This report from the Commonwealth fund uses an 11-country survey to identify the potential effects of insurance design on the population. The key finding is that Americans are much more likely than other nationalities to forgo care due to insurance and funding complications.

From the executive summary:

An 11-country survey focusing on health care access, cost, and insurance coverage found that adults in the United States are by far the most likely to go without care because of costs, have trouble paying medical bills, encounter high medical bills even when insured, and have disputes with insurers or payments denied.

The health insurance systems of the 11 countries included in the latest Commonwealth Fund International Health Policy Survey vary widely. They range from wholly public systems to hybrid systems of public and private insurance, with varying levels of costsharing. In analyzing the survey findings, the researchers examined how the design of insurance coverage can affect access to care, financial protection against high costs and medical debt, and insurance complexity.

Full Report: How Health Insurance Design Affects Access to Care and Costs, by Income, in Eleven Countries (PDF | 357 KB)

Commonwealth Fund. (2010). How health insurance design affects access to care and costs, by income, in eleven countries. Schoen, C., Osborn, R., Squires, D., Doty, M., Pierson, R., and Applebaum, S.