Twenty-two surveys conducted over the last year show a clear pattern that consumer concerns with health care are growing and have now intensified from a narrow focus with individual elements of the health care system to broader, system-wide concerns that are manifested in worries about:
the ability to pay for health insurance and medical care,
the increasing difficulty of gaining access to necessary care when coverage is lacking or inadequate, and
the quality of medical care.
These broader concerns are grounded in personal experience, and cut across all health care delivery and financing mechanisms. These concerns have contributed to a growing loss of trust in the health care system.
Cost Concerns: Consumers are concerned about rising health insurance premiums, and most consumers who do not have health insurance or have inadequate coverage report difficulty paying medical bills, especially if they have a chronic or serious health problem. According to one survey by The Commonwealth Fund, nearly 20 percent of uninsured people said they had to change their lives significantly (e.g., problems paying for basic living expenses like food and housing) to pay medical bills.
Access and Coverage Concerns: A majority of people in two major surveys by The Kaiser Family Foundation and The Commonwealth Fund felt that if they had a serious medical problem, their health plan would be more concerned about saving money than providing the best medical care regardless of the cost. Consistent survey results also show that consumers who do not have health insurance are foregoing or postponing needed medical care. The consequences are serious because the individuals polled stated that their conditions were made more painful or that carrying out normal daily activities was more difficult. People who are vulnerable and in great need of accessing the health care system are those often least likely to do so. Several polls show that only 30 to 40 percent of seriously ill respondents have a great deal of confidence they will receive care when they need it, and that healthy people are showing the same low level of confidence that the system will provide the care they need.
Quality of Care Concerns: There is an across-the-board concern with the quality of medical care and a loss of trust in the health care system. A number of polls, including a recent American Medical Association (AMA) survey, showed that the public believes that there are system-wide quality problems. The AMA extrapolated this conclusion from their survey: nearly 100 million Americans have been involved, either personally or through a friend or relative, in a situation where a medical mistake was made. Nearly one third of the AMA respondents indicated that the medical mistake had a permanent, negative effect on the patient’s health.
The public has serious doubts about the structure and operations of our health care system. These concerns reflect worries about the cost, coverage and quality of health care and loss of trust in the health care system.
The 22 polls clearly reflect that consumers are experiencing difficulty — or are concerned about –obtaining affordable, appropriate, quality health care for their families and that the economic well-being and health of these individuals and families are at stake.
Hard copies of “Reality Check: The Public’s Changing Views of our Health Care System” are available by contacting the National Coalition on Health Care at (202) 637-6830.