Three-quarters of Americans give U.S. healthcare affordability a D or F rating, according to a new poll from Gallup and West Health.
More than 5,000 Americans were asked to grade the U.S. healthcare system overall and regarding affordability, equity, accessibility and quality. Overall, 44% of Americans gave the entire system a poor or failing grade. One in 3 said healthcare affordability deserved an F.
The report also reveals new findings on what may be driving these perceptions: high rates of skipping or rationing treatment and medication due to cost, disparities in access and quality of care and increasing concern about the ability to pay for healthcare through retirement.
“This is a great country to be hit by a bus because we have some of the most cutting-edge interventions,” said Tim Lash, president of West Health. “But unfortunately, our life and our longevity and our health, our mental health, our ability to manage and prevent chronic conditions that go from birth to the oldest among us, that's where our healthcare system really fails: its ability to deliver the highest value care, because we've been incentivized for so long to just drive profit and drive volume.”
Since 2018, West Health-Gallup have together tracked Americans' views of the U.S. health system. The "West Health-Gallup 2022 Healthcare in America Report" revealed that only 22% of Americans give the overall health system an A or B rating; the same percentage was given to health equity.
Respondents who identified as women, Black or Hispanic said affordability has not increased in the last year, while men and white adults saw slight improvements.
System costs fell to the bottom of the class. Only 7% of Americans give the cost of care an A or B rating. For value of care, 7% gave the system a high perceived value while 57% said value was inconsistent and 36% said it was poor.
“It's not just Band-Aid fixes like capping insulin at $35; we need real structural reform,” Lash said. “One of the things that West Health is very focused on is aligning payment to value and outcomes so that at every level of the system you incentivize the right type of behavior, you drive access and ultimately improve health outcomes rather than incentivizing the billable.”
Just over a quarter of respondents said they could afford quality care today. Thirteen percent reported that in the last three months there was a time when they skipped medication because they could not afford it.
When Americans do cut back, the report showed they skimp on dental care, doctor visits and preventive care in order to cover other household expenses. Women are most likely to put household expenses over health with 16% avoiding doctor visits and 10% rationing or not filling prescriptions.
For those with chronic conditions, 1 in 5 skipped care in the last year due to cost. Black and Hispanic adults ages 50 to 64 appeared most likely to consider cost important when following healthcare recommendations.
“Our healthcare system, as we see it today, is an old vintage car,” Lash said. “It’s hard to maintain. It’s very expensive. It's hard to find parts for. It guzzles a lot of gas and does not get very good mileage. As I look through these results, what we have is a legacy system that is broken, and we need to advance and people should be demanding smarter policies and smarter reforms that can get at the root of some of these problems and deliver a healthcare system that addresses social determinants, the broader person, the whole person.”
This year’s Inflation Reduction Act was referenced in the report’s introduction as a possible beacon of hope. By allowing the government to negotiate prescription drug costs and cap the cost of insulin, the report said Medicare patients may see lower healthcare costs. However, the report emphasized that Medicare only covers about a quarter of the adult population.
In the last year, close to 1 in 5 adults reported worsening health problems due to inability to pay for treatment. Five percent of adults reported the loss of a family member due to the cost of healthcare.
“And we know in the Medicare population alone there's north of 100,000 deaths every year due to non-adherence to prescription drugs due to cost,” Lash said. “That's a massive problem for us and it's a choice. It's a policy choice. We're making some progress. The Inflation Reduction Act is a necessary step. But certainly, it does not go far enough.”
In the next year, 1 in 3 adult Americans is concerned about the ability to pay for healthcare. One in 2 respondents is concerned about the ability to pay for healthcare as they age. Two in 3 Americans under the age of 65 are concerned Medicare will not exist by the time they need it. And 77% of those aged 18 to 49 are worried about the future availability of Social Security.