American routes developed democracies in health care costs for older adults
Older Americans spend more on health care than peers in 10 other developed democracies, a new Commonwealth Fund finds report found.
The new report highlights how Medicare, the public health insurance program for people over 65 and people with disabilities, has significant cost-sharing requirements – including co-pays, deductibles and no cap on out-of-pocket costs.
“Although nearly all older adults in the US are covered by Medicare, this study highlights areas where the program has room for improvement,” said Munira Z Gunja, senior researcher for international health policy and practice innovations at the Commonwealth Fund, in a statement. “In some countries, almost no older adult skips care because of costs.”
Medicare is available through two programs: traditional Medicare, also called fee-for-service, and Medicare Advantage, which is administered by private insurers.
Traditional Medicare lacks many benefits that older Americans and people with disabilities need, such as vision, dental and hearing care, and long-term or home care. While Medicare Advantage offers some of these benefits, it has also been criticized wrongly deny care, being unnecessarily expensiveand is the target of federal fraud investigations.
Conservatives have proposed further privatization of Medicare by instituting “default enrollment” in Medicare Advantage. President-elect Donald Trump promised “no cuts” to the program in the official Republican platform, although there are few specifics beyond that promise.
Trump’s pick for the Department of Health and Human Services, which oversees the Medicare program, is Robert F. Kennedy Jr. environmental lawyerconspiracy theorist and the country’s biggest vaccine skeptic.
The Commonwealth report used data from the Fund’s International Survey of Older Adults to compare health benefits in ten countries, including: Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom and the United States.
They found that nearly a quarter of older adults in the U.S. spent $2,000 or more on health care in the past year, compared to less than 5% in France and the Netherlands. Similarly, older adults in the US reported the highest cost barriers to care, although less than 10% reported experiencing such barriers. One in five older adults in the US, Australia and Canada reported needing dental care when they skipped, compared to less than 5% in the Netherlands and Germany. Less than 5% of adults in all countries reported skipping mental health care because of costs.
The US has the most expensive healthcare system in the world. Despite these high prices, it performs poorly in health equity, accessibility and outcomes.
“This study highlights how important Medicare is for older adults in the U.S., but also underscores the challenge of providing needed care,” Gretchen Jacobson, vice president of Medicare at the Commonwealth Fund, said in a statement. “Rising costs are forcing many older Americans to pay more out of pocket, leading to delayed care, poorer health and higher long-term expenses.”