(92%) The United Kingdom and Ireland, a group of European countries linked by a common border, share at least one other trait , namely that they both have a universal health system. The majority would expect the two countries' healthcare systems to operate similarly, due to their proximity and the fact that they are both universal, but in reality the opposite is true. The Irish health system and structure is very different from the National Health Service in the United Kingdom (Gold, 2011). Made up of four constituent countries, England, Scotland, Wales and Northern Ireland, the United Kingdom (UK) is a sovereign country that is commonly referred to as Great Britain (or Great Britain) ( Johnson & Stoskopf, 2010, p. Located in northwest Europe, the United Kingdom has enjoyed one of the most prosperous periods of sustained growth in all of Europe, showing relatively consistent business maturity and development for over 150 years. (Johnson & Stoskopf, 2010, p. 87). This is a reversal of a trend seen in the first half of the 20th century, where, according to the CIA's World Fact Book, the UK's role as a world power had seriously weakened between two world wars, followed by Ireland's withdrawal from the union. The second half of the century saw the slow dismantling of the British Empire and the rebuilding of the United Kingdom into a modern, prosperous European nation (Johnson & Stoskopf, 2010, p. 85). A country steeped in tradition and institutionalism, Great Britain is one of the only countries without a common set of governing documents, namely the Declaration of Independence, the Bill of Rights and the Constitution. Instead, the governmental roots date back to the Magna Carta of 1215 which...... middle of paper ...... the clinical effectiveness of pharmaceuticals and the process of calculating profitability should not be s prove too difficult. The problem is that the Food and Drug Administration does not have the power to stop a drug from marketing if it is found to be cost-ineffective. Additional obstacles come from opposition from consumers who say the purchasing decision should be their choice. In the United Kingdom, the National Institute for Clinical Excellence (NICE) uses a threshold of $50,000 per quality-adjusted life year (QALY) for access under its National Health System (NHS). . If a drug does not meet this threshold, it is refused. The value of $50,000 is significantly lower than recent estimates in the United States which put the value of a year of life at almost $175,000 (Vernon, Goldberg, Dash, Muralimohan, 2007).