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How do people feel about their health care, reform?

Health Care Reform and Policy
by Cabe Chadick
Health care costs likely to keep climbing
Health care costs likely to keep climbing

With so much attention being paid by both elected officials and the general public to the state of health care these days, it's little wonder people have plenty of strong opinions about the issue. Not only do people generally have a lot of different takes on the state of the care they receive and how much they pay for it, but also provide plenty of positions on the shape of the industry as a whole and what might come of it.

It's vital for those in and around the health insurance industry to understand how people truly feel about coverage and the potential reforms that could come down the pike in the next few years. Right now, it appears the best way to describe the average American's feeling about the state of health care and reform is "mixed at best."

A basic understanding
Recent data from Gallup finds that the vast majority of Americans - about 80% - consider the care they receive to be either "good" or "excellent," though fewer than that (69%) say they're satisfied with their coverage. Interestingly, more often than not, people indicated they're also relatively satisfied with what they pay for coverage, but those in the minority say health care expenses dramatically impact their financial decisions.

For instance, 29% reported that they have delayed treatments they would otherwise seek simply because of how much it would cost, and nearly two-thirds of those people did so despite the understanding that their condition was serious. Not surprisingly, about a quarter say they're worried about being able to pay for even normal health costs, let alone serious issues. More than 2 in 5 also expressed "major concerns" about how much these expenses would rise in the next few years.

People have a lot of strong feelings about the state of health care.People have a lot of strong feelings about the state of health care.

Reining in costs
It should come as no surprise, then, that polling from the Kaiser Family Foundation finds that 68% of people believe Congress should make it a top priority to find ways to lower prescription costs, and nearly as many felt the same way about ensuring protections in federal law of coverage for people with pre-existing health conditions remained in place.

Another 57% were also concerned they or someone in their families would lose coverage if protections for people with pre-existing conditions were overturned, including 39% who were "very concerned" about the issue. Nearly as many - 56% - were worried about losing coverage altogether if the Patient Protection and Affordable Care Act were repealed.

Furthermore, half said Congress should prioritize protections for people who would otherwise be hit with massive "surprise" bills for getting treatment out of their network. Moreover, 63% of people had either a somewhat positive or very positive view of universal health coverage, up from 57% in early 2016.

A closer look at reform sentiment
With all these issues in mind, the plurality of consumers believe health care actually remains the single largest issue in America, according to Real Clear Politics. In all, 36% of those polled felt that way, putting it ahead of the economy (cited by 26%) and immigration (15%), among others.

But even those who prioritized other issues over health care specifically remain concerned. For instance, 28% say the American health care system writ large is "broken" and needs to be completely revolutionized. However, another 39% feel it's not working well and needs to be improved, and 29% believe more ongoing reforms are required even as they feel the current system is generally good. Just 4% believe the system doesn't require much change.

A recent poll from the Pew Research Center also found that 60% of people think it's the government's responsibility to make sure everyone in the country has health insurance, while 37% didn't feel that way and the rest weren't sure. While the portion of the populace who think the government should step up hasn't changed much since 2016, it is up considerably from the 51% seen in 2008, and those who think it's not the government's responsibility has fallen from well above 55% since just 2013.

Pew also found 31% prefer a single, national government health insurance program, while 25% want a mix of public and private options. Interestingly, more than 9 in 10 of those who think the government isn't responsible for covering people still wanted Medicare and Medicaid to exist.

Financial realities
All this comes against the backdrop of concerns about not just high costs, but the potential for them to rise in the future. As of 2016-17 (the most recent period for which complete data is available), approximately 150.5 million people under the age of 65 get their insurance through an employer, pay a median premium of about $2,200, with an additional $800 in out-of-pocket expenditures, according to research from the Commonwealth Fund.

That may be affordable for many families, but there are about 23.6 million people - about 1 in every 6.5 receiving coverage through an employer - for whom premiums and/or out-of-pocket costs amount to at least 10% of their annual income.

With all these situations in mind, those within the health insurance industry may want to think about the ways in which consumers' financial and personal health situations impact their feelings about the sector as a whole.



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