There's at least one group for whom America isn't quite the greatest country in the world, and that's seniors, who tend to be sicker and pay more for health care than their peers in other countries.

A Commonwealth Fund study, reports Health Day, finds that not only are seniors sicker in the U.S. than their counterparts in 10 other high-income countries, but they’re hindered by financial barriers to obtaining the care they need—despite the fact that they’re covered by Medicare.

“Our Medicare is not as generous as comparable insurance in other countries,” fund President Dr. David Blumenthal is quoted in the report. Blumenthal points out that while other countries don’t restrict government health insurance to the elderly, the U.S. is “complacent” about the value and benefits associated with Medicare.

“We do know that we, as a country, do tolerate higher levels of inequality. That’s most evident in the fact that we underinvest, compared to other countries, in social services and overinvest, despite the lack of generosity of our insurance, in health care,” he says in the report, adding that providing more social services to the elderly might help reduce the inequality of care.

According to the study, across the 11 countries— Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK. and the U.S.—at least one of eight older adults reported having three or more chronic conditions. In the U.S., that number was highest (36 percent), while New Zealand was lowest (13 percent). At least 10 percent of older adults also reported having a functional limitation, such as needing help with shopping or managing medications.M

Medicare isn’t helping as much as it could, with U.S. seniors standing out for the financial barriers they experience in getting care. Nearly a quarter (23 percent) of older adults in the U.S. said that, in the past year, they had not visited a doctor when sick, had skipped a recommended test or treatment, had not filled a prescription, or had skipped medication doses because of the cost. Five percent or fewer of respondents in France, Norway, Sweden, and the U.K. reported these cost barriers.

Across all 11 countries, the study finds, at least one of four older adults are categorized as “high need,” meaning they have multiple chronic conditions or trouble performing activities of daily living such as cooking or shopping. The U.S. and Australia have significantly higher proportions of high-need elderly adults (43 percent and 39 percent, respectively). And high-need older adults in the U.S. struggle with costs. Nearly a third (31 percent) skip care because of costs, compared to only 2 percent in Sweden.

In the U.S., 22 percent of seniors spent $2,000 or more on out-of-pocket costs during the past year. Only Switzerland had higher costs, with 31 percent spending more than $2,000 out of pocket; among all the other countries, less than 10 percent of seniors spent $2,000 or more, researchers found.

In addition, among U.S. seniors, 25 percent worry about having the money to buy food or pay rent or bills for heat or electricity or medical care, while in France, the Netherlands, New Zealand, Norway, Switzerland, Sweden and the U.K., only 10 percent or less said they had these concerns.

Finally, 26 percent of U.S. seniors suffering from several chronic health problems or having trouble with the basic activities of daily living reported being dissatisfied with the quality of their care.

Instant Insights /

U.S. seniors have tougher time paying for health care

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