In fact, nearly 1 in 5 seniors skipped a doctor's visit, test or a prescribed medication because of the out-of-pocket cost, far more than any other country looked at in the Commonwealth Fund survey.
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Older Americans are also more likely than counterparts in most of those countries to have problems getting a same-day or next-day appointment with their doctor, and having to go to the ER instead when they get sick, according to the survey, which is detailed in an article being published by the journal Health Affairs on Wednesday.
On the bright side, senior citizens in the U.S. had better luck than those in other countries in how their chronic illnesses are managed, communications with doctors and transitioning from the hospital back to home. And, notably, 86 percent of older U.S. adults said they could get an appointment with a specialist within one month—significantly better than any other country in the survey besides Switzerland, which had an 82 percent success rate on that question.
But the worse outcomes for Americans age 65 or older come despite the fact that they are the one group in the U.S. that has near-universal health coverage, in the form of the Medicare insurance program administered by the federal government. The other countries surveyed by the Commonwealth Fund all have some form of universal health coverage.
"Previous surveys have shown that older people with Medicare coverage fare better than working-age adults in the U.S.," said Robin Osborn, vice president of the Commonwealth Fund's international health policy program.
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"The new survey shows that there are areas, such as managing patients who have chronic illnesses and hospital discharge planning, where the U.S. does well compared to other countries," Osborn said. "However, older Americans struggle more to get and afford the health care they need, indicating the need to improve Medicare's financial protections."