Medicare Coverage Poses Affordability Challenges for Older Americans
While Medicare provides health insurance for most Americans over 65, a new study reveals that high out-of-pocket costs force many to skip necessary care. The US, unique among wealthy nations without universal healthcare, falls short when it comes to making healthcare affordable for seniors. A recent analysis by The Commonwealth Fund, a non-profit focused on promoting equitable healthcare, highlighted these cost burdens. Compared to seniors in nine other wealthy nations, Americans pay significantly more for healthcare, leading many to forgo doctors’ visits and necessary medications.
Nearly 25% of US seniors spent at least $2,000 on healthcare out-of-pocket, compared to less than 5% in France and the Netherlands. Only Switzerland, the study found, had higher out-of-pocket costs.
“Nearly every senior in the US has Medicare, and that beats the systems in nations where seniors face higher uninsured rates,” noted Munira Z. Gunja, senior researcher for international health policy and practice innovations at The Commonwealth Fund. However, he added, “Medicare doesn’t go as far in the US as what seniors get in other high-income countries.”
The study underscores the gap in affordability between the US healthcare system and those of other developed nations.
Gunja emphasized that deductible payments and the rising costs of prescription drugs put a significant financial strain on US seniors.
“We find that while almost every older adult has Medicare coverage, it costs more than for seniors in most other high-income countries, leading US seniors to skip care they need,” Gunja explained.
Similarly, Medicare Advantage members often find themselves seeing out-of-network doctors, leading to prohibitively expensive medical bills.
Mental Healthcare Access: An Exception
Mental
healthcare stands out as the only area where Medicare beneficiaries faced significantly less cost barriers. Nearly all surveyed Americans had access to mental health services without the financial strain prevalent other areas of healthcare. Less than 5% of people in these countries reported skipping mental healthcare due to costs.
Cells
This highlights the critical importance of affordability when it comes to accessing crucial medical attention. When people have the financial ability to access care, they are more likely to seek help.
Gunja suggests the US look to other developed countries for cruc crucial strategies to make healthcare more affordable for seniors. Some ideas include capping out-of-pocket expenses and providing full coverage for hospital and physician services. “Across the board, the US generally ranks last for most affordability measures,” Gunja remarked.
“Gaining healthcare is crucial, but it is just the first step,” Gunja emphasizes. “We need to ensure that coverage is not just comprehensive but also affordable.”
By circling offering more affordable health insurance
options, The Commonwealth Fund suggests, the US can improve the healthcare experience of aging Americans and ensure they can access the care they need without facing financial hardship.
– What specific policy changes could be implemented in the US to make Medicare more affordable for seniors, as seen in other successful healthcare systems?
## Medicare: Affordable in Name Only?
**Host:** Welcome back to the show. Today, we’re discussing a troubling new study on the affordability of healthcare for American seniors. Joining us is Munira Z. Gunja, senior researcher for international health policy and practice innovations at The Commonwealth Fund, the organization behind this important research. Munira, thank you for being with us.
**Munira Gunja:** Thanks for having me.
**Host:** Your study paints a stark picture of the struggles many older Americans face when it comes to accessing necessary healthcare. Can you elaborate on the key findings?
**Munira Gunja:** Certainly. While Medicare is a crucial safety net for seniors, covering most Americans over 65, it falls short when it comes to affordability compared to other developed nations. The study found that nearly 25% of US seniors shell out at least $2,000 out-of-pocket for healthcare, a significantly higher burden than in countries like France and the Netherlands, where less than 5% face such costs. [1](https://www.medicare.gov/basics/costs/help)
**Host:** That’s a staggering difference. What are the primary drivers of these high out-of-pocket costs for American seniors?
**Munira Gunja:** Several factors contribute to this. Deductibles, copays, and the rising cost of prescription drugs put a significant strain on seniors’ fixed incomes. This often forces them to make difficult choices between paying for medications, seeing a doctor, or covering other essential expenses.
**Host:** So, even with Medicare coverage, many seniors are effectively priced out of essential healthcare. What are the potential consequences of this?
**Munira Gunja:** The consequences can be serious. Skipping necessary medical care can lead to worsening health conditions, ultimately requiring more expensive interventions down the line. It can also lead to a decline in overall quality of life and increased financial stress.
**Host:** You mentioned that Medicare doesn’t go as far as healthcare systems in other high-income countries. What lessons can the US learn from these nations?
**Munira Gunja:** Many other developed countries offer more comprehensive coverage, including lower out-of-pocket costs for prescription drugs and services.
They often have mechanisms to negotiate drug prices with pharmaceutical companies, leading to significantly lower costs. These examples demonstrate that providing affordable healthcare for all seniors is achievable, and the U.S. can learn from their successful models.
**Host:** Thank you for shedding light on this important issue, Munira. Clearly, much work remains to be done to ensure that all American seniors have access to the affordable healthcare they deserve.
**Munira Gunja:** Thank you for having me. I hope this conversation will encourage further dialog on how we can improve the affordability of healthcare for our aging population.
