2010年的调查研究了澳大利亚、加拿大、法国、德国、荷兰、新西兰、挪威、瑞典、瑞士、美国和英国成人的医保相关经历。这些国家的医保有不同的覆盖范围,体现在既有公共的又有公私合营的保险体系,并且具有不同的费用报销比例。总的来说,本次研究发现医疗保险设计导致不同保险的可及性、成本分担和问题等方面存在显著差异。即使在有保险的情况下,美国的成年人承担的医疗费用最高,需要花费大量时间填写保险书面材料和处理争议并且有可能被拒绝支付。德国人和美国人在填写书面材料上花费的时间差不多,但是不需要自付费用;瑞士人的自付费用虽然很高,但是在获得医保或者费用支付上没有任何障碍。对于美国成年人,全面的医疗改革可以在很多方面改进,包括减少本次研究中发现的因收入不同而产生的差别。 The 2010 survey examined health care related experiences among adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United States and the United Kingdom. The coverage of Medicare in these countries varies from place to place, with both public and private-public-private insurance systems, with different rates of reimbursement. Overall, this study found significant differences in the accessibility, cost-sharing and problems of different types of insurance resulting from the design of health insurance. Even in the case of insurance, adults in the United States have the highest medical costs, spend a lot of time filling out insurance written materials and handling disputes and may be denied payment. Germans and Americans spend almost the same amount of time writing documents, but they do not need to pay their own expenses; while the Swiss self-pay fee is high, there are no barriers to getting Medicare or paying for it. For US adults, comprehensive health care reform can be improved in many ways, including reducing the differences in income found in this study.