U.S. Health Insurance Compared to 10 Other Nations

U.S. adults spend more time, money on insurance; have more coverage denials

FRIDAY, Nov. 19 (HealthDay News) -- Adults in the United States spend more time and money on health insurance than those in many other developed nations, and ultimately deal with more coverage-related disputes and denials, according to research published online Nov. 18 in Health Affairs.

Cathy Schoen, of the Commonwealth Fund in New York City, and colleagues conducted computer-assisted telephone interviews of adults in Australia, Canada, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United States, and the United Kingdom to assess their experiences with health insurance. Respondents were placed into one of three groups based on their income as compared to the median household income in their country.

The researchers found that insurance design was associated with significant differences in health care access, out-of-pocket cost burdens, and other problems with health insurance. Adults in the United States were the most likely to have high medical expenses despite having insurance coverage; they were also most likely to spend time on insurance paperwork and working out insurance-related disputes and to have payments denied. Income differences on cost-related access barriers and bill-paying problems were significant in all countries except the United Kingdom, and the gap was widest in the United States.

"The U.S. experience to date provides a cautionary tale of complexity, with high overhead costs and disparities by income. Similarly, the United States has the opportunity to learn as countries with insurance-based systems incorporate incentives for patients and providers, including reference pricing and value-based benefit designs, and as countries with competing insurers develop risk adjustment to focus competition on value," the authors write.

The study was supported by the Commonwealth Fund.

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