“In no other country does income inequality so profoundly limit access to care as it does here,” Blumenthal said. “Far too many people cannot afford the care they need and far too many are uninsured, especially compared to other wealthy nations.”
Half of lower-income US adults reported that they did not receive care because of the cost, compared to just over a quarter of higher-income Americans, the study found. In the United Kingdom, only 12% of people with lower incomes and 7% with higher incomes said they faced such financial barriers.
What’s more, a high-income American was more likely to report financial hurdles than a low-income person in nearly all the other countries surveyed — which include Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the UK.
Norway, the Netherlands, and Australia were the best performers in the study, which looked at access to care, health care outcomes, administrative efficiency, equity and care process, which includes preventative care, patient engagement and other metrics.
And the nation landed at the bottom when it came to administrative efficiency because of the time providers and patients have to spend dealing with paperwork, duplicative medical testing and insurance disputes.
The one area in which America excelled was care process, where it earned second place. The nation outperformed in terms of rates of mammography screening and influenza vaccination for older adults as well as the share of adults who talked with a health care provider about nutrition, smoking and alcohol use.
Adults in the US and Norway reported the highest usage of web-based portals for communicating medical concerns and refilling medications. And among those with chronic illness, American adults were among the most likely to discuss goals, priorities and treatment options with their providers, though less likely to receive as much support as they felt was needed.