Access, affordability, and insurance complexity are often worse in the united states compared to ten other countries

Health Affairs

Volumn 32, Issue 12, 2013, Pages 2205-2215

  Schoen, Cathy ^a   Osborn, Robin ^a   Squires, David ^a   Doty, Michelle M ^a  

^a Commonwealth Fund ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; AUSTRALIA; CANADA; COMPARATIVE STUDY; COST CONTROL; EMERGENCY WARD; FRANCE; GERMANY; HEALTH CARE ACCESS; HEALTH CARE COST; HEALTH CARE POLICY; HEALTH INSURANCE; HOSPITAL COST; HUMAN; NETHERLANDS; NEW ZEALAND; NORWAY; PRIMARY MEDICAL CARE; SWEDEN; SWITZERLAND; UNITED KINGDOM; UNITED STATES; ADULT; DEVELOPED COUNTRY; ECONOMICS; EMERGENCY HEALTH SERVICE; EUROPE; FINANCIAL MANAGEMENT; HEALTH CARE DELIVERY; HEALTH CARE SURVEY; INSURANCE; STATISTICS AND NUMERICAL DATA;

ADULT; AUSTRALIA; CANADA; DEVELOPED COUNTRIES; EMERGENCY MEDICAL SERVICES; EUROPE; FINANCING, PERSONAL; HEALTH CARE SURVEYS; HEALTH SERVICES ACCESSIBILITY; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; UNITED STATES;

EID: 84890150950     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2013.0879     Document Type: Article

References (25)

1. Kaiser Family Foundation. Summary of the Affordable Care Act [Internet]. Menlo Park (CA): KFF; [last modified 2013 Apr 23; cited 2013 Oct 18]. (Focus on Health Reform). Available from: http://kaiserfamilyfoundation.files.wordpress.com/2011/04/8061-021.pdf
2. Schoen C, Doty MM, Robertson RH, Collins SR. Affordable Care Act reforms could reduce the number of underinsured US adults by 70 percent. Health Aff(Millwood). 2011; 30(9):1762-71.
3. To access the Appendix, click on the Appendix link in the box to the right of the article online.
4. Van Ginneken E, Swartz K. Implementing insurance exchanges-lessons from Europe. N Engl J Med. 2012;367(8):691-3.
5. For country descriptions, see Thomson S, Osborn R, Squires D, Jun M, editors. International profiles of health care systems, 2013. New York (NY): Commonwealth Fund; forthcoming 2013.
6. Schoen C, Osborn R, Squires D, Doty MM, Pierson R, Applebaum S. How health insurance design affects access to care and costs, by income, in eleven countries. Health Aff(Millwood). 2010;29(12):2323-34.
7. Cohen RA, Martinez ME. Health insurance coverage: early release of estimates from the National Health Interview Survey, 2012. Hyattsville (MD): National Center for Health Statistics; 2013 Jun.
8. The 2013 international survey is the sixteenth in this series. The surveys alternately interview the general public, sicker patients, and primary care doctors.
9. The Commonwealth Fund provided core support, with cofunding to include countries from the German Federal Ministry of Health and the BQS Institute for Quality and Patient Safety; Haute Autorité de Santé and Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (France); Dutch Ministry of Health, Welfare, and Sport and the Scientific Institute for Quality of Healthcare at Radboud University Nijmegen Medical Centre; Norwegian Knowledge Centre for the Health Services; Swedish Ministry of Health and Social Affairs; and the Swiss Federal Office of Public Health. Support to expand samples was provided by the New South Wales Bureau of Health Information (Australia); and the Health Council of Canada, Health Quality Ontario, Commissaire à la Santé et au Bienêtre du Québec, and Health Quality Council of Alberta.
10. Weights included age, sex, region, education, and additional variables consistent with standards for each country. In the United States the weighted variables also included race and ethnicity.
11. These are weight-adjusted margins of error for each country. The margins of error reported apply to estimates of 50 percent; for smaller or larger estimates, the margin of sampling error will be smaller.
12. Commonwealth Fund. 2012 Commonwealth Fund International Survey of Primary Care Physicians. New York (NY): Commonwealth Fund; 2012.
13. A description of methodology and results for the survey in Note 12 can be found in Schoen C, Osborn R, Squires D, Doty M, Rasmussen P, Pierson R, et al. A survey of primary care doctors in ten countries shows progress in use of health information technology, less in other areas. Health Aff(Millwood). 2012;31(12): 2805-16.
14. Kringos DS, Boerma W, van der Zee J, Groenewegen P. Europe's strong primary care systems are linked to better population health but also to higher health spending. Health Aff(Millwood). 2013;32(4):686-94.
15. Starfield B. The future of primary care: refocusing the system. N Engl J Med. 2008;359(20):2087, 2091.
16. Organization for Economic Cooperation and Development. OECD health data 2013: statistics and indicators. Paris: OECD; 2013.
17. Including both private insurers and public programs such as Medicare.
18. Leu RE, Rutten FFH, Brouwer W, Matter P, Rütschi C. The Swiss and Dutch health insurance markets: universal coverage and regulated competitive insurance markets. New York (NY): Commonwealth Fund; 2009 Jan.
19. Cutler DM, Ly DP. The (paper) work of medicine: understanding international medical costs. J Econ Perspect. 2011;25(2):3-25.
20. Willcox S, Lewis G, Burgers J. Strengthening primary care: achievements and recent reforms in Australia, England, and the Netherlands. New York (NY): Commonwealth Fund; 2011 Nov.
21. Schoen C, Osborn R, Squires D, Doty M, Pierson R, Applebaum S. New 2011 survey of patients with complex care needs in eleven countries finds that care is often poorly coordinated. Health Aff(Millwood). 2011;30(12): 2437-48.
22. Yong PL, Saunders RS, Olsen L, editors. The healthcare imperative: lowering costs and improving outcomes: workshop series summary [Internet]. Washington (DC): National Academies Press; 2010 [cited 2013 Oct 21]. Available for download from: http://www.nap.edu/catalog.php?record_id=12750
23. See, for example, Thomson S, Schang L, Chernew ME. Value-based cost sharing in the United States and elsewhere can increase patients' use of high-value goods and services. Health Aff(Millwood). 2013;32(4): 704-12.
24. Rosenthal E. For medical tourists, simple math. New York Times. 2013 Aug 4.
25. Kaiser Family Foundation. Kaiser health tracking poll [Internet]. Menlo Park (CA): KFF; 2013 Mar [cited 2013 Oct 21]. Available from: http://extension.umd.edu/sites/default/files/_docs/articles/aae %20Kaiser%20tracking%20poll %203_13.pdf