1. THE COMMONWEALTH FUND Cost-Related Access Problems Among the Chronically Ill, in Eight Countries, 2008 Base: Adults with any chronic condition Percent reported access problem due to cost in past two years* * Due to cost, respondent did NOT: fill Rx or skipped doses, visit a doctor when had a medical problem, and/or get recommended test, treatment, or follow-up. Data: The Commonwealth Fund International Health Policy Survey of Sicker Adults (2008). Source: C. Schoen et al., “In Chronic Condition: Experiences of Patients with Complex Healthcare Needs in Eight Countries, 2008,” Health Affairs Web Exclusive, Nov. 13, 2008.

2. THE COMMONWEALTH FUND Access to Doctor When Sick or Needed Care Same-day appointment6+ days wait or never able to get appointment Data collection: Harris Interactive, Inc. Source: 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults. Base: Adults with any chronic condition Percent

3. THE COMMONWEALTH FUND Difficulty Getting Care After Hours Without Going to the Emergency Room Base: Adults with any chronic condition who needed after-hours care Percent reported very/somewhat difficult getting care on nights, weekends, or holidays without going to ER Data collection: Harris Interactive, Inc. Source: 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults. 62 56 36 30 39 44 60

4. THE COMMONWEALTH FUND Gaps in Hospital Discharge Planning and Transitional Care Percent did NOTAUSCANFRGERNETHNZUKUS Know who to contact for questions about condition or treatment151116111314178 Receive instructions about symptoms and when to seek further care2520372924282612 Receive written plan for care after discharge432939403731329 Have arrangements made for follow-up visits with any doctor3832403521322728 Any discharge gaps6150716151535038 Data collection: Harris Interactive, Inc. Source: 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults. Base: Adults with any chronic condition who were hospitalized in past 2 years

5. THE COMMONWEALTH FUND Average Annual Number of Physician Visits per Capita, 2006 *2005 **2004 Data: OECD Health Data 2008 (June 2008).

6. Cost-Related Access Problems Percent in past year due to cost: AUSCANGERNETHNZUKUS Did not fill prescription or skipped doses 13811210523 Had a medical problem but did not visit doctor 13412119225 Skipped test, treatment, or follow- up 1758213323 Percent who said yes to at least one of the above 261221525837 Source: 2007 Commonwealth Fund International Health Policy Survey. Data collection: Harris Interactive, Inc.

7. Difficulty Getting Care on Nights, Weekends, Holidays Without Going to the Emergency Room Percent reported very or somewhat difficult Source: 2007 Commonwealth Fund International Health Policy Survey. Data collection: Harris Interactive, Inc.

8. E-mail Communication with Doctor and Electronic Access to Medical Records Base: Have regular doctor/place Percent:AUSCANGERNETHNZUKUS Currently can e-mail doctor1591615221120 No e-mail: Would like to be able to communicate by e-mail 34401838403243 Have electronic access to medical records 12518711910 No current access: would like electronic access to medical records 35433049443637 Source: 2007 Commonwealth Fund International Health Policy Survey. Data collection: Harris Interactive, Inc.

9. Americans Spend More Out-of-Pocket on Health Care Expenses a 2003 b 2003 Total Health Care Spending, 2002 OOP Spending b a United States OECD Median New Zealand Netherlands Japan Germany France Canada Australia a Source: The Commonwealth Fund, calculated from OECD Health Data 2006. Total health care spending per capita Out-of-pocket spending per capita

10. Mirror, Mirror: Ranking of Six Nations AUSTRALIACANADAGERMANY NEW ZEALAND UNITED KINGDOM UNITED STATES OVERALL RANKING (2007)3.552 16 Quality Care462.5 15 Right Care563421 Safe Care451326 Coordinated Care364215 Patient-Centered Care362145 Access351246 Efficiency453216 Equity25 4 316 Long, Healthy, and Productive Lives1324.5 6 Health Expenditures per Capita, 2004$2,876*$3,165$3,005*$2,083$2,546$6,102 Source: K. Davis, C. Schoen, S. C. Schoenbaum, M. M. Doty, A. L. Holmgren, J. L. Kriss, and K. K. Shea, “ Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care, ” The Commonwealth Fund, May 2007 Country Rankings 1-2.66 2.67-4.33 4.33-6.0 * 2003 data