The Elderly's Experiences with Health Care in Five Nations: Findings from The Commonwealth Fund 1999 International Health Policy Survey

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This international study finds that universal health care systems, including the U.S. Medicare program, do a good job of providing quality care to the elderly. Respondents age 65 and older in five countries—Australia, Canada, New Zealand, the United Kingdom, and the United States—praised the quality of care and the ease of access to most services. Many expressed doubts, however, over the ability of the health systems to meet their needs in the future.

""The Elderly in Five Nations: The Importance of Universal Coverage"" is based on findings from The Commonwealth Fund 1999 International Health Policy Survey. Conducted by Harris Interactive, Inc., the survey examines the health care attitudes and experiences of people age 65 and older in each of the five nations. The study was done by Karen Donelan and Robert J. Blendon of the Harvard University School of Public Health; Cathy Schoen, Robin Osborn, and Karen Davis of The Commonwealth Fund; and Katherine Binns of Harris Interactive.

Access to health care for the elderly in the United States falls within the range of other countries. Fewer than 10 percent in any country said it was ""extremely"" or ""very"" difficult to get medical care or specialist care when needed, and fewer than 15 percent reported having any level of difficulty. In general, all five nations are also able to protect the elderly against high health care costs. Fewer than 6 percent in any country said they had problems paying medical bills.

Prescription drug coverage stands out as a key difference between the United States and the other four countries. The U.S. elderly are far more likely to face high out-of-pocket costs and be without insurance for medications.

Many elderly respondents expressed concerns about the future of their own health care. One of five (19%) elderly Americans is ""very concerned"" he or she will become a burden to his or her family, as are one of four (25%) New Zealanders and 13 percent of the elderly in Australia, Canada, and the United Kingdom.

In every country save the United Kingdom, more respondents said that health care for the elderly had declined rather than improved over the past five years. Opinions of the health care system were more favorable among the elderly in Canada and the United Kingdom than in the United States and New Zealand. The United States, where Medicare provides health insurance for everyone age 65 and older, was the only country where the elderly were more satisfied with their care than the nonelderly.


Facts and Figures
  • One of six (16%) U.S. elderly pays more than $100 monthly out-of-pocket for prescription drugs, while fewer than 5 percent of the elderly in Australia, Canada, New Zealand, and the United Kingdom pay that much per month.
  • Nearly a quarter (23%) of Canadian and British elderly had problems seeing medical specialists, compared with 14 percent in the United States and 10 percent in Australia.
  • About four of 10 Canadian and U.K. elderly believe their health system works fairly well, while fewer than one of five thinks it needs to be rebuilt. In Australia, New Zealand, and the United States, however, one-fourth or more think their country’s system should be rebuilt.

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Publication Details

Publication Date:
May 1, 2000
Authors:
Cathy Schoen, Karen Davis, Erin Strumpf, et al.
Citation:

The Elderly's Experiences with Health Care in Five Nations: Findings from The Commonwealth Fund 1999 International Health Policy Survey, Cathy Schoen, Erin Strumpf, Karen Davis et al., The Commonwealth Fund, May 2000

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