Since 1998, the Commonwealth Fund has been publishing an annual report comparing the healthcare systems of industrialized countries. The United States has repeatedly done poorly with its report card within the study because of the high proportion of uninsured people. However, this year the report focused on people over the age of 65, a segment of the population with almost universal coverage and access to care.
Elder Care Issues in America
Some of the countries that routinely rate highly for their senior healthcare include Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. So how does the United States stack up in terms of senior care? “It’s definitely a better picture than when we look at the U.S. population generally; that’s a pat on the back for Medicare.”
However, the survey of 15,617 respondents from the United States reveals that there are still large lapses and problems despite spending more on healthcare than any other country in the world. For one, our older population is sicker and leads the list in the proportion of people over the age of 65 who have two or more chronic diseases as well as who takes four or more prescription drugs. A total of 68% reported two or more chronic diseases and 53% reported four or more medications. In comparison, only one-third of participants in the United Kingdom reported two or more chronic conditions.
Seniors in the United States also struggle to pay for healthcare. In the last year, nineteen percent of participants in the U.S. stated that cost was a barrier that prevented them from seeing a doctor, undergoing a test, or filling a prescription. Only one other nation had numbers in the double digits in this area.
Among American seniors, 21% had out of pocket medical expenses that were over $2,000, and eleven percent said that they had problems paying for their medical bills. In comparison, Norway and Sweden only had one percent had problems paying, and in Germany that number was three percent.
Elder Care Successes in America
On the bright side, the United States also scored among the highest in other areas of elder care. A total of 86% of participants surveyed from the U.S. stated that their doctors spend enough time with them, and 81% said that their doctor encourages questions. The U.S. also rates the highest among countries where healthcare professionals talk to seniors about healthy eating and exercise.
Americans are also more likely than seniors in most countries to receive good guidance in managing their chronic illnesses. In addition, elderly Americans do better than almost every other country in terms of advance planning for long-term healthcare. Americans over the age of 65 were most likely to say that they have discussed having a healthcare proxy at 78% as well as to have actually named one at 67%. United States seniors also rank second around the world in having a written plan describing their end-of-life wishes at 55%.