View of U.S. Healthcare Quality Declines to 24-Year Low, Gallup Poll, December 6, 2024, by Megan Brenan
Evaluations of U.S. healthcareĀ qualityĀ among Republicans ā¦ are down sharply since President Donald Trump left office in 2021. Currently [late 2024], 42% of Republicans and Republican leaners rate healthcare quality positively, compared with 65% to 68% from 2017 to 2020. ā¦
Positive ratings of healthcare quality among Democrats and Democratic-leaning independents have been less variable since 2001 and typically lower than ratings among Republicans. Ā ā¦
Partisansā ratings of U.S. healthcareĀ coverageĀ have followed a similar trajectory as their views on quality.
An open-ended question measuring Americansā views of theĀ most urgent health problemĀ facing the country finds that two issues related to the healthcare system ā cost (23%) and access (14%) ā¦ are mentioned most often.
Comment:
By Jim Kahn, M.D., M.P.H.
This US poll is a bit dated (a colleague it sent it to me this week), but revealing and thought-provoking. Here are the main takeaways, as I see it:
(1) Unsurprisingly, concerns about cost, access, & quality are high and enduring over more than two decades. Efforts to improve health insurance have failed. This includes the ACA, with its bolstering of coverage at the expense of rising under-insurance (e.g., large deductibles). Thus, we can add recent health care policy innovations to the venerable list of failed efforts to remedy the underperformance of our fragmented, profiteering health insurance approach.
(2) When respondents are asked about the most urgent health issues, cost and access top the list, above specific diseases. This is astounding if you think about it: people are more worried about healthĀ insuranceĀ problems than widespread often fatal health problems. Curing disease is tricky. Fixing health insurance isnāt ā as we know from scores of other wealthy nations.
(3) Republican views (much less so Democratic) are sharply influenced by who the president is. In the graphic above on coverage, notice how the red line jumped up 25% while Trump was president, and then fell under Biden. Letās be clear: coverage did not actually improve 2017-2020, theĀ perceptionĀ changed. Iām confident that perceptions in the current Trump term will not follow the same pattern ā because many adults, Republican and Democratic alike, are aware that the federal budget bill slashed health programs, and they are likely to feel those effects ā e.g., when kicked off Medicaid or losing ACA premium subsidies. Nonetheless, itās a lesson we must incorporate into our health policy advocacy: messaging matters in perceptions of current problems.
I continue to believe that the growing frustration with Trump as he deconstructs US health insurance (along with public health), combined with inspirational young progressive voices, will provide a historically unique opportunity for true health insurance reform: single payer.
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