How Does U.S. Senior Healthcare Compare to Other Parts of the World?

Posted by Donna Mae Scheib on May 31, 2018

How Does U.S. Senior Healthcare Compare to Other Parts of the World?

Medicare is used by over 58 million people in the United States, with over 49 million of these beneficiaries being over the age of 65. According to a 2014 survey completed by a private organization called the Commonwealth Fund that focused on Medicare, the United States healthcare coverage for seniors seems to fall behind 10 other countries including Australia, Germany, United Kingdom, Switzerland, and Canada. Providing quality healthcare is not an easy feat and requires a complex solution.  Do you use Medicare? What are your thoughts on some of the challenges you have faced navigating Medicare, one of the most used resources of our nation’s health system? What are some ideas or strategies that could be part of a better solution for all?

What is Universal Healthcare?

The World Health Organization (WHO) defines universal healthcare coverage as a way that “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship” There are three objectives related to this topic:

• Equity to health services: everyone has access to care, not just those that can pay for it
• Quality: Health services should help to improve health
• Protection against financial risk: those that use health services aren’t put at financial harm

As healthcare looks different in every part of the world, as we move forward it is good to recognize both the good and bad as well as what works and doesn’t work when applied. Reviewing the survey mentioned earlier by the Commonwealth Fund is one way to see a broadened perspective of our own healthcare system as well as others around the world. Let’s consider some of the positive and negative outcomes of the survey.

Pros

• The United States ranked highest in health professionals discussing wellness factors with patients. For example, doctors talking with seniors about the importance of nutrition, exercise, and other health-promoting habits.
• American seniors were more likely to receive good direction and advice from doctors about managing chronic illnesses
• Establishing a written advanced care health plan and end of life wishes were highly ranked  in  the United States compared to other nations

Cons

• American seniors end up in after-hours emergency room care more than other countries which results in high medical costs, whereas in a country like the Netherlands, it is more common for doctors to make house calls for the elderly (around the 90% mark).
• In the United States, those aged 65 and older were more likely than those in other countries to skip recommended medical assessments, treatments, prescriptions, and other forms of care due to the financial cost of receiving help.
• The US leads in having the sickest elderly population as proportionally more seniors have two or more chronic conditions and take at least four prescription medications than those in other countries.
• American seniors are also more likely than seniors in other countries to struggle to have basic needs like housing met
• Americans pay the most out of pocket for care and rank highest in healthcare spending costs per person ratio; we are paying the most for healthcare without necessarily seeing the most improvement compared to other countries.

What Do Seniors Think of Medicare?

Often, American seniors are content with Medicare because for many before turning 65, were underinsured and didn’t receive health benefits that people in other countries have received their whole lives. This reasoning could also contribute to why American seniors have more chronic illnesses and are categorized as “most sick” because many health conditions were left untreated for much of their adult lives.

Although there are advantages for seniors using Medicare, there are also downsides. Medicare is complex and is very hard to navigate for both patients and health professionals alike. Every year there are different rules and things change to what is covered and what is not covered. So even though a patient may be using a medicine and a treatment plan that has worked well and then the following year it becomes no longer covered, they are left paying out of pocket costs or healthcare professionals must find a different treatment plan that is hopefully just as effective as the current one, so the patient is not financially burdened. Patients may also have to wait quite awhile to receive the care they need such as rehabilitative therapy or even being properly set up to receive oxygen.

How to approach healthcare in the United States is often a hotly debated (often political) topic. Every country shares similar frustrations and problems with helping those that need quality care. As it is a broad and complex issue not only for those 65 and older but for all stages of life, what do you think are some ideas that can offer a more promising solution?

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