Quality and Affordability Rank Highest for Health Care Reform

According to the October 2008 EBRI Notes, the items with the highest ‘extremely’ or ‘very important’ ratings for health care system reform include:

• Providing high quality care: 93%,
• Making health care more affordable: 90%,
• Making sure the system supports the development of new technologies: 87%,
• Making sure people can select the doctor or hospital of their choice: 84%, and
• Providing health insurance coverage to all Americans: 79%.

The report said there is strong support for tax incentives to help expand health insurance coverage, with 87% saying they would support tax incentives to help people pay for coverage they purchase on their own and 84% saying they would support tax incentives to help people pay for employer coverage. Substantial majorities also report they would support allowing the uninsured to buy into Medicare or Medicaid (78%) or to buy health insurance coverage offered to government employees (83%).

Survey respondents indicated they generally feel centrally maintained electronic medical records that can be shared by authorized health care providers are important (60% say this is ‘extremely’ or ‘very important’), but 62% indicate they are not too or not at all confident that such records would remain confidential.

Twenty percent of respondents said there is so much wrong with our health care system that it needs to be completely overhauled, and 51% agree with the statement “there are some good things about our health care system, but major changes are needed.” A majority rate the nation’s health care system as ‘fair’ (29%) or ‘poor’ (31%), while only 4% give it ‘excellent’ and 11% ‘very good’ marks.

While half of respondents (49%) to EBRI's 2008 Health Confidence Survey reported being extremely or very satisfied with health care quality, far fewer are satisfied with the cost of health insurance (17%) or with costs not covered by insurance (15%). Roughly half with health insurance coverage report having experienced an increase in health care costs in the past year (55%, down from 63% in 2007).

EBRI found that those who have experienced an increase in health care costs in the past year are more likely than those who have not to say they now choose generic drugs more often (74% v. 60%), talk to the doctor more carefully about treatment options and costs (63% v. 52%), and go to the doctor only for more serious conditions or symptoms (62% v. 48%).

Those experiencing cost increases are also likely to report that these increases have negatively affected their household finances. In particular, the report said they indicate that increased health care costs have resulted in a decrease in contributions to retirement (29%) and other (54%) savings and in difficulty paying for basic necessities (27%) and other bills (34%).

Full results of the 2008 Health Confidence Survey can be found at http://www.ebri.org/pdf/notespdf/EBRI_Notes_10-2008.pdf .