Half of U.S. Doctors Report Insurance Restricts Medications or Treatment Decisions

International survey of primary care physicians in 11 countries reveals U.S. lagging in access, quality, and use of health information technology. The 2009 Commonwealth Fund International Health Policy Survey, published online in the journal Health Affairs, found that:

• Fifty-eight percent of primary care doctors in the U.S. report their patients often have difficulty paying for medications and care, compared to between 5 percent and 37 percent in the other countries;


• Half of U.S. doctors (48%) spend substantial time dealing with restrictions insurance companies place on their patients’ care, compared to just 6 percent in the U.K.;


• Twenty-eight percent of U.S. doctors report their patients often face long waits to see a specialist, similar to the rate reported by Australian (35%) and U.K. (22%) physicians, while three-quarters of Canadian and Italian physicians reported long waits;


• Just 29 percent of U.S. doctors report any arrangement for patients to see a doctor or nurse after hours, compared to nearly all doctors in the Netherlands (97%), and large majorities in New Zealand (89%) and the U.K (89%) report after-hour provision, as do more than three of four doctors in France (78%) and Italy (77%);


• While nearly half (46%) of U.S. primary care doctors report using electronic medical records (EMRs)—up from 28 percent in 2006—U.S. primary care practices, along with Canadian doctors, continue to lag well behind other leading countries. EMRs are nearly universal in the Netherlands (99%), New Zealand (97%), the U.K. (96%), Australia (95%), Italy (94%), Norway (97%), and Sweden (94%).

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