The Commonwealth Fund Commission on a High Performance Health System August 2006 Public Views on Shaping the Future of the U.S. Health System
By Cathy Schoen, Sabrina K. H. How, Ilana Weinbaum, John E. Craig, Jr., and Karen Davis
The Commonwealth Fund
Abstract:
On behalf of The Commonwealth Fund Commission on a High Performance Health System, Harris Interactive surveyed U.S. adults to determine the public’s perspectives on ways to improve patient care and on health policy priorities facing the President and Congress. Overall, the representative sample of 1,023 adults ages 18 and older revealed strong public support for efforts to improve care coordination and access to information. There is a shared belief that expanded use of information technology, care teams, and improved delivery of preventive services could improve the quality of care. Patients reported recent experiences of wasteful, inefficient, or unsafe care. In addition, half of middle-income and lower-income families reported serious problems paying for care and insurance coverage. Three-quarters of all adults said the U.S. health care system needs either fundamental change or complete rebuilding. Expanding insurance and controlling costs, they said, should be top priorities for federal action.
Affordability concerns are moving up the income ladder
Half of middle-income ($35,000-$49,999 annually) and lower-income (less than $35,000 annually) families said they have had serious problems paying for care in the past two years. With the median U.S. household income at $44,000, the findings indicate that more than half of all households are experiencing stress when paying for medical care.
A similarly high proportion of middle- and lower-income adults reported difficulties paying for health insurance.
Affordability is a now a concern at even higher-income levels. One-third of adults with annual incomes between $50,000 and $74,999 reported serious problems in paying for care.
Shared Views, Values and Concerns
Across income groups and regions of the country, there was resounding agreement that ensuring reliable health insurance and controlling rising costs are the most pressing health policy issues for the President and Congress to tackle. The majority consistently ranked coverage and costs as their top two priorities.
http://www.cmwf.org/publications/publications_show.htm?doc_id=394606
Comment:
By Don McCanne, MD
This report is highly credible (Harris Interactive) and is current (survey conducted June, 2006). It confirms many other reports about pubic views on the U.S. health care system.
From the perspective of reforming health care financing in the United States, the most important finding in this report is that the concerns about affordability of health insurance and health care have moved up the income ladder. The concerns of average-income families are now as great as lower-income families (more than half!), and now even higher-income families are concerned (one-third!).
The other issues addressed are very important, especially the need for a medical home. But they will be very difficult to address until we fix the financing of health care by providing comprehensive coverage for everyone.