[Ip-health] US: 42% of chronically ill adults skip care because of costs

[Manon Ress]

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[ Picked text/plain from multipart/alternative ]
NYT Editorial
http://www.nytimes.com/2007/11/01/opinion/01thu3.html?
_r=3D1&ref=3Dtodayspaper&oref=3Dslogin

America=92s Lagging Health Care System

Published: November 1, 2007

Americans are increasingly frustrated about the subpar performance of
this country=92s fragmented health care system, and with good reason. A
new survey of patients in seven industrialized nations underscores
just how badly sick Americans fare compared with patients in other
nations. One-third of the American respondents felt their system is
so dysfunctional that it needs to be rebuilt completely =97 the highest
rate in any country surveyed. The system was given poor scores both
by low-income, uninsured patients and by many higher-income patients.

The survey, the latest in a series from the Commonwealth Fund, is
being published today on the Web site of Health Affairs, a respected
health policy journal. Researchers interviewed some 12,000 adults in
Australia, Canada, Germany, the Netherlands, New Zealand, the United
Kingdom and the United States.

Given the large number of people uninsured or poorly insured in this
country, it was no surprise that Americans were the most likely to go
without care because of costs. Fully 37 percent of the American
respondents said that they chose not to visit a doctor when sick,
skipped a recommended test or treatment or failed to fill a
prescription in the past year because of the cost =97 well above the
rates in other countries.
SNIP

On Health Affairs:

http://content.healthaffairs.org/cgi/content/full/26/6/w717#SEC3

EXHIBIT 6 Experiences Of Patients With Chronic Conditions In Seven
Countries, 2007
snip
Chronically ill adults were also often taking complex medication
regimens. Half or more of adults in each country reported taking two
or more medications regularly, with one-fifth to two-fifths (United
States) taking four or more. Among those with regular medications,
differences in insurance coverage across countries resulted in marked
differences in out-of-pocket spending for prescription drugs. U.S.
patients were the most exposed, with more than two-fifths spending
$500 or more a year=97a rare occurrence in the Netherlands or the
United Kingdom. Relatively high percentages of chronically ill
patients in Australia and Canada also reported spending at this level.

Affordability was of particular concern in the United States, where
42 percent of chronically ill adults said that they had skipped
medications, not seen a doctor, or forgone recommended care because
of costs=97a rate two to eight times higher than rates in the other
countries. Asked specifically about care/advice for their chronic
conditions, U.S. patients were the most likely to report a time when
they did not adhere to medical advice and to name cost as the reason.
In the other countries, the main reasons given for not adhering were
lack of agreement or that it was too difficult.




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Manon Anne Ress
manon.ress@keionline.org,

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Il vaut mieux remuer une question, sans la d=E9cider, que la d=E9cider,
sans la remuer.
Pens=E9es, essais, maximes et correspondance de J. Joubert  p.249
http://visualiseur.bnf.fr/Visualiseur?Destination=3DGallica&O=3DNUMM-88671
Translation: It is better to debate a question without settling it
than to settle a question without debating it