How is the health system organized and financed?
Publicly financed health care: In 2011, England spent about 9.4 percent of its GDP on health care. Public expendi- ture, mainly on the NHS, accounted for about 83 percent of that amount (ONS, 2013). Around 76 percent of NHS funding comes from general taxation and 18 percent from national insurance (a payroll tax). The NHS also receives income from copayments, those using NHS services as private patients, and some other minor sources.
Privately financed health care: Most private expenditure is for over-the-counter drugs and other medical prod- ucts (which together account for just over half of private spending) and private hospital care, including both insured and uninsured costs. Most private hospital care, largely for elective treatment, is financed through vol- untary health insurance. About 11 percent of the U.K. population has voluntary insurance, the majority as work- related benefits (Nuffield Trust, 2013). In addition, just over a million people are covered through self-insuring schemes run by employers. Private providers must be registered with the Care Quality Commission and with Monitor, an economic regulator of public and private providers (described further below), but their charges to private patients are not regulated by the government, and there is no public subsidy for either voluntary insur- ance or provision of private care.