Americans Skip Health Care Because of Cost


One-third of American adults skipped health care because of high cost, according to a new 11-country survey from The Commonwealth Fund. Compared with ten other industrialized nations, the United States ranks last when it comes to health care related issues, including the ability to pay medical bills and having to deal with high out-of-pocket costs.

Americans have the most negative health care experiences

If high health care costs prevented you from going to see a doctor when you were sick, stopped you from following recommended medical advice, or caused you to not fill a prescription, you are not alone if you live in the United States. While 33 percent of US adults can make these claims, only 5 to 6 percent of adults in the Netherlands and the United Kingdom are faced with these problems.

Similarly, 20 percent of US adults had major problems paying their medical expenses, compared with only 9 percent in France, which was the next closest on the list of 11 countries. Even when they have health insurance, 35 percent of Americans still pay the highest out-of-pocket costs than the other ten nations.

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The Commonwealth Fund 2010 International Health Policy Survey in Eleven Countries evaluated health care access and insurance experiences of 19,700 adults from Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Of all these countries, “the US is the only country in the study where having health insurance doesn’t guarantee you access to health care or financial protection when you’re sick,” reported lead author Cathy Schoen, who is Commonwealth Fund senior vice president.

The United States also “won” regarding another issue: health insurance system complexity. Compared with other countries that have competitive health insurance markets, American adults were most likely (33%) to have major disputes with their insurance carriers, including spending a great deal of time with paperwork and having claims denied. Germany came in a distant second at 23 percent, with 20 percent of adults in the Netherlands making similar claims.

A few other findings from the survey include:

  • Forty-six percent of American adults with below-average incomes who had health insurance skipped needed care because of costs compared with adults with above-average incomes
  • Between 70 and 93 percent of adults in Switzerland, New Zealand, the Netherlands, and the United Kingdom were most likely to get same-day or next-day access to doctors when sick compared with 57 percent of adults in the United States and Sweden
  • Only 58 percent of American adults felt confident they would be able to pay for their health care needs, the lowest rate among the eleven countries.

Possible good news may come in the form of the Affordable Care Act, according to Commonwealth Fund President Karen Davis. She also noted that “there are opportunities to learn from other countries” regarding their more successful health care service. However, the survey authors also noted that out-of-pocket costs will remain high for American adults compared with other countries, which may still force them to skip health care because of cost.

The Commonwealth Fund