Five-Nation Survey Highlights Healthcare Cost and Access Problems
Originally published by Reuters Health, May 14, 2002
NEW YORK (Reuters Health) — Americans are much more likely than residents of four other industrialized nations to report problems securing access to healthcare due to cost, according to study released on Tuesday.
At least one in five US adults in the study reported having a problem paying medical bills or difficulty affording prescriptions, medical care or doctor-recommended tests and follow-up treatment, researchers from the Harvard School of Public Health and the Commonwealth Fund reported.
In large part because of the nation's high rate of uninsurance, low-income Americans were the least satisfied of any group in the study and the most at risk of foregoing needed medical care.
The survey, which is the fourth in a series gauging perceptions of international healthcare systems, was conducted between April and May of last year. The United States is the only nation in the survey that lacks universal health insurance coverage.
While the results suggest there's no "Utopian answer" to healthcare cost and access problems, "covering the uninsured would make a dramatic difference in the pattern of care in the United States," co-author Robert Blendon, a professor of health policy and management at Harvard, told Reuters Health.
"For countries with universal systems, the results suggest the need to focus on the problems of people who are less well-educated and have lower incomes," he said.
The US, which has the highest percentage (21%) of people reporting having a problem paying medical bills, ranks below other nations on most measures of patient perceptions and experiences.
While lower-income citizens in all five countries reported difficulty getting access to dental care because of cost, for example, the gap was greatest in the US. Just over half (51%) of lower-income Americans reported foregoing needed dental care in the previous year, versus 24% of the nation's higher wage-earners.
Blendon, who's been tracking peoples' perceptions of the five nations' healthcare systems for more than a decade now, says no country has been able to satisfy the expectations of all its citizens, particular of middle-income people.
Every country in the poll has its unique difficulties. Adults in the UK reported the longest waits for elective surgery, for example, while New Zealanders had more income-related inequities in the care they received. In Canada, 16%, on average, found it very or extremely difficult to see a specialist. And 19% of Australians said they did not fill a prescription in the past year due to cost.
Yet the US remains "an outlier" among the five nations, with many more problems than the other countries, especially for low- and moderate-income people, Blendon said. That's partly due to a lack of universal insurance coverage, but also reflects, in some cases, an inadequate level of benefits to protect Americans from cost of illness, he added.
