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On Health Policies, U.S. Lags Other Nations: Survey
Date:11/18/2010

f U.S. adults paid $1,000 or more in out-of-pocket medical costs in the past year, the authors noted.

The researchers used data reported earlier this year by 19,700 adults included in the Commonwealth Fund's 2010 international health policy survey, which focuses on insurance and access to health care in these 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States.

In the United States, 31 percent of adults spent a lot of time dealing with insurance paperwork, had claims denied, or their insurer paid less than anticipated. Patients younger than 65 were more likely than those on Medicare to report problems dealing with health insurance providers.

In Switzerland, 13 percent reported these problems as did 20 percent of patients in the Netherlands and 23 percent of patients in Germany. All three countries have competitive health insurance markets, the authors pointed out.

Although the uninsured in the United States were the most likely to go without needed care, insured adults with below-average incomes were twice as likely as higher-income adults to skip medical care because of costs, the report found.

The survey also found disparities between the United States and other countries regarding access to medical care.

For example:

  • Patients in Switzerland, New Zealand, the Netherlands and the United Kingdom were the most likely to have same- or next-day access to doctors when sick.
  • Two-thirds of Dutch, New Zealand and U.K. patients had easy access to after-hours care without going to the emergency room. Meanwhile, two-thirds of Swedish, Canadian, French, and U.S. patients found it difficult to arrange for after-hours care.
  • Access to specialists was higher in the United States than in some countries. Between 70 and 83 percent of U.S., German, Swiss, Dutch and U.K. adults waited fewer than four weeks to see specia
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