U.S. Health Care Lags Behind Other Affluent Countries, Study Finds

WEDNESDAY, Nov. 13 (HealthDay News) -- American adults are far more likely than those in 10 other high-income countries to go without health care due to cost, or to have trouble paying their medical bills, a new study finds.

The study, from independent think tank The Commonwealth Fund, also found more Americans complaining of hassles over health insurance disputes and paperwork.

"The U.S. spends more on health care than any other country, but what we get for these significant resources falls short in terms of access to care, affordability and quality," Commonwealth Fund president Dr. David Blumenthal said in the group's news release.

The survey of 11 high-income countries found that 37 percent of U.S. adults went without recommended care, did not see a doctor when sick or did not fill prescriptions because of the cost, compared with as few as 4 to 6 percent of adults in the United Kingdom and Sweden.

Nearly one-quarter (23 percent) of American adults also either had serious trouble paying medical bills or were unable to pay them, compared to less than 13 percent in France (which had the next-highest rate), and 6 percent or fewer of those in the United Kingdom, Sweden and Norway, according to the survey.

The investigators also found that 41 percent of U.S. adults spent $1,000 or more out-of-pocket for health care in the past year. That's by far the highest rate of any other country in the survey, according to the study published online Nov. 13 in the journal Health Affairs.

The 2013 survey included more than 20,000 adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States.

Thirty-two percent of American adults also said they had either spent a lot of time dealing with insurance paperwork and disputes, or their insurer had denied a claim and/or paid less than anticipated. This contrasted with 25 percent of adults in Switzerland, 19 percent in the Netherlands and 17 percent in Germany, all countries with competitive health insurance markets.

The poll also found that three-quarters of U.S. adults said the country's health system needs to undergo fundamental changes or be rebuilt. In comparison, 51 percent of Dutch adults, 54 percent of Swiss adults and 63 percent of U.K. adults had strong positive views of their health systems, saying they required only minor tweaking.

However, the U.S. spent $8,508 per person on health care in 2013, which is more than any other nation. The next highest-spending countries were Norway ($5,669) and Switzerland ($5,643). New Zealand was the lowest at $3,182.

The United States also had the highest health insurance administrative costs at $606 per person. The next-highest countries were France ($277) and Switzerland ($266), the results showed.

High administrative spending is a symptom of the complex, more fragmented health insurance system in the United States, according to the study authors.

Finally, many Americans say they have to wait for primary care if they fall ill. The poll found that fewer than half said they got seen by a practitioner the same day or the next day, and one-quarter of respondents said it took them six days or longer to receive care.

Cathy Schoen, Commonwealth Fund senior vice president and lead author of the study, said the findings haven't changed much over the years.

"For more than 10 years now, The Commonwealth Fund has compared the U.S. health system to the systems of other industrialized nations, and the U.S. has always been an outlier when it comes to costs, access and affordability," she said. "Far too many people go without care or can't afford to be sick, even when they have health insurance."

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SOURCE: The Commonwealth Fund, news release, Nov. 13, 2013