Half of lower-income adults in the US don’t go to the doctor for this reason

The United States is one of the wealthiest countries in the world, yet when compared to other high-income countries, the Unites States comes in last in access to healthcare, equity, and outcomes, according to a report released this week. That’s despite spending far more of its gross domestic product on health care than the other countries, according to the study. 

The Commonwealth Fund ranks high-income countries based on access to care, care process, administrative efficiency, equity, and health care outcomes. The U.S. has come in last every year since 2004, when the organization began tracking results. The main reason is that the U.S. is the only country of the 11 on the list that does not have universal health insurance coverage. The other countries are Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom. 

Health insurance in the United States does not provide enough protections, which compromises Americans' health and finances, David Blumenthal, president of the Commonwealth Fund, told CNN. That means people are forced to skip care or take on medical debt. 

In fact, half of lower-income adults in the U.S. reported that they did not receive care because of the cost, compared to only 12% of lower-income adults in the United Kingdom. About 25% of higher-income Americans said they would forgo care because of cost, and 7% in the U.K. 

"In no other country does income inequality so profoundly limit access to care as it does here," said Blumenthal. "Far too many people cannot afford the care they need and far too many are uninsured, especially compared to other wealthy nations."

It’s not only lower-income Americans impacted. The study found that a high-income American was more likely to report financial hurdles than a low-income person in all other countries surveyed.

Norway, the Netherlands and Australia scored highest in the study. The U.S. also ranked poorly on maternal mortality, infant mortality, life expectancy, deaths that were preventable with timely access to care,  and administrative efficiency. 

The U.S. did excel in the care process, taking second place. Rates of mammography screening, flu vaccination for older adults, and the number of adults who talked to a health care provider about nutrition, smoking and alcohol use was higher than other countries.