Older Americans Sicker and Face More Financial Barriers to Health Care

Older Americans Sicker and Face More Financial Barriers to Health Care Than Counterparts in Other Countries

Findings from the 2017 Commonwealth Fund International Health Policy Survey of Older Adults

An international survey of older adults finds that seniors in the United States are sicker than their counterparts in 10 other high-income countries and face greater financial barriers to health care, despite the universal coverage that Medicare provides. Across all the countries, few elderly adults discuss mental health concerns with their primary care providers. Moreover, nearly a quarter are considered “high need” — meaning they have three or more chronic conditions or require help with basic tasks of daily living.

With assistance from the survey research firm SSRS, the authors interviewed adults age 65 and older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the U.K., and the U.S. Interviews were conducted by phone (and also online in Switzerland) between March and June 2017.

The survey results highlight the importance of insurance benefit design. In the U.S., Medicare provides universal health coverage to adults 65 and older, but premium contributions and cost-sharing continue to be a serious burden for many. Other health systems offer more protection. For instance, Canada, the Netherlands, and the U.K. have no deductibles or cost-sharing for primary care. In addition, the U.S. stands out for its disproportionately low government spending on social services — such as housing, nutrition, and community outreach — vis-à-vis health care. The authors say a compelling business case exists for aligning health and social care spending.