Americans Are Satisifed with Health Care, But Coverage and Cost?
Mark Blumenthal | June 24, 2009
Topics: ABC/Washington Post , CNN , Health Care Reform , Kaiser Family Foundation
The ABC News analysis of the newly released ABC/Washington Post poll results on health care reform leads off with this paragraph:
The chief obstacle to reform is that large majorities are satisfied with their current care and coverage; most, albeit fewer, also call their costs tolerable. Dissatisfaction with the system overall, and worry about future costs, are countered by broad concerns that change could worsen the quality, choice and coverage most Americans enjoy now.
The result: pushback works.
While I have no quarrel with that summary -- my column earlier this week made a similar point -- it is easy to miss the part about "tolerable" costs and the worry about costs in the future. So for this post, I want to focus more on those measures of satisfaction, especially those pertaining to cost. (I will leave questions about specific policy options for another post, although, as Nate Silver points out this morning, it is also possible to "push" respondents in the direction of greater support for reform).
The ABC/Post poll asked four satisfaction questions about health care and health coverage. These illustrate the point in the ABC analysis: Americans are generally satisfied with the quality of their health care, but less so their coverage and much less so with cost, although they still find more Americans satisfied (54%) with "health care costs, including both expenses not covered by insurance, and the cost of your insurance" than dissatisfied (44%).
A minor nitpick: The results reported on the ABC/Post poll for "your health insurance coverage" were tabulated among those with health coverage. That's fine, but in comparing across items we might want to factor in the 16% that say (on this survey) that they lack insurance coverage. Do that and we find that 68% are satisfied -- still a big number -- 16% are dissatisfied and 16% lack insurance.
Also note that while 49% of Americans are "very satisfied" with the "quality of care" they receive, only 35% of Americans have coverage and are very satisfied with it. Put another way, it looks as though nearly half either lack insurance coverage, are dissatisfied with their coverage or are less satisfied with their coverage than they are with the quality of their care. The point is, Americans differentiate between the quality of their care and the quality of their coverage.
Now take a look at a very similar set of satisfaction questions asked by CNN/ORC back in March. They asked very similar questions about the quality of health care received, insurance coverage and "your health care costs" and obtained virtually identical results (and it looks as though they asked their coverage question of respondents without coverage -- a few, presumably, were satisfied with their lack of coverage).
What catches my eye in this context, however, is the probe of satisfaction with "the total cost of health care in this country." On that measure, Americans are far less satisfied (23%) than on the ABC/Post question about "the overall health care system in this country" (42%). So guess what worry appears to be driving the desire for reform? Cost. Or more precisely, Americans worry about rising costs and how they may affect their access to needed care in the future.
The April tracking survey conducted by the Kaiser Family Foundation took a more extensive look how Americans experience and perceive health care costs. They found 72% of Americans worried about "having to pay more for your health care or health insurance" (37% were very worried). Almost as many (66%) said they worried about "not being able to afford the health care services you think you need" (34% were very worried. They also found cost concerns affecting the treatment that Americans seek:
As the economy continues to falter, a majority of Americans continue to say they or someone in their household have taken steps to put off health care for cost reasons over the course of the last year. Overall, six in ten (59 percent) say they have taken at least one of seven steps to delay or skip care this past year
According to a new Kaiser Family Foundation health tracking survey, most common was relying on home remedies or over the counter drugs rather than consulting a physician, which 42 percent report, followed by skipping dental care. Three in ten reported not filling a prescription.
So yes, Americans are generally satisfied with the quality of care they receive, but less satisfied with their coverage and especially the cost of that coverage and other necessary medical expenses they incur. They also worry a lot about about being able to afford the health care services they might need in the future. Those are the attitudes that fuel the desire for reform.
By Mark Blumenthal | June 24, 2009 1:49 PM | Permalink | Comments (0) | TrackBacks (0)
