Commonwealth Fund, New York City, NY, USA.
Health Aff (Millwood). 2010 Dec;29(12):2323-34. doi: 10.1377/hlthaff.2010.0862. Epub 2010 Nov 18.
This 2010 survey examines the insurance-related experiences of adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United States, and the United Kingdom. The countries all have different systems of coverage, ranging from public systems to hybrid systems of public and private insurance, and with varying levels of cost sharing. Overall, the study found significant differences in access, cost burdens, and problems with health insurance that are associated with insurance design. US adults were the most likely to incur high medical expenses, even when insured, and to spend time on insurance paperwork and disputes or to have payments denied. Germans reported spending time on paperwork at rates similar to US rates but were well protected against out-of-pocket spending. Swiss out-of-pocket spending was high, yet few Swiss had access concerns or problems paying bills. For US adults, comprehensive health reforms could lead to improvements in many of these areas, including reducing differences by income observed in the study.
这项 2010 年的调查研究了澳大利亚、加拿大、法国、德国、荷兰、新西兰、挪威、瑞典、瑞士、美国和英国成年人的保险相关经验。这些国家的医疗保险制度不尽相同，有的是公共系统，有的是公私混合系统，费用分担程度也有所不同。总体而言，研究发现，与保险设计相关的保险获取、费用负担和保险问题存在显著差异。即使有保险，美国成年人也最有可能产生高额医疗费用，而且在保险文书工作和纠纷上花费时间或被拒绝支付。德国人报告称，他们在文书工作上花费的时间与美国相似，但却能很好地免受自付费用的影响。瑞士的自付费用很高，但很少有瑞士人有支付账单方面的顾虑或问题。对于美国成年人来说，全面的医疗改革可能会改善这些方面的许多问题，包括缩小研究中观察到的收入差异。
