Health spending in Great Britain is quite low (7.5% of GDP) and very fair. Long waiting lists for treatment, however endemic, and rationing pervade the system. Patients have little choice of provider and little access to specialists, but 100% of people are insured (Health Care around the World). In Great Britain there is a central healthcare system and all doctors and nurses are state employees. Unlike Britain, the Philippines' healthcare system is dominated by high-end, for-profit private institutions. As a result, inequality continues to be a major health problem in a health sector where poor health outcomes persist for the poorest income groups and geographic areas. The Philippines has attempted to establish a central healthcare system, but has failed for years due to political influences on the healthcare system. Despite strong efforts in implementing the Philippine Health Insurance Law, out-of-pocket costs have continued to rise, eroding progress toward more equitable health financing (The Philippines Health System