With nearly 20% of the US economy now consumed by health care expenditures, it is important to consider how this level of spending impacts the public. Thanks to the foresight and collaboration of two organizations, West Health and Gallup, results from a large and comprehensive survey on the state of health care in America provide important insights. Fielded during the pandemic, the survey reveals the opinions of more than 6,600 adults in all 50 states. Spoiler alert: it isn’t pretty.  

Here are a few of the highlights: 

1. Negative perceptions of the US health care system related to cost, quality, and access grew dramatically over the course of the COVID-19 pandemic. Nearly half of all Americans surveyed (48%) say their view of the US health care system worsened due to the pandemic. 
   
   
2. An estimated 38 million Americans (15%) report that their ability to pay for health care has become worse due to the pandemic, resulting in a greater portion of Americans delaying and deferring needed care.
   
   
3. Few Americans believe they receive good value when weighing the quality of care against the cost. An overwhelming majority of Americans (93%) agree citizens across the country are paying too much for the quality of care received. This view is consistent across all income groups and has increased significantly throughout the year.
   
   
4. More than a third (35%) of respondents say they are “more worried” about affording health care in the future, a concern shared by at least one in five households making more than $90,000 a year. One-fifth of Americans (21%) report a time in the prior 12 months when they or a household member had a health problem worsen after postponing care, with Medicaid beneficiaries (37%) reaching nearly the same level as the uninsured (39%). Black adults are twice as likely as White adults to know someone who died because cost kept health care out of reach.
   
   
5. When falling ill, 73% of Americans report being somewhat or very worried about insurance covering the cost of treatment. Among respondents, there is more concern about the cost of care than missing work or finding a provider to treat the illness. For many Americans, the cost of care may worsen their health conditions due to both care avoidance and added anxiety.
   
   
6. More than two-thirds of Americans, regardless of party affiliation, say they are pessimistic about the federal government enacting policies to reduce health care costs in the coming year. Two-thirds of US adults (66%) think voters have very little to no power in reducing the cost of health care in the US, but nearly nine in 10 think American businesses, corporations, and US Congress do.  

The report points out that this overwhelmingly negative public sentiment has been years in the making. Tim Lash, President of West Health, sums the report up like this: “Bottom line – Americans are increasingly getting priced out of the system, and many of those who can still afford to pay don’t think they’re getting their money’s worth relative to the cost. We must begin to change this trajectory with smarter policies that put patients over profits.” So what happens next? Will politicians in Washington and across state governments feel the public's pain and finally take meaningful action to lower costs, improve access, and reduce inequities? The BHC will continue advocating on behalf of purchasers, businesses, and workers that they do.

Warm Regards,

Louise Y. Probst

BHC Executive Director