Even with near-universal Medicare coverage, older adults in the U.S. face substantial financial barriers to accessing necessary medical care. A new Commonwealth Fund survey highlights the growing strain of medical debt on this demographic, with implications for health outcomes and debt collection trends.
By the numbers:
- Nearly 1 in 4 older Americans spent at least $2,000 out-of-pocket on healthcare in the past year, compared to less than 5% in France and the Netherlands.
- 33% of U.S. older adults with cost-related access issues reported being in fair or poor health.
- U.S. seniors were among the most likely to skip prescriptions or doses due to costs, at more than double the rate of most other surveyed countries.
- About 20% of older Americans delayed dental care because of expenses, a trend shared with Canada and Australia but far higher than the 5% or less reported in Germany and the Netherlands.
The big picture: While Medicare Advantage plans offer some cost caps and expanded coverage for services like vision and dental, affordability gaps persist. Traditional Medicare’s lack of out-of-pocket spending limits and limited dental coverage exacerbate these issues.
Between the lines: Forgoing care leads to worsening health outcomes, which, in turn, increases overall healthcare costs — a vicious cycle that affects not only patients but also healthcare providers, insurers, and debt collectors.
What’s next: Cost-cutting reforms, like those in the Inflation Reduction Act, aim to alleviate some burdens through prescription drug price caps and expanded subsidies. However, the survey underscores the need for comprehensive policy shifts to bring U.S. healthcare affordability on par with other high-income nations.
