Old Age Isn’t For Sissies


It was Bette Davis who said, “Old age is no place for sissies.” And apparently, the U.S. is no place for old people who are trying to maintain their health.

The Commonwealth Fund surveyed older adults in 11 nations and found that the U.S. leads the pack in the percentage of older adults who have trouble paying their medical bills. Making things even worse, 68 percent of Americans age 65 and older have two or more chronic illnesses.

Older adults in the U.S. also reported difficulty getting care in a timely fashion and using emergency departments for issues that a primary care physician could treat.

The Commonwealth Fund’s survey looked at how well health systems are caring for older adults, where the gaps in performance are, and how policy reforms can make a difference.

Because of the complex nature of older people’s health care needs, they are at higher risk of having their health care system break down and experiencing higher costs. Entering into this scenario is the fact that so many older people see more than one physician, manage more than one physical illness or condition, and take numerous prescription medications.

For many older Americans, paying for health care remains a problem. Even with Medicare, older Americans are faced with high deductibles and copayments, especially for prescription drugs, as well as limitations on catastrophic expenses and long-term care coverage, according to The Commonwealth Fund.

Among the survey’s key findings:

  • The U.S. has the highest rates of chronic health conditions, such as diabetes and heart disease: 87 percent of older adults in the U.S. reported having at least one chronic illness, and 68 percent reported having two or more.
  • Despite having Medicare coverage, U.S. adults age 65 or older were the most likely to report that cost posed a barrier to obtaining medical care. One-fifth said cost was the reason they did not visit a doctor, skipped a medical test or treatment recommended by a doctor, did not fill a prescription or skipped doses.
  • U.S. survey respondents were also the most likely to report trouble paying their medical bills (11%). Only 1 percent in Norway and Sweden reported the same.
  • Older residents of Canada, Sweden, Norway and the U.S. were the least likely to be able to get a same-day or next-day doctor’s appointment when sick or to find it easy to get after-hours care without using the emergency department.

But there were some positive findings for the U.S. in The Commonwealth Fund survey. Seniors in the U.S. were most likely to have a care plan to manage their chronic illnesses. They also appeared to be unafraid to plan for end-of-life care, including communicating their wishes to family members and designating a health care proxy.


Susan Rupe is assistant editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Connect with Susan →

Ad will close in 15 seconds or Skip this ad