Older Americans Face Higher Health Care Costs Compared to Other Nations

In the United States, older Americans face significant challenges in accessing affordable health care despite being covered by Medicare.

Unlike countries with universal health care systems, where costs are largely managed to ensure accessibility, Medicare often leaves seniors with high out-of-pocket expenses that make necessary treatments unaffordable for many. 

A recent study by The Commonwealth Fund highlights these disparities, revealing that nearly one in four older Americans spent at least $2,000 on out-of-pocket medical expenses in the past year. In contrast, fewer than 5% of seniors in France and the Netherlands reported similar spending levels, showcasing the affordability gaps between the U.S. and other wealthy nations.

While Medicare ensures that most Americans over 65 have some form of health insurance, the study suggests it does not provide comprehensive or affordable coverage compared to health care systems in countries like Australia, Canada, Germany, Sweden, Switzerland, and the United Kingdom. In fact, only in Switzerland did older adults report higher out-of-pocket health care costs than in the U.S.

This financial strain forces many seniors to make difficult decisions about their health care. Approximately 8% of older Americans delayed or skipped medical care due to costs, a figure higher than in most other developed nations.

This lack of access has serious consequences: one-third of older adults who face cost-related barriers to care report being in fair or poor health, further exacerbating their medical needs.

The study also points out that many Medicare Advantage beneficiaries face unexpected expenses when visiting out-of-network doctors. These added costs create significant financial burdens, especially for seniors who already struggle to manage their health care expenses.

Prescription drugs are another area where costs weigh heavily on older Americans. Many report skipping medications due to the high prices, which can lead to worsened health outcomes and increased long-term medical expenses.

Interestingly, mental health care was identified as an area where affordability is less of an issue for Medicare beneficiaries.

Fewer than 5% of seniors in any of the nations studied, including the U.S., skipped mental health treatments due to cost concerns. This exception demonstrates how making specific services affordable can significantly increase access and encourage people to seek the care they need.

The Commonwealth Fund suggests several reforms to address these affordability challenges. Key recommendations include capping out-of-pocket expenses for seniors and fully covering essential hospital and physician services under Medicare. 

These strategies are already in place in many countries with universal health care systems and could help reduce the financial burden on older Americans. The study argues that improving the affordability of health care would not only enhance the well-being of older adults but also reduce overall Medicare spending.

By ensuring that seniors receive timely and necessary care, the system could prevent the progression of untreated conditions, which often require more expensive treatments later.

"Having health insurance is just the first step," said Munira Z. Gunja, senior researcher at The Commonwealth Fund.

"For coverage to be effective, it must also be affordable and comprehensive." As health care costs continue to rise, reforming Medicare to align with global best practices could provide a sustainable path forward for the U.S. health care system.