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Access to Care

Posted 10/24/2014

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  Anyone who has been diagnosed with cancer immediately becomes an active participant and an active critic of our healthcare system. Anyone who pays any attention to the news is well aware that health care costs are climbing rapidly, and that there is increasing concern about the need to slow the rise--and even reduce costs. Our country cannot sustain the situation as it stands. Most of us know that and we surely care about the nation and the world that we leave for our children and grandchildren--but we also want access to the best possible care for ourselves and those whom we love.

  It makes no sense that the US, the wealthiest country in the world, the self-proclaimed champion of liberty and democracy and human rights has a terrible record around access to healthcare. In fact, a recent survey by The Commonwealth Fund ranks the US last among wealthy nations in providing access to care to all citizens. Within the US, there are enormous regional differences.

  We are very lucky in Boston and in Massachusetts. Thanks to the efforts of Mitt Romney some years ago, we have universal health care and a number of good insurance plans available to all MA residents. People who live here who are undocumented do not have access to these plans, and I will avoid getting into the politics of that reality. (Since I am a social worker, you can probably guess what my view is). In MA, if you are diagnosed with cancer, you do have access to excellent care. In Boston, you have choices among several world-class cancer care facilities. There is no better place to be a cancer patient.

  This is not to say that people being treated in MA or in Boston for cancer don't have high medical expenses; many do. As I have been writing about this week, there are often high co-pays and deductibles and other related costs. But there are plenty of people, sadly, around the country who can't access similar care at any cost.

  This is a fine article from Consumer Health Day about this critical problem. This is an issue that directly affects you and me. Pay attention.

U.S. Ranks Last Among Wealthy Nations in Access to Health Care

The U.S. health care system ranks dead last compared to other industrialized nations when it comes to affordability and patient access, according to a new survey.
The 2013 survey of the American health care landscape was conducted by the Commonwealth Fund just prior to full implementation of the Obama administration's Affordable Care Act (ACA).
"I would say that we found two things that really seem to drive the higher barriers to health care in the U.S.," said David Squires, a senior researcher with the Commonwealth Fund in New York City.
"The first is that we have a huge uninsured population, which at least at the time of the survey was about 50 million people. And, the second is that we have millions more who have some kind of insurance, but the coverage isn't really good enough to protect them fully if they actually become ill," explained Squires.
"And these two issues don't really exist in any of the other countries we looked at. They all have universal health insurance," he noted.
"So everyone has access and the insurance they have is generally much more protective. It covers more costs and either has no copays or relatively modest co-pays. And there's a ceiling on what a patient would have to pay in any one year, if anything," Squires said.
"That's a huge difference from the American experience. In addition, the U.S. is just a much more expensive health care system. We spend about $9,000 per person a year. That compares, for example, with just $3,000 a year in the U.K., and is overall about 50 to 200 percent more than is spent on our peers in other Western nations. So even if an American has insurance it's still in the context of an extremely expensive situation," Squires added.
The new survey is the subject of a perspective analysis, written by Karen Davis and Jeromie Ballreich of Johns Hopkins, and published in the Oct. 23 issue of the New England Journal of Medicine.
The survey included Canada, Australia, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States.




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