Older Americans struggle to afford health care compared to those in other countries

Older Americans struggle to afford health care compared to those in other countries

Doctors who accept Medicare could face another pay cut in 2025, AMA says


Doctors who accept Medicare could face another pay cut in 2025, AMA says

03:28

In the United States, having health insurance is necessary, but not sufficient to ensure access to affordable health services.

Although the United States does not have a universal health care system like those in most other wealthy countries, most Americans over the age of 65 are insured by Medicare. Yet despite this, they still struggle to afford care, with high out-of-pocket costs putting necessary medications and doctor visits out of reach for many, according to a new study from the Commonwealth Fund, a non-profit organization dedicated to promoting an equitable health care system. healthcare system.

These additional costs, borne by Medicare beneficiaries, make it more difficult for older Americans to receive affordable care compared to seniors in nine other countries. The researchers compared coverage of older adults in the United States to the health systems of Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland and the United Kingdom. United.

Case in point: Nearly one in four seniors in the United States spent at least $2,000 on personal expenses last year, compared to less than 5% of seniors in France and the Netherlands who spent that much, according to the study. find. Only in Switzerland do older people report spending more than those in the United States on health care.

“The reason to focus on this population is that in the United States, almost all adults over 65 have Medicare,” Munira Z. Gunja, a senior health policy researcher, told CBS MoneyWatch international and practical innovations at the Commonwealth Fund. Although the United States stands out as “the only high-income country without a universal health care system,” when it comes to the population over 65, “we are at least on par with other countries,” he said. she declared.

Is health insurance not up to par?

But the study suggests that the type of coverage provided by Medicare plans doesn’t meet the needs of many Americans. In the United States, 8% more seniors reported delaying or forgoing medical care because of costs than in any other wealthy country except Austria. And not getting the care you need has repercussions: One-third of older U.S. adults who report facing cost barriers to receiving care report being in fair or poor health.

“We find that although almost all seniors have Medicare coverage, it remains more expensive than that faced by seniors in other countries and, as a result, seniors in the United States are more likely to not receive care,” Gunja said. “When they need prescription medications, they are also more likely not to get them.”

Often, for example, Medicare Advantage members find themselves seeing out-of-network doctors, exposing them to “a ton of healthcare costs,” according to Gunja.

An exception

There is one area where Medicare beneficiaries faced few out-of-pocket costs and, therefore, were less likely to skip care: mental health treatment. Less than 5% of residents across all countries have avoided mental health care for reasons of cost, illustrating that when treatment is affordable, patients are less likely to not seek medical attention.

“It’s a benefit offered on all health plans, and we see what happens when people don’t need to spend so much on a service,” Gunja said.

Solutions?

When older adults skip or delay care, their conditions deteriorate, leading to sicker patients, who tend to require more expensive care. This increases federal Medicare spending, according to the Commonwealth Fund.

Gunja suggests that the United States can look to other countries for solutions that make health care more affordable for older adults. Some examples include capping out-of-pocket expenses and comprehensive coverage of hospital and medical services.

“Overall, the United States generally comes in last place on most measures of affordability,” Gunja said. “Obtaining health insurance is absolutely necessary. But it’s only the first step. We need to make sure that coverage is not only comprehensive, but also affordable.”