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Among wealthy nations, Americans more likely to skip health care

Americans, even those with higher incomes, are more likely than people in other wealthy nations to skip doctor visits or medication.
Among wealthy nations, Americans more likely to skip health care
Posted at 8:14 AM, Nov 16, 2023

A new survey released Thursday by the Commonwealth Fund found that Americans are more likely to skip or delay needed health care because of cost compared to citizens of other developed nations. 

According to the Commonwealth Fund International Health Policy Survey, 46% of low- or average-income Americans say they have skipped getting needed care due to costs. That rate is nearly double the percentage of low or average-income Canadians and three times higher than the rate of low- or average-income British, Dutch, German or French respondents. 

This is despite the average pretax family income in the U.S. standing nearly $10,000 more than in Canada and Germany; $19,000 more than in France; $26,000 more than in the United Kingdom; and $30,000 more than in the Netherlands.

Examples of skipping care include having a medical issue but not seeing a doctor, skipping a medical test, missing a recommended follow-up appointment and missing or skipping doses of prescription medication. 

The survey also found that 29% of higher-income Americans skipped care. 

The report showed that 44% of Americans had at least one medical bill problem in the last 12 months, and that there was no difference between high-income earners and others. 

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The authors of the report said the findings show that America's high cost for health care is affecting all income levels. 

"This study shows that high health care costs affect Americans in all income groups, not just people with low incomes. In fact, when it comes to health care, people with lower or average incomes in other countries may be better off than higher-income Americans," said Munira Gunja, lead study author and senior researcher at the Commonwealth Fund. "People in the U.S. with average and lower incomes are the most likely to face affordability challenges. Not only is the U.S. the only country in this study without universal health coverage, but it also has the highest health care prices. To make health care accessible to all Americans, we need to address these issues." 

Dr. Joseph Betancourt, president of the Commonwealth Fund, said skipping care can cause negative effects for patients. 

"As a primary care doctor, I have witnessed the dire consequences of people delaying or going without health care due to challenges with affordability — or having to weigh spending money on basic needs such as food and utilities against spending money on needed health care and medicine. This is frustrating and unacceptable. Given how much we invest, everyone in the country should have meaningful access to affordable health care," he said. 

SEE MORE: New data shows millions of children have lost Medicaid coverage

According to annual data released by KFF, the average family's health care premium for employer-sponsored coverage cost $23,968 in 2023, marking a 7% increase over last year. Most of that cost was covered by the employer. In the last decade, health care costs have generally risen 3% to 5% annually. 

The average worker now contributes $6,575 annually to their family's health care plan, which is up nearly $1,000 from 2018. But during that same time, the cost for employers has gone up over $3,000 per family plan. 

Human Rights Watch has previously decried the U.S. government for lacking regulations to protect the public from racking up debt for hospital care. 

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