Healthcare in the U.S. stands out from other developed nations not just because we spend more than any other country on it, but because the infrastructure leads to a host of other challenges around access, payment and satisfaction.
“The United States is unique in its complexity of health insurance designs, mix of public and private insurance, and relatively limited insurance market regulations,” the authors of a new report from the Commonwealth Fund wrote.
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The Commonwealth Fund and its partners surveyed thousands of people in 11 countries (Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States) this year about their access to healthcare. The fascinating results were published in Health Affairs last week.
Here are some of the highlights from the report:
- U.S. adults were more likely than adults in any other country to report out-of-pocket expenses of more than $1,000 per year (40 percent).
- Fewer than 10 percent of adults in Sweden, the UK, France, the Netherlands and New Zealand reported high out-of-pocket costs.
- Australia and Switzerland reported larger out-of-pocket spending, but fewer respondents said that it led to access or affordability concerns. The report’s authors suspect this reflects spending caps and other protections in their insurance systems.
- Even among insured respondents, U.S. adults were significantly more likely to go without care because of high costs.
- About 70 percent of respondents in Germany and New Zealand reported being able to get a same-day or next-day appointment when they are sick. Fewer than half of Canadian and American adults reported the same kind of access.
- Access to specialists was different, though. More than one in four respondents from Norway and Canada reported having to wait at least two months to see a specialist, whereas about three-fourths of the respondents from Switzerland, UK, US, Netherlands and Germany said they were seen within four weeks.
- Among U.S. respondents, a lack of insurance coverage corresponded with slower callback time and longer waits for appointments.
- A majority of respondents from five of the 11 countries (not including the U.S. or Canada) reported it was easy to get care after-hours.
- One in three adults in the Netherlands said they could email their primary care physician with a medical concern; percentages in other countries were lower.
- 3 of 4 U.S. respondents said the health system needed to undergo fundamental change or be rebuilt.
[Image credit: Health Affairs]
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