Among the key findings, 77 percent said they fear rising health care costs will damage the nation’s economy, 47 percent have no idea how much a trip to an emergency room would cost, 41 percent have declined visiting an ER because of cost uncertainty, and 45 percent fear a major health problem will lead to bankruptcy.
Between 67 and 70 percent of respondents identifying as Republicans or Democrats said they were not confident lawmakers of any party will be able to lower health care costs. The report also cites data from an unspecified source stating of 11 developed nations, the United States spends the most on health care, at $10,348 per person, nearly 30 percent higher than second-ranked Switzerland and more than double the costs in Japan and the United Kingdom.
The poll surveyed 3,537 randomly selected adults from all 50 states and found widespread concern and pessimism about the U.S. health care system. The poll reports a margin of error of 1.2 to 5 percent.
Third-Party Payer Symptoms
Jane Orient, a physician and executive director of the Association of American Physicians and Surgeons, says the poll results show patients feel disconnected from a system in which third parties generally pay the bills.
“I think Americans have been taught to believe that doctors are too rich and it isn’t fair that they should have to pay,” said Orient. “They know their house or car will be foreclosed on it if they don’t pay, whereas they think there are fewer consequences for not paying a medical bill.”
Orient says she has had patients decline treatment because of cost, but not because they cannot pay.
“Many decide to forgo treatment that might help, if it is not paid for by insurance, even if they can afford it,” Orient said.
The poll reports only 33 percent of respondents said they have had a discussion with their provider about treatment costs. Orient says this represents a big problem.
“The lack of honest price signals is disastrous,” Orient said. “Markets could not function without them. If people could find out what things cost, they would seek and choose needed treatment based on cost and quality and do without a lot of things they accept only because they [see them as being] free.”
Government Cause or Solution?
Polls showing public concern about health care costs often bring on calls to get government more involved, not less so, and this phenomenon has increased in recent years as health care costs have risen, says Kathleen Brown, a physician based in Oregon.
“I think that the best that politicians could do is try to get out of the way [remove bureaucratic obstacles] of private-sector solutions, or at least avoid making it worse,” said Brown. “Unfortunately, most of the electorate doesn’t support that, because they see government as the answer, not as the cause of most of the problems. Until voters understand that, they will lose choices by giving more power over health care to the government. We will get more of the same.”
‘It is Incredibly Wasteful’
Brown says she is dismayed by the high U.S. per capita health care costs noted in the report.
“We are getting very poor value for the money spent, and that siphons off money from other uses and decreases choices for individuals,” Brown said. “The costs of actually providing care are much lower than what we pay. It is incredibly wasteful and a poor allocation of limited resources.”
“The United States does spend the most money on health care, but at least 30 percent and probably much more is skimmed off in the third-party payment system for things that provide no goods or services that help any patient,” said Orient. “It is interesting that in many nations with ‘universal’ coverage, a bigger fraction of expenses is paid out of pocket than here. Also, costs, especially hospital costs, are grotesquely inflated [in the United States]”
As for the public’s lack of confidence in the ability of politicians to fix the problems, Orient says the perception is accurate.
“Change can only occur in the private sector, and only if government gets out of the way,”Orient said.
Rocco Cimino ([email protected]) writes from Washington, D.C.
The U.S. Health Care Cost Crisis, WestHealth/Gallup, April 2, 2019: https://heartland.org/publications-resources/publications/the-us-healthcare-cost-crisis