Equitable Access to Care — How the United States Ranks Internationally (New Eng Jour Med)

[pinto]

Equitable Access to Care — How the United States Ranks Internationally

Karen Davis, Ph.D., and Jeromie Ballreich, M.H.S.
October 23, 2014

The United States has been unusual among industrialized countries in lacking universal health coverage. Financial barriers to care — particularly for uninsured and low-income people — have also been notably higher in the United States than in other high-income countries. As more Americans become insured as a result of the Affordable Care Act (ACA), differences in access to care between the United States and other countries — as well as among income groups within the United States — may begin to narrow.

According to a 2013 Commonwealth Fund survey of adults in 11 high-income countries, the United States ranks last on measures of financial access to care as well as of availability of care on nights and weekends.1 Uninsured people in the United States are particularly likely to report encountering barriers to care.

In general, the survey reveals that such barriers are particularly striking for adults with incomes below or well below their countries' median income (data table at website) lower-income Americans are more likely than their counterparts in other countries to indicate that, in the past year, they've had a medical problem but did not visit the doctor because of cost, did not fill prescriptions or skipped doses of medications because of cost, or did not get recommended tests, treatments, or follow-up care because of cost. Indeed, the United States ranks last among the 11 countries in terms of financial access to care for lower-income people. At least 30% of lower-income adults in the United States report encountering such financial barriers to care; the average proportion of lower-income adults in the other surveyed countries who reported encountering one of these three types of financial barriers was around 10%.

The United Kingdom, France, Germany, Norway, Sweden, and Switzerland stand out as leaders in ensuring equitable financial access to care. Switzerland, which provides coverage through nonprofit private insurance plans with deductibles, ensures that cost sharing is lower for lower-income individuals. The United Kingdom, Norway, and Sweden have public health care systems for the entire population with little or no patient cost sharing and allow a limited role for private insurance. France has a public insurance system, and Germany has a social insurance system with competing private “sickness funds.”

http://www.nejm.org/doi/full/10.1056/NEJMp1406707?query=TOC

[Louisiana1976]

1. America needs single payer. Obamacare which benefits insurance companies more than it does

people isn't good enough.