Medicare reform has been among the prominent political topics
lately, as Democratic presidential hopefuls have come up with their
own plans for how to improve the U.S. healthcare system. Many of
these proposed changes are reminiscent of healthcare policy in
Canada and Great Britain, where universal care is the standard.
Recent Gallup Polls conducted in the United States, Canada, and
Great Britain* asked residents of each country how satisfied they
are with their healthcare systems and whether they would like them
changed. More than 50% of respondents in each country feel that
their respective healthcare system has "major problems." Roughly a
third in each country feel that there are minor problems.
Relatively small percentages define their systems as "in a state of
crisis," but few feel there are no problems at all.
Quality of Healthcare
Given that the ratings of the state of their healthcare systems
do not differ by country, one might suppose that Americans,
Canadians, and Britons would similarly rate the quality of
the healthcare they receive. But there are modest differences here:
A somewhat higher percentage of Americans rate the quality of
healthcare they receive as "excellent" (33%) than do either Britons
(27%) or Canadians (24%). Roughly half of the residents of each
country rate the healthcare they receive as "good," but the
percentage of people rating their healthcare "only fair" is higher
in Canada (19%) and Great Britain (20%) than it is in the United
States (13%).
It seems that U.S. policy-makers should pause before looking to
Canada and Great Britain for solutions to their country's
healthcare issues. Despite highly publicized concerns about medical
errors and other healthcare quality issues in the United States,
Americans are no less likely than Britons and Canadians to give
high marks to their healthcare services.
Changing the Healthcare System
One might suppose that their levels of satisfaction with
healthcare received would make Americans as likely as Britons and
Canadians to call for changes to the system. However, U.S.
residents are actually more likely than Canadians or
Britons to feel such change is necessary.
Thirty-eight percent of Americans say they would like to replace
the current, private U.S. healthcare system with a government-run
system similar to that in Canada and Great Britain. But only 21% of
British citizens would like to see the government-run British
system replaced with a system based mostly on private insurance.
And Canadians are less likely than Britons to want to replace their
government-run system, at 13%.
Bottom Line
The majority of people in all three countries want to maintain
their current systems. But the key to their differences may not be
quality, but cost. Nearly a quarter of Americans (24%) say that
they or someone in their family has put off medical treatment
because of cost (see "Healthcare Decisions: Penny-Wise,
Pound-Foolish?" in Related Items), and roughly 8 in 10 Americans
say they are dissatisfied with the cost of healthcare in the United
States. This problem is less likely to arise in Canada or Great
Britain, because universal healthcare is provided -- quality is an
issue, but cost is not.
Furthermore, in America, those who have put off healthcare
because of cost aren't alone in thinking that healthcare costs in
the United States have gotten out of hand. Even the majority of
those who have not delayed healthcare because of cost are still
dissatisfied with the healthcare costs in the United States more
generally. And healthcare costs are Americans' No. 1-rated most
urgent health problem.
Perceived inequality may be a major factor in continued support
for replacing the U.S. system with a government-run system. As long
as this problem persists, healthcare policy will continue to
maintain its high-profile status during presidential election
years.
*Results in the United States are based on telephone
interviews with 1,007 national adults, aged 18 and older, conducted
Nov. 3-5, 2003. For results based on the total sample of national
adults, one can say with 95% confidence that the maximum margin of
sampling error is ±3 percentage points. The survey was
conducted by Gallup USA.
Results in Canada are based telephone interviews with 1,012
national adults, aged 18 and older, conducted Dec. 5-11, 2003. For
results based on the total sample of national adults, one can say
with 95% confidence that the maximum margin of sampling error is
±3 percentage points. The survey was conducted by Gallup
Canada.
Results in Great Britain are based telephone interviews with
1,000 national adults, aged 18 and older, conducted Dec. 2-21,
2003. For results based on the total sample of national adults, one
can say with 95% confidence that the maximum margin of sampling
error is ±5 percentage points. The survey was conducted by
Gallup UK.
