Older adults in the United States are sicker and more likely to skip treatment than senior patients in 10 other developed countries, according to an international survey by the Commonwealth Fund.
The reason: They can’t afford care.
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The 2017 Commonwealth Fund International Health Policy Survey of Older Adults examined healthcare and access issues of those 65 and older in the United States, Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.
What makes this survey unique is that it looked only the age group of people who all are covered by Medicare, says Robin Osborn, MBA, vice president and director of The Commonwealth Fund’s International Policy and Practice Innovations program and one of the authors of this study.
“We were surprised at how much more serious the shortfalls were for U.S. elderly than we thought,” Osborn says. “In other surveys, the U.S. looks relatively poor on many measures, just because of access, but everyone age 65 has Medicare. Medicare is such a beloved program…yet in quite stark relief, we see some of (its) real shortfalls.”
Across all 11 countries, at least one in eight older adults reported having three or more chronic conditions. But in the United States, the rate was the highest, with 36 percent being considered high needs. “That’s three times the rate of New Zealand (13 percent), and of this group, we are the sickest,” Osborn says.
Americans, nearly a quarter at 23 percent, reported financial worries, saying that in the past year, they had not visited a doctor when they were sick, had skipped a recommended test or treatment, had not filled a prescription or had skipped medication doses because of the cost. This compares to five percent or less in France, Norway, Sweden and the United Kingdom. Additionally, 22 percent of American respondents in the survey reported spending $2,000 or more on medical care in the past year. Except for Switzerland, which reported 31 percent, less than 10 percent of older adults in the other countries spent that much.
Problems get even more exacerbated for the high-need older adults – those with three or more medical issues – in that 31 percent of them skip care because of costs.