Seniors faced more economic, healthcare disruptions in U.S. than other wealthy nations during COVID

U.S. seniors more often reported economic insecurity and disruptions in their regular care due to the COVID-19 pandemic compared to older adults living in 10 other high-income countries. 

“The chronic lack of economic security facing U.S. seniors, especially those who are Black or Hispanic, is exacerbating the pandemic toll,” David Blumenthal, M.D., president of The Commonwealth Fund, said during a media teleconference. “Our leaders can do more to address these disparities and ensure affordable, quality healthcare is within reach for all Americans during COVID-19 and beyond.”

The findings from the fund's new international survey—which also included insights on caregiving services and COVID-19 vaccine perspectives—highlight differences between the effectiveness of Medicare and the universal healthcare services adopted by other wealthy nations, Commonwealth Fund leadership said.

“Medicare is a critical lifeline for older people in our country, whose health needs tend to increase as they age. But the program has flaws,” Blumenthal said. “Medicare plans have significant gaps that leave beneficiaries vulnerable to sizeable out-of-pocket expenses, which is why seniors who can afford it will buy supplemental health insurance. We could make healthcare more affordable to seniors through a variety of approaches including placing caps on out-of-pocket costs and covering more health services, including dental, vision and hearing.”

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Reginald Williams II, vice president of international health policy and practice innovations at The Commonwealth Fund and the survey report’s lead author, stressed seniors’ increased chronic disease burden and the negative impacts disrupted medical visits or monitoring gaps can have on their treatment plan goals.

He also pointed to the potential of telemedicine as an avenue for mitigating disruptions in care alongside other economic support and social service measures. Like Blumenthal, Williams appealed to the national leadership to improve access to social services and strengthen Medicare protections.

“The health and financial security of older adults in the U.S. will only improve when our leaders address these disparities and ensure that affordable, high-quality care is within reach for all Americans,” Williams said.

According to the report, based on responses from more than 18,000 people, 19% of polled U.S. adults aged 65 years or older said they either used up the majority of their savings or lost a source of income due to the COVID-19 pandemic—four to six times higher than rates in Switzerland (4%), the Netherlands (5%), Norway (5%) and Sweden (5%). Reports of economic difficulties from other polled countries ranged from Germany’s 3% to Canada’s 15% and were all significantly lower than the U.S., with the exception of Australia (14%).

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Americans’ responses to the question significantly differed by race, with those identifying as Black (32%) or Latino/Hispanic (39%) more frequently reporting pandemic hardships than their white counterparts (14%).

Among the respondents with two or more chronic conditions, 37% of Americans said they had a healthcare appointment canceled or postponed due to the pandemic. This was significantly higher than all other countries other than Canada (32%), the Netherlands (32%) and the U.K. (32%). Germany (11%) led the other end of the spectrum, followed by Australia (14%) and New Zealand (16%).

The report also noted that multiple chronic diseases were significantly more frequent among American seniors (68%) than those of other countries.

America (23%) ranked third for the percentage of seniors who did not receive the help they needed for “instrumental activities of daily living” such as housework or medication management behind Canada (31%) and the U.K. (30%).

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The Commonwealth Fund found that receipt of a COVID-19 vaccine generally matched the country’s relative wealth and that seniors across the board were overwhelmingly interested in getting a shot.

Still, the U.S. led the way with the highest percentage of seniors who do not plan to be vaccinated (10%), nearly a quarter of whom pointed to distrust of the government’s ability to ensure safety as the primary reason behind their decision.

The Commonwealth Fund’s survey was conducted by SSRS and other contractors from March 1 to June 14. It included a total of 18,477 online or computer-assisted telephone interviews with seniors from 11 countries.

The report’s authors noted that they would be releasing additional analyses from the survey over the coming weeks and months as they become available. These will include a comparison of care affordability and coordination among seniors enrolled in Medicare or Medicare Advantage programs during the pandemic.