Public: Healthcare Costs and Availability Are Major Concerns

GALLUP NEWS SERVICE

PRINCETON, NJ -- The annual Gallup survey on health in the United States finds two-thirds of Americans saying the U.S. healthcare system either is in a state of crisis (14%) or has major problems (53%). These views are little changed over the past 10 years -- except for the survey conducted two months after 9/11, when Americans tended to rally their support for all American institutions.

Which of these statements do you think best describes the U.S. healthcare system today -- [ROTATED: it is in a state of crisis, it has major problems, it has minor problems, (or) it does not have any problems]?

Among the most urgent health problems cited by respondents in the poll, the cost and the availability of healthcare top the list -- each item mentioned by 29% of respondents. Specific diseases are also mentioned, such as cancer (9% of respondents), obesity (7%), and AIDS (5%).

MOST URGENT HEALTH PROBLEM
FACING THE COUNTRY

The most dramatic change in the trends has been the decline in the number of people who rate AIDS as the most urgent health problem. In 1987, 68% cited AIDS, but by early in this decade, fewer than 1 in 10 mentioned that problem. Only 5% mention it in the current poll.

Access to healthcare has emerged as a dominant problem in the past couple of years, with more than a quarter of Americans identifying it as the most urgent problem. The cost of healthcare has been a perennial leader, though the number of Americans mentioning it has varied considerably over the years.

Among diseases, cancer usually is the most often cited -- except for AIDS. But 1999 was the last year that more people mentioned AIDS than cancer. In 2001, following several anthrax scares, bioterrorism briefly emerged as one of the most urgent concerns, but by the next year, it had virtually disappeared from the list.

Quality, Coverage, and Costs of Healthcare -- in the United States and Personally

The poll reveals a pronounced "BIMBY" ("better in my back yard") phenomenon on healthcare issues, with Americans rating their own healthcare quality, coverage, and costs much more positively than the quality, coverage, and costs in the country as a whole.

While 59% of Americans rate the quality of healthcare in the United States as excellent or good, 80% rate the quality of healthcare they personally receive as excellent or good.

The largest difference is found in the rating of healthcare coverage, with only 30% of Americans giving it a high rating in the country as a whole, compared with 69% who give a high rating to their own coverage.

Similarly, a clear majority of Americans are satisfied with the costs they pay for healthcare, but only 21% express satisfaction with the costs of healthcare in the country as a whole.

Prescriptions for Change

Most Americans believe the federal government has the responsibility to make sure all Americans have healthcare coverage, a view that has not varied significantly over the past five years. The current poll shows 64% who say the government has that responsibility, while 34% disagree.

Do you think it is the responsibility of the federal government to make sure all Americans have healthcare coverage, or is that not the responsibility of the federal government?

BASED ON 522 NATIONAL ADULTS IN FORM A

But at the same time, Americans are leery of having the government actually run a national healthcare system, as is the case in Canada. Instead, by a two-to-one margin, they prefer a system that is still based primarily on private health insurance.

Which of the following approaches for providing healthcare in the United States would you prefer -- [ROTATED: replacing the current healthcare system with a new government run healthcare system, (or) maintaining the current system based mostly on private health insurance]?

BASED ON 494 NATIONAL ADULTS IN FORM B

Partisan Differences

Generally, Democrats are more concerned and more pessimistic about the healthcare system in the country than are Republicans, and Democrats are also more likely to prefer a strong government role in improving the system.

• Fifty-six percent of Republicans say the healthcare system is either in a crisis or suffers from serious problems, compared with 79% of Democrats.
• Among Republicans, 74% rate the quality of healthcare in this country as excellent or good, compared with 45% of Democrats.
• Similarly, 47% of Republicans, but only 15% of Democrats, rate healthcare coverage in the country as excellent or good.
• A majority of both Democrats and Republicans are dissatisfied with the overall costs of healthcare in the country, but Democrats (86%) more so than Republicans (69%).
• At the personal level, the differences between Republicans and Democrats are also quite pronounced, to a significant degree reflecting the underlying socioeconomic differences between members of the two parties.

• The party groups express major differences in philosophy about the federal government's responsibility to ensure coverage for everyone -- 85% of Democrats support that view, compared with only 44% of Republicans.
• And when it comes to the federal government actually running a healthcare system, Republicans are overwhelmingly opposed (84% to 14%), while Democrats are divided -- 50% in favor and 45% opposed.

Survey Methods

Results are based on telephone interviews with 1,016 national adults, aged 18 and older, conducted Nov. 7-10, 2004. For results based on the total sample of national adults, one can say with 95% confidence that the margin of sampling error is ±3 percentage points.

For results based on the 522 national adults in the Form A half-sample and 494 national adults in the Form B half-sample, the maximum margins of sampling error are ±5 percentage points.

For results based on the sample of 618 adults employed full or part-time, the maximum margin of sampling error is ±4 percentage points.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

On a different topic,

11. What would you say is the most urgent health problem facing this country at the present time? [Open-ended]

Now thinking about healthcare in the country as a whole,

12. Overall, how would you rate -- [ROTATED] -- as excellent, good, only fair, or poor?

A. The quality of healthcare in this country

B. Healthcare coverage in this country

Thinking again about healthcare in the country as a whole,

26. Are you generally satisfied or dissatisfied with the total cost of healthcare in this country?

36. Overall, how would you rate -- [ROTATED] -- as excellent, good, only fair or poor?

A. The quality of healthcare you receive

B. Your healthcare coverage

37. Are you generally satisfied or dissatisfied with the total cost you pay for your healthcare?