Despite major coverage expansions under the Affordable Care Act, Americans are sicker and have more trouble affording care than 10 other high-income countries, a new survey shows.
Moreover, almost half of the poorest U.S. adults can't get the care they need, and many resort to the emergency room for treatment, according to the Commonwealth Fund study.
The non-partisan group surveyed almost 27,000 adults across 11 high-income countries about their health and experience with their country's healthcare system. The nations surveyed included Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.
The U.S. is the only country studied without universal healthcare coverage, though the uninsured rate in the U.S. has dropped to a record low.
It's the first international survey by the foundation conducted after some of the major coverage expansions under the ACA.
And yet, “Americans still struggle to afford care and face greater financial barriers to care than adults in the 10 other countries,” Robin Osborn, the study's lead author and the Commonwealth Fund's director of the international program in health policy and practice innovations, said during a press conference this week. “They also have a relatively hard time getting into primary care when they need it, and gaps in coordination of care are problems in all countries, with the U.S. at the top of the range.”
The survey found that Americans are much sicker than people in other high-income countries. The highest rate of all 11 countries, 28% of American adults said they have two or more chronic illnesses, such as a joint pain or arthritis, asthma, chronic lung disease, diabetes, heart disease, hypertension or high blood pressure. And 26% said they experienced emotional distress they couldn't cope with alone.
Canada reported the second-highest rate of chronic conditions at 22%, but the highest rate of emotional distress at 27%. In each country surveyed, at least 14% of adults reported having multiple chronic conditions.
Though Americans are in poorer health, they're also more likely than others to go without recommended healthcare, fail to fill a prescription or avoid the doctor when sick because of costs.
About a third of U.S. adults said they skipped needed healthcare because they couldn't afford it, down from 37% in the last 2013 survey. While that's an improvement, adults in the U.S. still report greater financial barriers to accessing care than the 10 other countries surveyed.