The U.S. has the most powerful military in the world, is home to many of the globe's top universities, has the highest per-capita GDP of any developed country, and has the eyes of the world upon it at all times. However, the past few weeks haven't been so kind to America.
Last week China overtook America to become the largest economy in the world, and The Commonwealth Fund released an extensive report on America's senior citizens which uncovered that relative to 10 other developed countries America's senior citizens face significant shortcomings in their access to medical care.
America's seniors pull the short stick
Medicare covers 80% of the medical expenses of those aged 65 and up, but this program lags far behind its peers.
The Commonwealth Fund's study found that senior citizens in the U.S. were the mostly likely to have trouble meeting their medical bills. In the U.S., 11% of seniors noted difficulty in keeping up with medical costs. Comparatively, just 1% of respondents in Norway and Sweden noted an inability to keep up with their medical bills.
Expounding on the first point, close to one-in-five American seniors noted that they'd put off medical care because of out-of-pocket costs. This was nearly double the second-highest country, New Zealand, and more than 500% higher than France, where just 3% of respondents admitted to holding off on medical treatment because of cost.
American seniors also ranked with residents of Canada, Sweden, and Norway for being the least likely to be able to get in to see their primary care physician on the same day or the following day when sick. In the U.S. just 57% of study participants admitted to being seen the same day or the following day if sick.
And there's more...
The United States also stood out for having the highest rate of chronic health conditions, like diabetes and heart disease, among its seniors. Seven out of eight (87%) U.S. seniors reported having one chronic health condition with 68% of respondents noting they had an additional two chronic health conditions. Canada was the next-closest country with 83% of respondents claiming at least one chronic health problem and 56% claiming two or more.
What this could mean
One frightening implication of The Commonwealth's study is what might happen to insurers over the long run. Although Medicare covers 80% of seniors' medical costs, chronic diseases are the ultimate nightmare of insurers since they can increase patient care costs considerably over the long run. The Centers for Disease Control and Prevention lists direct coronary heart disease costs at $108.9 billion per year in the U.S., while the American Diabetes Association lists diabetes' direct and indirect costs (i.e., productivity losses) at $245 billion annually as of 2012.
The study itself didn't look into the specifics of why chronic health conditions are so prevalent in the U.S., but I can certainly offer a few guesses.
First, and seemingly paradoxically, it could partly be due to the high standard of living in the U.S. With high per-capita incomes Americans have easier access to potentially fattier foods than many other nations. In other words, blame our diet! Secondly, at least within the scope of this 11-country study, Americans are the most prone to put off medical procedures due to their cost. Therefore, this delay could be responsible for the development of chronic conditions later in life. Lastly, I have to wonder if seniors' inability to regularly be seen quickly by their primary care physicians might play a part in exacerbating their chronic conditions.
Another concern is how the Affordable Care Act, known better as Obamacare, could affect patient care moving forward. As of mid-October there were 6.7 million paying Obamacare enrollees per the Department of Health and Human Services. According to Gallup, this lowered the uninsured rate to 13.4%. If these newly insured individuals begin to regularly see their doctor for preventative care reasons, it could be even tougher for seniors to get an appointment with their primary care physician.
Will these companies benefit?
Several Medicare Advantage policy providers, such as Humana, Universal American, Health Net, and Anthem (formerly known as WellPoint), could actually see a benefit if this study's findings are true across a wider scope of the U.S. population. These companies derive in the neighborhood of 60%, 75%, 25%, and 25%, respectively, of their annual revenue from Medicare Advantage plans.
Medicare Advantage plans offer the same coverage as Medicare, but they can come with added perks, such as better out-of-pocket coverage for prescriptions, and they can cover other routine visits like dental and eye exams. As medical costs rise, seniors may turn to these plans in increasing numbers simply as added financial protection for when they do seek medical care. I don't expect these insurers would see an overnight benefit mind you, but instead a gradual increase in members each year, especially as baby boomer retirements kick into high gear.
What we do know is the data has spoken and it suggests that Congress and our healthcare system as a whole still have a lot of work to do to ensure our seniors are getting the best care possible. America may be the world's greatest superpower, but the medical care being provided to our nation's elderly is far from the best.