivers it free at the point of use, while the US relies on private insurance, Medicare, and Medicaid with significant gaps in coverage (KFF, 2025). Approximately 8.3% of Americans remained uninsured in 2025 (CDC, 2025). This gap leads to delayed care and preventable hospitalizations.
Spending patterns diverge as well. The US spent about 17.2% of GDP on healthcare compared with 11.1% in the UK, yet Americans live shorter lives on average (Peterson-KFF Health System Tracker, 2025). The US does better on some clinical measures but worse on maternal mortality.
The UK faces access failures despite universal coverage (Waitzberg et al., 2025). Neither system is a clean template. The comparison reveals trade-offs between financial protection and timely access.
Advocacy Pathways
APRNs can influence policy through professional organizations, legislative testimony, and coalition building (Benton et al., 2020). Membership alone is insufficient; mentorship and structured training convert membership into influence (Kung & Rudner Lugo, 2015).
A Texas project found APRNs scored high on internal efficacy but low on external efficacy, meaning they doubted policymakers would listen (Rogers et al., 2026). Policy toolkits and direct legislator contact templates narrowed that gap.
Nurses have ranked as the most trusted profession for 22 consecutive years, giving them unusual credibility in legislative settings (Brenan & Jones, 2024). Full practice authority now exists in 27 states and the District of Columbia (Medscape, 2025).
Coalition building with allied professions expands reach. The 2025 AANP coalition letter supporting the Improving Care and Access to Nurses Act, signed by more than 260 organizations, shows how broad alliances move federal legislation (AANP, 2025).
Course: MSN Health Care Policy | Assessment: Week 3 Discussion 2 | Institution: Florida National University
This discussion requires students to compare the UK and US health systems, identify two key differences, and analyze advocacy opportunities for advanced practice nurses. The comparison should draw on the Peterson-KFF Health System Tracker and the assigned YouTube resource, while the advocacy analysis should reference peer-reviewed sources published within the past five years. All posts must be a minimum of 250 words across at least two paragraphs, with APA 7th Edition citations and a minimum of two different scholarly resources published within the past five years.
Example Essay Excerpts for Study
Financing and Access
The National Health Service in the UK provides healthcare free at the point of use, funded primarily through general taxation. This model achieves near-universal coverage and eliminates the financial barriers that keep many Americans from seeking timely care (KFF, 2025). The US system, by contrast, relies on a mix of employer-sponsored insurance, individual market plans, Medicare, and Medicaid. Approximately 8.3% of Americans lacked any health insurance in 2025, and many more were underinsured (CDC, 2025). The coverage gap produces measurable harm: uninsured adults delay preventive care, skip medications, and face higher rates of preventable hospitalization.
Spending and Outcomes
The United States spends far more on healthcare than the UK but does not achieve commensurate results. In 2025, US healthcare spending reached approximately 17.2% of GDP compared with roughly 11.1% in the UK (Peterson-KFF Health System Tracker, 2025). Life expectancy in the US remains nearly four years shorter than the peer-country average. The US performs well on some treatment measures, such as 30-day mortality after heart attacks, but poorly on maternal mortality and primary care access.
Advocacy and Policy Intervention
Advanced practice nurses can advocate for policy change through several evidence-based strategies. Joining professional nursing organizations provides access to advocacy training, mentorship, and collective action opportunities (Benton et al., 2020). Direct engagement with legislators, whether through testimony, letters, or meetings, gives APRNs a platform to translate clinical experience into policy recommendations. Coalition building with allied health professions and patient advocacy groups amplifies nursing’s voice and strengthens legislative campaigns.
A 2026 study of Texas APRNs found that structured advocacy interventions, including policy toolkits and webinars, increased political efficacy and engagement (Rogers et al., 2026). The study also identified a persistent gap between APRNs’ confidence in their own skills and their belief that policymakers would act on their input. Targeted mentorship and direct legislator contact helped close that gap. APRNs in other states with restrictive practice environments could adapt similar interventions to their own contexts.
Full practice authority represents one of the most consequential policy goals for APRNs. Currently, 27 states and the District of Columbia grant APRNs full practice authority, while the remaining states impose varying levels of physician supervision or collaboration requirements (Medscape, 2025). Expanding full practice authority has been linked to improved access in rural and underserved communities. APRNs can support these campaigns by sharing patient stories, providing evidence on quality and safety, and joining coalitions that include physician assistants, public health associations, and patient advocacy groups.
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Week 4 Discussion: The Affordable Care Act and Nursing Practice
This discussion asks you to evaluate how the Affordable Care Act has shaped nursing practice, patient access, and reimbursement over the past decade. Review the assigned readings and identify one provision of the ACA that has directly affected advanced practice nursing. Then analyze whether that provision has achieved its intended goals and propose one policy adjustment that would strengthen its impact. Your post should be a minimum of 250 words with at least two peer-reviewed references published within the past five years.
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