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Faced with Increased Health Costs, Americans Favor Major Overhaul

By Jesse Stanchak, CQ Staff

October 7, 2008 -- With increased medical costs putting a strain on household finances, Americans say they are unhappy with their health care system and want to see major changes, according to the Employee Benefit Research Institute's 11th annual Health Confidence Survey.

A majority of Americans, 51 percent, want a "major change," says the survey, while 20 percent say that a complete overhaul of the health care system is necessary. Thirty-one percent would rate the American health care system as poor and 29 percent would rate it as fair.

Survey respondents appeared content with the quality of care—49 percent say they're very or extremely satisfied with quality of care—but not as content with the cost of care. Only 17 percent say they're satisfied with the costs of insurance and just 15 percent say they're satisfied with the cost of treatments insurance doesn't cover.

Overall, 55 percent of Americans with insurance report having increased costs in the past year. While that figure is down from 63 percent in 2007, increased costs are still taking a toll on American finances. According to the survey, 27 percent say they have trouble affording basic necessities because of increased health spending, while 34 percent report trouble paying other bills. At the same time 29 percent say they're saving less for retirement and 54 percent say they're saving less overall.

Yet just 13 percent of Americans think health care is the biggest crisis facing America today, behind the economy (33 percent) and rising fuel costs (24 percent). They're also of two minds about how to solve the problem. The study shows 87 percent favor health tax credits, similar to the health plan of Republican presidential nominee Sen. John McCain of Arizona, while 83 percent favor letting people buy into the same health care system government employees get, an option some would have under the health plan of Democratic presidential nominee Sen. Barack Obama of Illinois.

The survey shows that Americans who have seen their costs go up aren't waiting for the health care system to change. Instead, many are changing the ways they use health care. Patients with insurance who experienced an increase in health care costs over the last year are looking to cut costs themselves, with 63 percent saying they discuss treatment options more thoroughly with their doctor and 62 percent saying they go to the doctor only for more serious problems and 47 percent saying they had delayed a doctor visit. Generic drugs are also a popular cost-cutter, with 74 percent saying they choose them more often, while 39 percent say they're switching to over-the-counter medicines. Only 33 percent of insured patients with higher costs are looking at cheaper providers or cheaper insurance.

The survey finds that those with health insurance who haven't seen an increased cost are less likely to economize. Among insured patients who hadn't seen higher costs, just 52 percent were having more thorough discussions with their doctors, 48 percent were more likely to see a doctor only for serious problems, and just 33 percent had delayed a doctor visit. They were also less likely to use generic drugs (60 percent) or shop for cheaper health care providers or insurance (12 percent), according to the survey.

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