Robin Osborn, David Squires, Michelle M. Doty, Dana O. Sarnak, Eric C. Schneider, M.D.
R. Osborn, D. Squires, M. M. Doty, D. O. Sarnak, and E. C. Schneider, "In New Survey of 11 Countries, U.S. Adults Still Struggle with Access to and Affordability of Health Care," Health Affairs Web First, Nov. 16, 2016.
Also read a companion To the Point post, Fewer Americans Say Cost Is a Barrier to Getting Care, But U.S. Still Has a Long Way to Go.
An 11-country survey finds that adults in the United States are far more likely than those in other countries to go without needed care because of costs and to struggle to afford basic necessities such as housing and healthy food. U.S. adults are also more likely to report having poor health and emotional distress. Bright spots for the U.S. include rates of timely access to specialist care, discussion with a physician about ways to lead a healthy life, and coordinated hospital discharge planning.
"In comparison to adults in the other 10 countries, adults in the U.S. are sicker and more economically disadvantaged. The resulting challenge to the U.S. health system is compounded by higher health care costs, greater income disparities, and relatively low levels of spending on social services."
Asking people directly about their experiences with the health care system can reveal valuable information about how well a country is meeting the needs of its population. A new Commonwealth Fund study in Health Affairs examines patients’ experiences based on responses to a 2016 survey of adults in 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.
Although the U.S. has made significant progress in expanding insurance coverage under the Affordable Care Act, it remains an outlier among high-income countries in ensuring access to health care. The authors point out that all of the other countries surveyed provide universal insurance coverage, and many provide better cost protection and a more extensive safety net. To address the barriers to access and affordability identified in the survey, policymakers might consider expanding Medicaid eligibility in the 19 states that have not yet done so; limiting the amount people need to spend out of pocket on health care; and creating a stronger primary care system.
Telephone surveys were conducted in each of the 11 countries between March and June 2016 among adults age 18 and older. Questions focused on people’s experiences with their country’s health care system in terms of access, quality, and affordability, as well as on self-reported health and well-being.
Despite progress since passage of the Affordable Care Act, adults in the United States remain more likely to go without needed health care because of costs compared to adults in other high-income countries.