This study missed our radar when it was published last fall, but now we’re paying attention.  According to the Commonwealth Fund, paying medical bills is still a challenge for more than one-third of Americans.  Adults in the U.S. are more likely than those in 10 other countries to go without needed health care because of costs. One-third (33%) of U.S. adults went without recommended care, did not see a doctor when sick, or failed to fill a prescription because of costs.  Even though there has been a decrease since 2016,  the percentage is higher than in other countries, such as the United Kingdom and Germany.  Also, half of U.S. adults have struggled to get health care on weekends or evenings without going to the emergency room.

The researchers note, “Although the U.S. has made significant progress in expanding insurance coverage under the Affordable Care Act, it remains an outlier among high-income countries in ensuring access to health care.”  That is because, the authors note, all of the other countries surveyed provide universal insurance coverage, and many provide better cost protection and a more extensive safety net.

Speaking of safety net, the value of Community Health Centers is that they not only now reach 25 million people (or 1 in 13 Americans), they also make health care more affordable and effective. Services are offered on a sliding scale basis and the care is also cost-effective. For instance, a patient visit is a fraction of the cost of an emergency room visit, on average a dollar less per patient a day compared to all other physician settings, according to this NACHC fact sheet. The care is also accessible in medically underserved communities and that is an important consideration when factoring in the need to put more health centers in medically underserved communities.  And certainly the need is there, according to the Commonwealth Fund researchers.  The bottom line, they write, is that people in the United States “remain more likely to go without needed health care because of costs compared to adults in other high-income countries.”

The 2016 survey, published in Health Affairs,  covered adults in 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.