Americans Cast Wary Eye Toward Health Care's Future

October 1, 2003 ( - Even though Americans report being satisfied with their health care services, fewer American workers are confident of their employer's ability to deliver health insurance to them in the coming years.

For the time being though, most Americans who received care in the last two years do not see their current level of coverage as a problem, with 49% that are extremely or very satisfied with the care they receive in general, up from 44% in 2002. Further, 40% continue to be somewhat satisfied with the health care received, with the ability to choose their doctor (54%) and the quality of the care (57%) getting top marks on the satisfaction scale , according to the Health Confidence Survey conducted by the Employee Benefit Research Institute (EBRI) and Mathew Greenwald & Associates, Inc.

Levels of satisfaction were far from perfect when the full group of associates rated the health care system in America today. Just 5% say it is excellent and another 9% say it is very good. Instead the sample rated it primarily as good (26%), fair (30%) and poor (28%). Perhaps most telling is the growing number that rate the system as poor, up 15% from 1998, compared with the declining levels of very good responses, down 4%, over the same period.

Levels of dissatisfaction appear most driven by the ever-escalating costs of health care. Roughly half (48%) of the group surveyed said they are not too/not at all satisfied with the health care cost, compared with only 32% that gave this response in 1998 and 2001. Additionally, the same number said that when they are forced to step outside of their sphere of insurance coverage, they are not happy with the costs.

“The American people are feeling the impact of higher health care costs,” said EBRI President and CEO Dallas Salisbury, “and they are concerned about what lies ahead.”

Bleak Future

Between 2000 and 2003, the percentage of Americans with employment-based health benefits that are extremely or very confident that their employer will continue to offer coverage has declined from 68% to 61%. Further, only 33% responded to being either extremely or very confident that in 10 years they will be able to get the treatments they need.

Faced with the prospect of losing health care coverage, a growing number of health care participants are turning to the government as a possible solution. More than a third (36%) of those polled would now prefer to receive their insurance through the government, up from only 25% in the previous study. Even despite the upswell of support for a government sponsored program, the employment-based system remains the most popular type of system for health insurance coverage in the US, favored by 41% of those canvassed, followed by 18% who would prefer to receive coverage straight from the insurance company and 5% who were unsure.

Much of this may stem from the sentiment among the majority (51%) that providing health insurance to those currently uninsured is the most important priority national, over prescription drug benefits (25%) and tax cuts (22%). Similar numbers were seen among the profiled groups personal profiles, where insuring the uninsured came in as the most important to the respondent and the family for 47% of the sample, followed by tax cuts (26%) and prescription drug benefits (25%).

Golden Years?

Not surprisingly, almost half (47%) of those currently working over the age of 40 said they think about access to health care a lot when trying to determine their retirement age, compared with 31% who think about it a little and 21% that do not weigh health-care access in their retirement decisions. After pondering the health care question though, the survey still found a relatively high degree of uncertainty. Far and away the answer was that even if they wanted to get out early, most (62%) plan to work longer than they like to continue receiving coverage. However, at the same time, only 15% who plan to retire at age 65 or later said they would retiree earlier if the promise of health care coverage was on the other side.

Some are much more committed to begin the golden years regardless of health care coverage. Nearly three out of 10 (28%) plan to retire before 65, representing a gap of coverage between their current level of coverage and eligibility for Medicare. Similarly 33% expect to receive health insurance through a former employer or union during their retirement.

More information and a more complete copy of the2003 Health Confidence Survey’s results are available on the EBRI Web site at .