Health Reform Does Not Increase Confidence in Health Care System

"It is still too early to determine how the new health reform law is being received, but we do know Americans have been and continue to be unhappy with the nation's health care system," said Paul Fronstin, director of EBRI's Health Research and Education Program. "But people do see the law as detrimental to employment-based health coverage, which is where most Americans currently obtain their health insurance coverage."

The 2010 HCS represents the 13th wave of an annual survey undertaken to assess the attitudes of the American public toward the U.S. health care system. Among its key findings:

• Conducted two months after the passage of health reform, the HCS finds that dissatisfaction with the American health care system remains widespread. A majority of Americans rate the health care system as poor (27 percent) or fair (31 percent).
• Confidence in today's health care system has remained fairly level despite the passage of health reform. More than half of the survey respondents say they're extremely or very confident that they will be able to receive the treatments they need. Compared with 2009 levels, confidence that they'll have enough choice about their medical care providers is largely unchanged. The percentage of individuals who say they are extremely confident that they are able to afford health care without financial hardship increased from 11 percent to 16 percent between 2009 and 2010.
• Americans' ratings of their own health plans are generally favorable: Fifty-eight percent of those with health insurance coverage are extremely or very satisfied with their current plan, and 30 percent are somewhat satisfied.
• Satisfaction with the quality of health care remains fairly high, with 59 percent of Americans saying they are extremely or very satisfied with the quality of the medical care they have received in the past two years. This is the highest level of satisfaction reported since the HCS was started in 1998. In contrast, just 22 percent are extremely or very satisfied with the cost of their health insurance, and only 19 percent are satisfied with the cost of health care services not covered by insurance.
• Confidence in the future availability of employment-based health benefits fell. In 2010, 52 percent of individuals with employment-based coverage reported that they were extremely or very confident that their (or their spouse's) employer or union would continue to offer health insurance, down from 59 percent in 2009. The decline may be due to passage of health reform, the continuing weak economy, or both.
• Many Americans see themselves as good consumers of the health care system. Three-quarters report that they always or often have their doctor or medical professional explain to them why a test was needed, and two-thirds say they ask their doctor about the risks of treatment or side effects of medications. Slightly more than half said they ask about the success rate of any given treatment option. Fewer say they always or often bring a list of medications, bring a list of symptoms, ask about less costly treatment options or medications, or ask for less invasive or easier treatment options.
• Many Americans have tried to find objective information about various aspects of health care. Nearly half tried to find information on the advantages and disadvantages of different treatment options, whereas one in three tried to find information about a doctor's training and the costs of different treatments. Fewer people sought information on costs of doctors and hospitals, the number and success rate of hospital-based procedures, and disciplinary actions. Among those seeking information, between 17 and 35 percent found all of the information they sought, whereas between 54 and 72 percent found some of the information being sought.
• Many Americans may not be ready to use rating systems to make decisions about providers. Only about one in three indicates they would be extremely or very comfortable using such a rating system to find a doctor or hospital. Individuals rank the importance of information about the effectiveness of different types of treatments much more highly than a rating system based on cost. One-half think information about the effectiveness of different types of treatments would be extremely important if they were trying to choose a treatment, and 31 percent think it would be very important.

Source: EBRI