2005 Health Confidence Survey: Cost and Quality Not Linked

November 2005, Vol. 26, No. 11
Paperback, 12 pp.
PDF, 430 kb
Employee Benefit Research Institute, 2005

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Executive Summary

The HCS: The 2005 Health Confidence Survey (HCS) represents the eighth wave of an annual survey to assess the attitudes of the American public regarding the health care system in the United States. It is co-sponsored by the Employee Benefit Research Institute (EBRI), a private, nonprofit, nonpartisan public policy research organization, and Mathew Greenwald & Associates, Inc., a Washington, DC-based market research firm, and funded by grants from 13 private organizations.


• Cost not considered part of quality: Findings from the 2005 HCS appear to confirm the notion that Americans tend to view cost as one of the least important factors when considering health care quality. In particular, they are less likely to see a relationship between quality and the comparative costs of health care providers.


    --> While almost all Americans consider the characteristics of their own health care providers to be very important when judging the quality of health care, considerably fewer indicate that information on the cost of alternative providers is very important (63 percent).


    --> A majority of Americans feel that increased access to information about the effectiveness of treatment options (65 percent) and the quality of health care providers (59 percent) would improve the quality of the health care they receive. They are less likely to say that more information about the actual cost of services would improve quality (28 percent).


But cost increases are affecting use: At the same time, many Americans say that health care cost increases have affected the way they use health care and their financial well-being.


    --> Insured Americans who have experienced an increase in health care costs in the past year indicate they have changed the way they use health care. Some reported changes in behavior are positive, such as choosing generic drugs (79 percent) or taking better care of themselves (71 per-cent). Others, such as not taking prescribed medications (21 percent), could have long-term negative consequences.


Poor most affected by higher costs: The increasing cost of health care has disproportionately affected lower-income Americans. They are less likely to express satisfaction with health care and more likely to report shifting resources or changing health care usage to cope with the cost increases they have experienced.


Care rated highly, costs are not: More than half of Americans are extremely or very satisfied with the quality of the health care they have received in the past two years, but only about one-quarter are satisfied with the cost of coverage or the costs of health care services not covered by insurance.