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Thursday, November 13, 2014

Equitable Access to Care — How the United States Ranks Internationally

Karen Davis, Ph.D., and Jeromie Ballreich, M.H.S.
N Engl J Med 2014; 371:1567-1570
October 23, 2014
DOI: 10.1056/NEJMp1406707

Here are two excerpts:

According to a 2013 Commonwealth Fund survey of adults in 11 high-income countries, the United States ranks last on measures of financial access to care as well as of availability of care on nights and weekends. Uninsured people in the United States are particularly likely to report encountering barriers to care.


The United Kingdom, France, Germany, Norway, Sweden, and Switzerland stand out as leaders in ensuring equitable financial access to care. Switzerland, which provides coverage through nonprofit private insurance plans with deductibles, ensures that cost sharing is lower for lower-income individuals. The United Kingdom, Norway, and Sweden have public health care systems for the entire population with little or no patient cost sharing and allow a limited role for private insurance. France has a public insurance system, and Germany has a social insurance system with competing private “sickness funds.”