2006 Health Confidence Survey: Dissatisfaction With Health Care System Doubles Since 1998

November 2006, Vol. 27, No. 11
Paperback, 12 pp.
PDF, 138 kb
Employee Benefit Research Institute, 2006

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Executive Summary

Public dissatisfaction focuses on costs: The 2006 Health Confidence Survey (HCS) finds that the public’s increasing dissatisfaction with the American health care system appears to be focused primarily on the rising cost of care. Many Americans report that rising costs have hurt their financial well-being and feel that steps should be taken to slow these increases.


Sharp growth in poor ratings of the health system: Six in 10 Americans rate the health care system as fair (28 percent) or poor (31 percent). The percentage of individuals rating the system as poor has doubled since the inception of the HCS in 1998 (15 percent).


Health care quality still ranks high: Even as they report growing dissatisfaction with health care costs, Americans are more satisfied with the quality of care they have received than they are with the health care system as a whole, and prefer to use quality rather than cost as their primary consideration when making decisions about care.


Health costs force increasing trade-offs in other spending: Those with health coverage who have experienced an increase in health care costs in the past year are more likely to report their household finances have suffered as a result. They indicate that increased health care costs have resulted in a decrease in saving for retirement (36 percent, up from 25 percent in 2004) and other savings (53 per-cent) and in difficulty paying for basic necessities (28 percent, up from 18 percent) and other bills (37 percent, up from 30 percent).


Employment-based health benefits rated higher than cash: Three-quarters of those with employment-based health benefits state they would prefer $6,700 in employment-based coverage to an additional $6,700 in taxable income (75 percent). When those preferring to keep their coverage are asked how much they would need in additional taxable income to willingly give it up, the median response is $11,000.


Ninth annual HCS: This is the ninth wave of the Health Confidence Survey (HCS), which examines a broad spectrum of health care issues, including Americans’ satisfaction with health care today, their confidence in the future of the health care system and the Medicare program, and their attitudes toward health care reform. The HCS is co-sponsored by the Employee Benefit Research Institute (EBRI) and Mathew Greenwald & Associates, Inc., a Washington, DC-based market research firm. The 2006 HCS data collection was funded by grants from 10 private organizations.