Figure ES-1. Difficulty Getting Care on Nights,
Weekends, Holidays Without Going to ER
Percent saying “very” or “somewhat difficult”
100
75
Below average income
53 56
Above average income
70*
60 59
50
32 32
60
42 44
25
0
Australia
Canada
New
United
United
Zealand
Kingdom
States
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure ES-2. Under 65: Lab Test Errors—
Comparisons with U.S. Insured and Uninsured
Base: Under 65 who have had lab tests in past two years
Percent given wrong result or delay in receiving abnormal test result
75
50
27*
25
9*
12
AUS
CAN
15
9*
16
13
0
NZ
UK
Total
Insured Uninsured
United States
* Significantly different from U.S. insured at p<.05.
Uninsured = uninsured at time of survey or any time during the year.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 1. Insurance and Cost-Sharing Policies
in Four Countries with Universal Public Coverage
AUS
CAN
NZ
UK
Permitted only for
hospital services
Prohibited for core
services in most
provinces
Permitted
Permitted
Percent with private
coverage
49%
79.9%
(to cover benefits
excluded from
‘free-of charge’
public plan)
33%
12%
Public Plan Patient
Cost-Sharing
Variable
depending on
service type and
provider
None for core
services
Copayments
for many
services
None for basic
services (except
Rx and optical)
Covered
Publicly covered for
social assistance
beneficiaries and in
most provinces for
seniors
Covered
Covered
Private insurance
for services covered
by public
Prescription Drugs
Source: B. K. Frogner and G. F. Anderson, Multinational Comparisons of Health Systems Data, 2005
(New York: The Commonwealth Fund, Apr. 2006).
Figure 2. Private Insurance in Four Countries
with Universal Coverage
Percent who have private insurance in addition to public
Below average income
100
81
63
75
50
Above average income
30*
57
36*
35
19*
25
11*
0
Australia
Canada
New Zealand
United
Kingdom
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 3. Insurance Profile of U.S. Adults by Income
Uninsured
Below
average
income
Insured all year
40 *
Above
average
income
58*
12
0
88
25
50
75
Uninsured = uninsured at time of survey or any time during the year.
Below average income numbers do not add up to 100% because of not sure/decline to answer.
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
100
Figure 4. Spent More than US$1,000 Out-of-Pocket
for Medical Care in Past Year, by Income
Percent
75
Below average income
Above average income
50
24*
21
25
8*
10 12
4
6
2*
32
5
0
Australia
Canada
New
United
United
Zealand
Kingdom
States
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 5. Health Status by Income
Percent:
AUS
CAN
NZ
UK
US
Below Average
22*
19*
22*
24*
30*
Above Average
7
7
6
8
6
Below Average
63*
58*
62*
64*
62*
Above Average
41
42
40
39
42
Fair/Poor Health:
Any of 6 Chronic
Illnesses:^
^ Chronic illnesses include: hypertension, heart disease, diabetes, arthritis, lung problems, and depression.
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 6. Access to Doctor When Sick or
Need Medical Attention, by Income
Percent waited six days or more for appointment when sick
75
Below average income
Above average income
50
24 *
25 24
25
7
14 12
5
3
13
3
0
Australia
Canada
New
Zealand
United
Kingdom
United
States
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey
Figure 7. ER Visit for Condition a Primary Care
Doctor Could Have Treated if Available, by Income
Percent
75
Below average income
Above average income
50
25
21
12
9
19
14
6
6
6
5
11
0
Australia
Canada
New
United
United
Zealand
Kingdom
States
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 8. Difficulty Getting Care on Nights,
Weekends, Holidays Without Going to ER
Percent saying “very” or “somewhat difficult”
100
75
Below average income
53 56
Above average income
70*
60 59
50
32 32
60
42 44
25
0
Australia
Canada
New
United
United
Zealand
Kingdom
States
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 9. Cost-Related Access Problems, by Income
Percent reporting any of three access problems because of costs^
75
Below average income
Above average income
57*
44 *
50
35 *
25
24
29
26*
25
12*
12
6
0
Australia
Canada
New
United
United
Zealand
Kingdom
States
^ Access problems include: Had a medical problem but did not visit a doctor; skipped a medical test,
treatment, or follow-up recommended by a doctor; or did not fill a prescription because of cost.
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 10. Care Coordination, by Income
Base: Have seen a doctor in past two years
Percent reporting any of three care coordination problems^
75
Below average income
Above average income
50
26 28
25
29
36*
25
27
26 24
27
New
United
United
Zealand
Kingdom
States
23
0
Australia
Canada
^ Coordination problems include: Test results or medical records not available at time of appointment,
received conflicting information from different doctors, or doctor ordered duplicate medical test.
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 11. Did Not Receive Test Results
or Results Not Clearly Explained, by Income
Base: Adults with test in past two years
Percent
75
Below average income
Above average income
50
25
19*
28 30
23 24
23 20
New
Zealand
United
Kingdom
25*
11
17
0
Australia
Canada
United
States
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 12. Percent of Patients Whose Doctor
Has Not Reviewed All Medications, by Income
Base: Adults taking prescriptions regularly
Percent
Above average income
Below average income
75
50
27
35
25
25 23
28
32
38 35
29
21
0
Australia
Canada
New
United
United
Zealand
Kingdom
States
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 13. Rated Doctor Fair or Poor, by Income
Percent
75
Above average income
Below average income
50
25
22*
9
7
11 8
9*
4
12 11
7
0
Australia
Canada
New
United
Zealand
Kingdom
United
States
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 14. Had Blood Pressure Check in Past Year,
by Income
Percent
100
Below average income
83 79
79 82
75
Above average income
77*
70
72*
91
*
85
61
50
25
0
Australia
Canada
New
United
United
Zealand
Kingdom
States
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 15. Had Pap Test in Past Three Years,
by Income
Base: Women ages 25–64
Percent
Below average income
100
75
75*
84
69*
84
Above average income
82
93
*
86
New
United
United
Zealand
Kingdom
States
*
84
71
73*
50
25
0
Australia
Canada
* Significant difference between below and above average income groups within country at p<.05.
Source: Commonwealth Fund 2004 International Health Policy Survey
Figure 16. Under 65: ER Use—
Comparisons with U.S. Insured and Uninsured
Percent under 65 with ER visit in past two years
75
50
46*
39*
29
26
25
30
34
27
0
AUS
CAN
NZ
UK
Total
Insured Uninsured
United States
* Significantly different from U.S. insured at p<.05.
Uninsured = uninsured at time of survey or any time during the year.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 17. Under 65: Coordination Problem—
Comparisons with U.S. Insured and Uninsured
Percent under 65 with at least one of three coordination problems^
75
44 *
50
30
26
26
26
CAN
NZ
UK
33
28
25
0
AUS
Total
Insured Uninsured
United States
^ Coordination problems include: Test results or medical records not available at time of appointment,
received conflicting information from different doctors, or doctor ordered duplicate medical test.
* Significantly different from U.S. insured at p<.05.
Uninsured = uninsured at time of survey or any time during the year.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 18. Under 65: Lab Test Errors—
Comparisons with U.S. Insured and Uninsured
Base: Under 65 who have had lab tests in past two years
Percent given wrong result or delay in receiving abnormal test result
75
50
27*
25
9*
12
AUS
CAN
15
9*
16
13
0
NZ
UK
Total
Insured Uninsured
United States
* Significantly different from U.S. insured at p<.05.
Uninsured = uninsured at time of survey or any time during the year.
Source: Commonwealth Fund 2004 International Health Policy Survey.
Figure 19. Health Care Experiences by Income
and Insurance: U.S. Adults Ages 19–64
Access problem
because of cost
22 *
Duplication
of tests
23*
7
8
Lab error
6*
0
Uninsured
Insured: Below average income
10
Rated doctor
fair/poor
44
76*
27 *
15
Insured: Above average income
27 *
14
25
50
* Significantly different from insured below average income group at p<.05.
Uninsured = uninsured at time of survey or any time during the year.
Source: Commonwealth Fund 2004 International Health Policy Survey.
75
100
Figure 20. Ranking of Below Average Income Adults’
Experiences by Country
Number of Measures Where Below Average Income Adults’
Experiences in Country Was the Worst Compared with
Below Average Income Adults in the Other Four Countries
General
access
(4)
Access
because
of cost
(4)
AUS
0
0
0
0
1
1
CAN
2
0
3
0
1
6
NZ
0
0
1
1
0
2
UK
0
0
2
1
3
6
US
2
4
3
7
0
16
Doctor–
Coordination Patient Prevention
(9)
(8)
(5)
Source: Commonwealth Fund 2004 International Health Policy Survey.
Total
(30)
Figure 21. Inequity Summary:
Number of Measures Where Below Average Income
Adults Have More Negative Experiences
General
access
(4)
Access
because
of cost
(4)
AUS
0
3
1
0
0
4
CAN
0
4
1
0
0
5
NZ
0
4
1
3
0
8
UK
0
1
0
0
0
1
US
3
4
5
7
2
21
Doctor–
Coordination Patient Prevention Total
(9)
(8)
(5)
(30)
* Inequity counted when significant difference between income groups
where p  .05 and gap of >5%; for U.S. p<.05 and gap>5%, or gap>5%.
Source: Commonwealth Fund 2004 International Health Policy Survey.