How Health Insurance Design Affects Access To Care And Costs, By Income, In Eleven Countries
1 Cathy Schoen is senior vice president for policy, research, and evaluation at the Commonwealth Fund, in
2 Robin Osborn is a vice president at the Commonwealth Fund and director of its International Program in Health Policy and Innovation.
3 David Squires is a program associate for research and programs in the International Program in Health Policy and Innovation, Commonwealth Fund.
4 Michelle M. Doty is assistant vice president and director of survey research at the Commonwealth Fund.
5 Roz Pierson is a vice president at Harris Interactive, in
6 Sandra Applebaum is a research manager at Harris Interactive.
Health Affairs, doi: 10.1377/hlthaff.2010.0862 - Published online November 18, 2010
Available online at: http://bit.ly/9ZwmGF
“……This 2010 survey examines the insurance-related experiences of adults in
The countries all have different systems of coverage, ranging from public systems to hybrid systems of public and private insurance, and with varying levels of cost sharing.
Overall, the study found significant differences in access, cost burdens, and problems with health insurance that are associated with insurance design. US adults were the most likely to incur high medical expenses, even when insured, and to spend time on insurance paperwork and disputes or to have payments denied.
Germans reported spending time on paperwork at rates similar to US rates but were well protected against out-of-pocket spending. Swiss out-of-pocket spending was high, yet few Swiss had access concerns or problems paying bills. For US adults, comprehensive health reforms could lead to improvements in many of these areas, including reducing differences by income observed in the study….”.
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