Is U.S. Health Insurance Still Behind the Curve?

A recent international study released by the Commonwealth Fund revealed that U.S. patients forgo medical care more than some other developed countries, largely because we have the highest out-of-pocket expenses for health insurance. While recent health care reform measures are set to make many changes to the current system, it seems that as of today, insurance costs are still too high and not enough coverage is available to pay for continually increasing health care costs.

The purpose of health care reform is to make sure the U.S. health care system provides Americans with affordable coverage. However, if Americans are still paying too much in out-of-pocket expenses and a record number of people are still without health insurance, it appears U.S. health insurance and health care as a whole is still behind the curve when compared to other developed countries.

U.S. Health Care and Insurance Not Up to Par

The study, titled How Health Insurance Design Affects Access to Care and Costs, By Income, in Eleven Countries, published in Health Affairs, found that compared with 10 other industrialized countries, the U.S. has the highest out-of-pocket costs and the most complex health insurance.

The researchers conducting the study discovered that overall, our health care system falls far behind other countries when measuring access, quality, efficiency and health outcomes.

Also, the U.S. spent far more than $7,500 per capita in 2008, which is more than twice what other countries spend to cover everyone. Further, even though we spend more, researchers revealed 33 percent of adults still go without recommended care or drugs.

Some other issues that the researchers found include:

  • Medical bill payments: Twenty percent of U.S. adults had problems paying their medical debt compared to 9 percent in France and 2 percent in the United Kingdom.
  • Out-of-pocket expenses: More than one-third of U.S. adults paid $1,000 or more in out-of-pocket medical costs in the past year.
  • Paperwork/insurer problems: In the U.S., 31 percent of adults spent too much time dealing with insurance paperwork, had their claims denied or received a smaller payment from their insurer than anticipated.

In addition to the United States, the study focused on insurance and access to health care in Australia, Canada, France, Germany, the Netherlands, New Zealand, the United Kingdom, Norway, Switzerland and Sweden. After gathering their data, researchers concluded that while the U.S. has access to the best resources, we are not getting a good value for health care.

How Could Health Care Reform Help?

Some may think that taking a look at health care in comparison to the rest of the world is no longer fair since health care reform has not had a chance to fully kick in and prove its worth. There are some aspects of the law that could indeed help to lower costs, at least in theory.

For instance, health insurance exchanges are being formed and are meant to lower insurance costs for consumers who are self-employed or don’t have coverage available via an employer. They offer discounts similar to what workers receive through their employers’ group insurance. California has already started developing the first one that should be fully operational by 2014.

In addition to exchanges, the government plans to offer a number of subsidies and even expand Medicaid eligibility to give more families access to affordable care. It also will be providing employers with tax breaks if they offer affordable plans.

However, some have disputed that while costs may decrease, they won’t lower enough to make a real difference.

A recent study from the Employee Benefit Research Institute (EBRI) revealed that health care reform should indeed lower health insurance rates and subsequent out-of-pocket expenses, but it also noted retirees would need to save at least $124,000 to have a 90 percent chance of covering all of their health care expenses with Medicare.

Also, Republicans who have taken control of the House of Representatives are expected to fight health care reform. They announced shortly after the Nov. 2 elections that they plan to repeal so-called Obamacare.

With so much instability in the health care world, the average health insurance premium costing more in the U.S. than in other parts of the world, fewer patients having access to quality care and proof from the U.S. Centers for Disease Control that 59 million lacked health insurance for at least part of 2010, there’s no doubt that we have work to do to improve our system.

Unfortunately, until much of this is straightened out, we may have to admit the U.S. is at least temporarily behind the curve when comparing health care and insurance against the rest of the world.