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Informing Policy. Advancing Health.

Access and Cost: Where Does the US Stand?

The Fourth of July and all of the grilling and fireworks may be over. But it’s not too late for us to have a little data-related fun.

In honor of the United States’ 238th birthday, the CHI team decided to compare data between the United States and other countries to see how we stack up in terms of health care access. And, because we are always interested in where Colorado stands, we included state data as well.

A 2014 report by the Commonwealth Fund ranked 11 countries – Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States – in the areas of equity, access and efficiency.

Results showed room for improvement for the United States, especially in cost-related access.

The United States ranked last overall and last in each of the cost-related access problem categories. More than one of three (37 percent) of Americans reported that they did not fill a prescription, skipped a recommended medical test, treatment or follow-up, or had a medical problem but did not visit a doctor or clinic in the past year because of cost. In comparison, the highest ranking country – the United Kingdom – had four percent of respondents report these access problems.

The Colorado Health Access Survey (CHAS) asks similar questions about cost-related access, though it should be noted that differing methodology means these numbers cannot be directly compared. In 2013, 12.3 percent of Coloradans said they didn’t get needed doctor care due to cost. Additionally, 19.3 percent didn’t get needed dental care and 11.9 percent didn’t get specialist care. 

More than one of five Americans (23 percent) said they had serious problems paying or were unable to pay medical bills, according to the Commonwealth Fund study, putting the U.S. last of the 11 countries. The United Kingdom, again, stole the top spot in this category with one percent of those in the UK reporting problems or inability to pay. Here in Colorado, 18.1 percent of Coloradans reported having problems or being unable to pay their medical bills.

With recent changes to the health care system in the United States, all eyes will be on data in the upcoming years to see the impact. For Colorado-specific changes, keep an eye out in 2015 for the next CHAS. 

Access and Cost Graphic