Public Feedback on Cost
While the public favors increased spending on healthcare, people are concerned about the impact of rising health care costs on families. The perceived negative impact of increased insurance premiums, deductibles, co-payments and direct payments for goods and services on families far outweigh concerns about aggregate spending.
- Twenty-six percent of respondents to a recent survey believe the county as a whole is spending too much on healthcare, in contrast to the 57% who believe we spend too little.
- The question may hinge on who is doing the spending – 70% believe the government spends too little, compared to just 11% who think governments spend too much. But views are just the opposite for individual spending, where 65% stated that individuals spend too much, and 17% believe they spend too little.
- The percentage of people who believe the system has ‘major problems’ has remained stable at 58% to 52%, while the percentage of people who say the U.S. healthcare system is in a state of crisis has increased from 12% in 2000 to 22% in 2006.19
- Overall, just 6% of Americans rate the nation’s health care system as “excellent” and 69% rate is as “fair” (32%) or “poor” (37%).20
- Despite these concerns, most survey respondents rate the quality of services (84%) and physician care (85%) they receive as good or excellent.21
- At just 4.3% of the total, nursing home care accounts for a lesser percentage of total spending than the national average of 7.4%.10
The Public’s Priorities
Despite high levels of attention being paid by the media and public officials, just 2-3% of the public saw illegal immigration, malpractice lawsuits and waste as the one of the two most important healthcare system issues that government should address.
Topping the list of health care system issues government should address are healthcare costs, which were cited by 43% as one of the two most important issues, and insurance coverage, which was cited by 34%.
In 16 out of the 19 citizen forums held throughout the country, creating a national health program ranked as the #1 option for increasing access to care. Reliance on the free market was the least favorite option, ranking #10 of the ten options in 84% of the forums.22
When asked where the state should place its public spending priorities to reach the goal of “health care that works for all Americans,” participants in a Phoenix forum ranked the options as:
- Guarantee health insurance for all.
- Invest in public health.
- Improve access for minorities.
- Guarantee enough providers.
- Biomedical and technological research.
- Develop health information technology.
- Preserve Medicare and Medicaid.
- Ensure health care for all, including safety net programs for the poor.
At the federal level tax incentives have been a primary strategy for increasing insurance coverage, however in Arizona, public support for tax incentives appears to be somewhat lukewarm. In Phoenix, 53.1% of participants supported further tax policy incentives for ESI, while in Tucson the level of support for employer tax breaks was 50%.23
19 Blendon, Robert, et al. (2006) “Understanding the American Public’s Health Priorities: A 2006 Perspective.” Health Affairs Web Exclusive; October 17, 2006, w508-515..
22 Health Care That Works for All Americans: Recommendations of the Citizens’ Healthcare Working Group. (2006) Accessed 10/10/06 from: http://www.citizenshealthcare.gov/recommendations/appendix_b.php.