Public Concern About Health Costs Rises in Past Year

by Lydia Saad

Majority still satisfied with own costs

GALLUP NEWS SERVICE

PRINCETON, NJ -- A recent Gallup Poll addressing health and healthcare in the United States found Americans fairly satisfied with their current medical care, coverage and costs, and showed little change in the public's generally negative assessment of the U.S. healthcare system. At the same time, the poll documented small but statistically significant increases in public dissatisfaction with healthcare costs compared with last year at this time.

Of the many challenges facing U.S. healthcare, rising insurance costs are perhaps the most critical. A 12%-13% increase in health insurance premiums in 2002, following an 11% increase last year, is reportedly forcing employers to shift more of the cost burden to their workers, and is putting health insurance even further out of reach for the uninsured.

Two questions in the new survey, conducted Nov. 11-14, tap public perceptions on this issue:

  • Are you generally satisfied or dissatisfied with the total cost of healthcare in this country?
  • Are you generally satisfied or dissatisfied with the total cost you pay for your healthcare?

Americans' answer to the question about the total cost of healthcare in the country is decidedly negative. Only 22% are satisfied while 75% are dissatisfied. Last November, the figures were slightly better, with 28% satisfied and 71% dissatisfied.

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

A majority of Americans say they are satisfied with the total amount they pay for healthcare, but that figure has dropped from 64% in 2001 to 58% today. The percentage who are dissatisfied has risen from 33% to 39% -- again a small, but statistically significant increase.

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

The Gallup Poll finds that roughly 6 in 10 Americans have private health insurance and about one-quarter (including virtually all adults aged 65 and older) are covered by Medicare, Medicaid or California's Medi-Cal insurance program. The remaining 12% told Gallup they had no health insurance coverage at the time of the survey.

Insurance Coverage, November 2002

Private
insurance

Medicare/
Medicaid

No
coverage

%

%

%

2002 Nov 11-14

61

27

12

18-29 years

59

15

26

30-49

80

11

9

50-64

74

13

13

65+

3

97

0

Employees Footing More of the Bill

Among those with private health insurance, the vast majority is employed. As a result, most receive some financial help from their employer in covering their health insurance costs. Gallup's annual polls on healthcare in 2001 and 2002 record a slight shift in the cost burden away from the employer and to the employee over this period. Only 19% of privately insured Americans today, down from 24% in November 2001, say their employer pays the full cost of their health insurance. The percentage saying the costs are shared has increased slightly, from 54% to 57%, as has the percentage saying they pay the full cost themselves (21% this year, up from 19% in 2001).

BASED ON -- 607 -- ADULTS WITH PRIVATE HEALTH INSURANCE

Self/ household

Employer pays all

Costs are shared

NONE/
OTHER (vol.)

No
opinion

2002 Nov 11-14

21%

19

57

2

1

2001 Nov 8-11

19%

24

54

2

1

(vol.) Volunteered response

Rising Dissatisfaction With Costs Across the Board

The new Gallup Poll finds rising dissatisfaction with healthcare costs among Americans with a variety of health insurance situations. As might be expected, the vast majority of Americans whose employers pay the full cost of their health insurance are satisfied with their personal health costs, but satisfaction among this group dropped slightly over the past year, from 87% to 80%. This is about the same level of decline as is seen among those who share health costs with their employers: 60% are satisfied with the total amount they pay for healthcare, versus 66% last year. The only privately insured group not to grow more dissatisfied with costs over the past year are those who pay the full cost themselves, but this could be because this group was already widely dissatisfied. Today, 49% of this group is satisfied and an equal number is dissatisfied.

Satisfaction With Personal Costs for Private Health Insurance

Employer Pays All

Employer/Employee
Share Costs

Employee Pays All

%

%

%

2002

80

60

49

2001

87

66

47

Gallup Polls show a uniform rise (of about 6 points) in dissatisfaction with personal health costs among those with private health insurance, Medicare/Medicaid coverage, and no insurance. Those with private insurance and Medicare/Medicaid coverage report that, on balance, they are satisfied with the total amount they pay for healthcare, but this satisfaction has dropped from 68% to 62% over the past year for both groups. The uninsured tend to be dissatisfied with their costs, but the rate of dissatisfaction has risen from 52% last year to 60% today. Only 30% of the uninsured now say they are satisfied, down from 36% in 2001.

Satisfaction With Personal Healthcare Costs

Privately Insured

Covered by Medicaid/Medicare

Uninsured

%

%

%

2002

62

62

36

2001

68

68

30

Costs Impacting Medical Care

Another indicator of the financial difficulty healthcare poses for Americans comes from a question asking respondents whether they or a family member have had to postpone medical treatment over the past year because of the cost involved. This, too, shows that healthcare costs are a growing problem for the public. Twenty-five percent of Americans now say they have delayed treatment in the past year because of costs, up from 19% in 2001 and 22% in 1991. Only one-quarter of those saying they postponed treatment currently have no health insurance. About half are currently covered through private insurance while another 22% are those covered by federal programs such as Medicare.

This year, as last, the poll finds that younger women (aged 18-49) are especially likely to report that they or a family member has delayed medical treatment for financial reasons.

Percentage Reporting That They or Family Member Delayed Medical Treatment Because of Costs
Nov. 11-14, 2002

Survey Methods

These results are based on telephone interviews with a randomly selected national sample of 1,001 adults, 18 years and older, conducted Nov. 11-14, 2002. For results based on this sample, one can say with 95 percent 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.

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

Satisfied

Dissatisfied

No opinion

%

%

%

2002 Nov 11-14

22

75

3

2001 Nov 8-11

28

71

1

1993 May 10-12 ^

8

90

2

^

WORDING: Now, thinking about healthcare in the country as a whole, are you generally satisfied, or dissatisfied, with ... Next, … The quality of healthcare in this country.

Next we'd like to ask about your health insurance coverage. Do you currently have medical coverage through Medicare or [Medicaid/Medi-Cal]?

Yes

No

No opinion

%

%

%

2002 Nov 11-14

27

72

1

2001 Nov 8-11

26

73

1

Do you currently have medical coverage through some other form of health insurance?

BASED ON -- 706 -- ADULTS NOT INSURED BY MEDICARE OR MEDICAID

Yes

No

No opinion

%

%

%

2002 Nov 11-14

83

17

*

2001 Nov 8-11

84

16

*

* Less than 0.5%

SUMMARY TABLE: HEALTH INSURANCE COVERAGE (Q.24-25)

Private
insurance

Medicare/
Medicaid

No
coverage

No
opinion

%

%

%

%

2002 Nov 11-14

61

27

12

--

2001 Nov 8-11

62

26

11

1

Who pays the cost of premiums on your health insurance? Do you or someone in your household pay the total cost, does an employer pay the total cost, or is the cost shared between the employer and you or someone in your household?

BASED ON -- 607 -- ADULTS WITH PRIVATE HEALTH INSURANCE

Self/ household

Employer pays all

Costs are shared

NONE/
OTHER (vol.)

No
opinion

%

%

%

%

%

2002 Nov 11-14

21

19

57

2

1

2001 Nov 8-11

19

24

54

2

1

(vol.) Volunteered response

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

Satisfied

Dissatisfied

No opinion

%

%

%

2002 Nov 11-14

58

39

3

2001 Nov 8-11

64

33

3

Within the last twelve months, have you or a member of your family put off any sort of medical treatment because of the cost you would have to pay?

 

Yes

No

No opinion

2002 Nov 11-14

25%

75

*

2001 Nov 8-11

19%

81

*

1991 Jan 3-6

22%

77

1

* Less than 0.5%

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Gallup http://www.gallup.com/poll/7414/Public-Concern-About-Health-Costs-Rises-Past-Year.aspx
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