Commonwealth Fund Compares Care Rationing in the U.S. to Countries with Universal Coverage


Critics of universal health coverage often cite “care rationing” as a reason not to move the United States towards a health care system that guarantees access to health care for all. Care rationing occurs when patients are forced to endure long wait times to see a health care provider or if they experience limited access to innovative treatments. Researchers with the Commonwealth Fund recently published an article that explores the actual differences in access to care between the United States and five European countries with universal health coverage. The ability for patients to quickly see a health care provider is touted as a benefit of our for-profit system. However, the researchers found that 25 percent of patients in the United States must wait longer than one month to see a specialist while patients in Germany and Switzerland experienced similar wait times. This suggests that short wait times are not a unique benefit of the American health care system and that similar benefits can be obtained while also providing universal coverage. The authors of this article assert that the cost of health care and a lack of adequate coverage can act as de facto rationing. These researchers found that less than 10 percent of patients in the United Kingdom, Germany, the Netherlands, and Sweden reported skipping necessary care because of the cost. Roughly one-in-three Americans reported doing the same, which demonstrates how high costs can act as a barrier to health care access.


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