Americans Continue to Report Mixed Views of U.S. Healthcare System

GALLUP NEWS SERVICE

PRINCETON, NJ -- Gallup's annual Health and Healthcare poll, conducted Nov. 9-12, 2006, finds that Americans continue to report conflicting attitudes about the U.S. healthcare system. Most Americans give positive ratings to the quality of healthcare in the country, but very poor marks to healthcare coverage and costs nationwide. Most believe that the system is riddled with major problems, if not in a state of crisis. And while more than two in three say the government has the responsibility to provide healthcare for all citizens, less than a majority favors a national government-run system. These basic attitudes have shown little change in the last several years.

The Good and the Bad

At a very general level, most Americans appear to hold a fairly dim view of the healthcare system -- 7 in 10 say it is in a state of crisis (16%) or has major problems (55%), while just 28% believe it has only minor problems, if any.

These "problems" most likely revolve around the cost of, and access to, healthcare. Only 19% of Americans say they are satisfied with the total cost of healthcare in the country, while 79% are dissatisfied. Also, just 25% of Americans describe healthcare coverage in this country as "excellent" or "good," while 41% say it is "only fair" and 33% say it is "poor." Moreover, when Gallup asked Americans to say -- without prompting -- what is the most urgent health problem facing the country, cost of and access to healthcare represent the top categories of mentions, well beyond any specific disease or health condition.

All of these attitudes are similar to what Gallup has measured in recent years.

Americans living in lower-income households have more negative views of the healthcare system than those in higher-income households. In fact, only about one in three Americans whose annual household income is $30,000 or less rate the quality of healthcare in the United States in positive terms, compared with 54% in middle-income households (those reporting incomes between $30,000 and $74,999) and 69% of those in upper-income households ($75,000 or more). These differences are even greater than those observed among respondents based on political party -- 42% of Democrats, 53% of independents, and 70% of Republicans give a positive evaluation of the quality of healthcare in the United States.

Despite many criticisms of the U.S. healthcare system, Americans do not have universally negative views of care in the United States. A majority of Americans give positive ratings to the quality of healthcare in this country, describing it as either "excellent" (16%) or "good" (37%). Thirty-two percent say the quality of healthcare is "only fair" and just 14% say it is "poor."

Americans are even more positive about their own healthcare -- even to the point where a majority express satisfaction with its coverage and costs. Sixty-five percent describe their healthcare coverage as excellent or good, and 54% of Americans say they are satisfied with the total cost they, personally, pay for healthcare. Meanwhile, 79% percent rate the quality of care they receive as either excellent or good.

This is another of a series of examples where Americans rate their personal or local situation much more positively than national conditions in that same area.

Even a majority of those in lower-income households (66%) rate the quality of their own healthcare positively (66%), but that is still significantly less then the percentages of those in middle- (82%) and upper-income households (91%) that give the same ratings.

Changing the System

In the current poll, 69% of respondents say the federal government has the responsibility to provide healthcare to those who do not have it, while 28% maintain this is not a government responsibility. Since Gallup first asked the question in 2000, a majority has always held the view that the federal government should provide healthcare coverage for all Americans, but the current reading is the highest Gallup has recorded.

Nevertheless, the data make clear that the public does not translate this sentiment into a desire for a government-run national healthcare system. Only a minority of 39% would prefer to replace the current system of private insurance with a government-run system, while 51% would opt to keep the current system in place. The gap in preferences has narrowed in recent years, with closer to 60% favoring the current system in 2001-2004 but only about half doing so in the past two years.

Views of the proper government role in healthcare are most strongly related to one's political leanings. Democrats are much more likely than Republicans to say that the federal government should ensure all Americans have health coverage and to prefer to junk the current system in favor of a government-run system. Eighty-eight percent of Democrats believe the government should make sure all Americans have coverage, compared with just 39% of Republicans. On this issue, independents (70%) are closer to Democrats than they are to Republicans. A majority of Democrats, 55%, favor a government-run healthcare system, while only 40% of independents and 15% of Republicans do the same.

Survey Methods

These results are based on telephone interviews with a randomly selected national sample of 1,004 adults, aged 18 and older, conducted Nov. 9-12, 2006. For results based on this sample, one can say with 95% confidence that the maximum error attributable to sampling and other random effects is ±3 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.

Now thinking about healthcare in the country as a whole,

10. 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,

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

24. 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]?

Q.25-26 SPLIT SAMPLED

25. 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 526 NATIONAL ADULTS IN FORM A

26. 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 478 NATIONAL ADULTS IN FORM B

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

A. The quality of healthcare you receive

B. Your healthcare coverage

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