Uncovering the Healthcare Disparities Among Older Americans
Medicare's Cost-Sharing Requirements
The new report emphasizes how Medicare, the public health insurance program for those aged 65 and above and the disabled, has substantial cost-sharing obligations. These include co-pays, deductibles, and no cap on out-of-pocket expenses. As a result, even though nearly all older adults in the US are covered by Medicare, there are areas where the program can be improved. In some countries, almost no older adults skip or delay care due to cost.For example, traditional Medicare lacks many essential benefits that older Americans and disabled people need, such as vision, dental, and hearing care, as well as long-term or home care. While Medicare Advantage offers some of these benefits, it has faced criticism for unfairly denying care and being overly costly. It has even been the target of federal fraud investigations.
Conservatives have proposed further privatization of Medicare by implementing "default enrollment" in Medicare Advantage. The president-elect, Donald Trump, promised "no cuts" to the program in the official Republican platform, but the details remain unclear.
Medicare Programs and Their Implications
Medicare is available through two main programs - traditional Medicare, also known as "fee-for-service", and Medicare Advantage managed by private insurers. Each program has its own set of advantages and disadvantages. Traditional Medicare may lack certain benefits, but it provides more flexibility. Medicare Advantage, on the other hand, offers additional benefits but has faced criticism for its practices.For instance, in terms of healthcare access and outcomes, the US has the most expensive health system in the world. Despite the high prices, it performs poorly on metrics such as health equity, accessibility, and outcomes. Rising costs are forcing many older Americans to pay more out of pocket, which leads to delayed care, poorer health, and higher long-term spending.
Data from the Commonwealth Fund's international survey of older adults shows that almost a quarter of older adults in the US spent $2,000 or more on healthcare in the past year, compared to less than 5% in France and the Netherlands. Similarly, older adults in the US reported the highest levels of cost barriers to care, although less than 10% actually encountered such barriers. In contrast, one in five older adults in the US, Australia, and Canada reported skipping needed dental care, while in the Netherlands and Germany, the rate was less than 5%. Less than 5% of adults in all countries reported skipping needed mental health care due to cost.
Comparing Healthcare Across 10 Countries
The Commonwealth report used data from its international survey to compare health benefits across 10 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and the United States. This comparison highlights the differences in healthcare systems and their impact on older adults.It becomes evident that different countries have different approaches to healthcare for older adults. Some countries have managed to provide better access and affordability, while others still face challenges. Understanding these differences can help inform policy decisions and improve healthcare for older Americans.
Overall, this study emphasizes the importance of Medicare for older adults in the US but also highlights the need to address the challenge of affording needed care. By examining these issues in detail, we can work towards finding solutions to improve the healthcare situation for older Americans.