Universal healthcare systems are under mounting pressure from demographic change, technological advancement, and fiscal constraints. This narrative review compares two high-performing health economic models—the United Kingdom’s National Health Service (NHS) and Australia’s Medicare, each grounded in distinct philosophical and structural foundations. This review analyses their respective funding architectures, cost-effectiveness, and sustainability challenges. The NHS operates a taxation-funded, vertically integrated system with a £185.8 billion budget, while Medicare Australia combines a 2% levy with widespread private insurance, covering 46% of the population for inpatient care. Despite similar demographic pressures, Australia ranks higher (1st vs. 3rd) in the 2024 Commonwealth Fund assessment. The NHS benefits from monopsonistic cost control but faces capacity constraints; Medicare’s hybrid design offers flexibility yet raises equity concerns. Both systems have pursued major reforms since 2015, including the NHS’s Integrated Care Systems and Australia’s expanded bulk-billing incentives. The COVID-19 pandemic accelerated digital health adoption, with telehealth consultations surging to over 30% of total usage at their peak. Long-term sustainability in both systems hinges on addressing aging populations, chronic workforce shortages, and the need to redesign service delivery beyond financial solutions.

Enoch Chi Ngai Lim. Universal Coverage, Divergent Designs: A Comparative Review of Health Economics Models of NHS UK and Medicare Australia. Frontiers in Medical Science Research (2025), Vol. 7, Issue 5: 9-17. https://doi.org/10.25236/FMSR.2025.070502.

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