U.S. citizens face widespread disparities in healthcare access compared to people in other high-income nations, according to a new study published Monday in Health Affairs.
The study finds that most Americans think their fellow citizens can't access the care they need. But fewer Americans think it's unfair this disparity exists.
"There is vastly high awareness in the U.S. of widespread unmet need. Decades of debate over healthcare appear to have sunk in," said Joachim Hero, lead author of the study and doctoral candidate in health policy at Harvard University. "But it's surprising that a relatively low proportion feel that it's unfair."
Hero and his co-authors examined 2011 to 2013 data of 32 countries from the International Social Survey Programme, a collaboration between nations that analyzes social science research. They looked at surveys that focused on healthcare disparities between people in the top and bottom tertiles of household income in their respective countries.
About 67% of U.S. respondents said that "many" people in the country don't have access to the healthcare they need. This is over 10 percentage points higher than any other country. Yet only 54% of U.S. respondents reported that it was unfair that healthcare services were easier to get for those with higher incomes compared to the median rate of 68% for citizens in other countries.
Hero said it could be that U.S. citizens have a "general expectation" that healthcare disparities will exist. He said this perspective is important to keep in mind as efforts to repeal and replace the Affordable Care Act continue.
"For people who care about this issue, they need to go beyond just raising awareness," Hero said. Most people seem to accept that healthcare disparity is a problem so educating citizens about the impact of taking away insurance coverage should be a priority for advocates, he added.
The U.S. also ranked lower than many other countries in perceived health status. About 38% of low-income Americans reported fair or poor health, representing the third-highest disparity overall behind Chile and Portugal.
At 16.5 percentage points, the U.S. also reported the second-largest disparity for citizens likely to forgo needed medical treatment because of costs. Hero said that metric was also wide among those with high incomes and insurance. "It's important we understand the problems of disparity in the U.S. is not just an issue of insurance status."