This site uses cookies to provide you with a more responsive and personalised service. By using this site you agree to our use of cookies. Please read our PRIVACY POLICY for more information on the cookies we use and how to delete or block them.
  • SAME DIFFERENCE - A comparison of international health systems

SAME DIFFERENCE - A comparison of international health systems

21 December 2016

Steve Smurthwaite, Alexander Morton, Patrick Pilch

Healthcare stories dominate headlines around the world. Recently there has been a focus on increased demand caused by growing and ageing populations, the introduction of new technologies and the need to contain spread of conditions such as obesity and diabetes.

Whether it’s the Affordable Care Act in the U.S., reforms of the English National Health Service (NHS) or the Hospital Structure Act in Germany, healthcare systems are constantly evolving their local responses to address these international problems.

Using BDO’s experience working with and advising clients in these countries, this paper provides an insight into factors that are currently impacting on their healthcare systems and how the countries are adapting to meet the common challenges.

Our paper identifies three key themes which are significantly impacting the design and delivery of healthcare across the three countries:


Changing Environment

Significant demographic shifts, financial and political pressures and disruption through new market entrants and technology.


Changing Payer/Commissioner Behaviour 

A shift in how those who commission and pay for healthcare organise coverage that incentivises improved quality and safety outcomes.


Changing Care Models

A trend towards integrated working across acute, community, primary and mental health settings which breaks down traditional silos and promotes place and person-centred care.


Although there will always be local differences, we think the paper reveals a significant degree of similarity between the challenges facing England, the U.S. and Germany and the approaches that can be taken to address them.

We hope the paper will facilitate the transfer of learning between these nations and to other areas facing similar challenges with their healthcare systems.