The senior population will be doubling over the next twenty years, making it increasingly important to take a closer look at the issues the U.S. healthcare system is currently up against in relation to patient costs and outcomes. The Commonwealth Fund carried out a cross-national comparison to help track the performance of the U.S. healthcare system, and ultimately better identify areas needing improvement. Aspects of the study focus on comparing costs and outcomes of patients in the U.S. to those in other, similarly developed countries.
In particular, working-age adults and seniors tended to have the most difficulty managing out-of-pocket costs. In 2013, seniors over 65 totaled 44.7 million, accounting for 14.1% of the total U.S. population. By 2060, this group will have doubled to about 98 million seniors– many of which will be struggling to afford health care costs. Currently, 75% of adults over 50 take prescription medications on a regular basis. 39% take at least two drugs, with 20% taking six or more drugs. These numbers continue to rise with age– 86% of seniors take prescription medications on a regular basis. 35% take 2-3 drugs, with 29% taking 4-5 drugs, and 24% taking 6+ drugs.
Furthermore, 4 in 10 adults over 50 are currently concerned about being able to afford their medications, with 23% of these adults choosing not to fill a prescription within the last 2 years because of high costs. Additionally, 1 in 5 seniors skipped a doctor’s visit, test or prescribed medication because of the cost.
Particularly focusing on pricing data included in the study, findings suggest that prices for health care in general are significantly higher in the U.S. In 2013, the average U.S. adult spent $1,074 on out-of-pocket healthcare costs (copayments, premiums, deductibles and prescription drugs). To put these costs into perspective– residents of France and the Netherlands spent less than 25% as much as the U.S.
Despite its heavy investment in health care, the U.S. sees poorer results on measures such as life expectancy and the prevalence of chronic conditions. Essentially, the U.S. spends the most on healthcare, yet has the worst outcomes on its citizens’ health.
In 2013, 68% of U.S. adults over the age of 65 had at least 2 chronic conditions. In other countries, this figure ranged from 33% to 56%. Additionally, the life expectancy rate was an average of 78.8 years, compared to the 2nd-highest spending country, France, which had an average life expectancy of 4 more years.
It’s clear the U.S. healthcare system’s structure is lagging when compared to those in other countries at similar developmental stages. Breaking down the differences, the U.S. is one of the few countries without a publicly financed universal health system, yet still manages to spend more on healthcare than any other. In 2013, the U.S. spent 17.1% of its gross domestic product (GDP) on healthcare, averaging out at $9,086 per person. This rate is 50% higher than the next-highest spender.
Previous findings suggest that seniors with Medicare coverage actually fare better than working-age adults, potentially suggesting the success of a publicly financed universal health care system, one that mirrors similarly developed countries faring better than the U.S.
In the meantime, it’s important to fill the healthcare gaps our country is suffering from as best we can to help improve patient outcomes and lower costs. Pharmacies are in a very unique position to enact major change in these areas. Pharmacists are arguably the most knowledgeable professionals when it comes to prescriptions and patient adherence to those drugs. While it may take years for significant change to take place to lower patient costs and improve outcomes, it’s important to stay proactive and work towards improving the healthcare system with the resources currently available.