How Do Americans Rate Their Healthcare?

April 13th, 2011 at 7:52 am | 18 Comments |

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News reports are trumpeting a new poll which seems to suggest that Americans are unhappy with the quality of their healthcare. But are Americans really dissatisfied or just buying into news coverage suggesting our healthcare system is broken? In this case, the study organizers got what they polled for.

Here’s one report on the study from The Hill that seems typical of much of the coverage:

More than half of Americans believe the quality of U.S. healthcare is average at best, a new poll finds.

Fifty-fifty percent gave healthcare quality a C or D grade on a typical report card scale, and 11 percent said the system completely flunks out, according to a survey from the Robert Wood Johnson Foundation.

“The poll is a wake-up call for payers and the healthcare industry, both of which have been working steadily to improve the quality of care, but need to kick their efforts into overdrive toward accountability,” said foundation president and CEO Risa Lavizzo-Mourey.

Now, the Robert Wood Johnson Foundation is a fine organization. But the above blurb is at best misleading and at worst intellectually dishonest. The question posed was:

Using an A,B,C,D, and F grading scale like they do in school, how would you grade each of the following”… with respondents then being asked to appraise “The quality of health care in the country as a whole.”

That’s the question that led to the conclusion that Americans don’t think much of their healthcare system. And it provides great fodder for those looking to affirm the need for Obamacare.

Here’s the problem: When the same 1034 respondents were asked how they would rate the “quality of health care YOU receive”, 65% gave it an A or B and another 19% a C.

There’s clearly a disconnect between how respondents view their own personal healthcare experiences and what they imagine the experience of others with the system to be.  In the end though, respondents have little clear expertise for evaluating anything but their own personal experiences and are perfectly happy with those personal experiences.  They may believe that others’ health care experiences, elsewhere in our country, are profoundly unsatisfying, but rate their own interactions with providers as mostly positive.

Couldn’t the headline of the blog piece have been, “Americans love their healthcare” rather than the actual headline: “Poll: Most Americans have unfavorable view of healthcare quality”?

American healthcare is too expensive and needs reform, but don’t believe that patients and healthy citizens hate our system. They seem satisfied with the results too: According to a Congressional Research Service study conducted in 2007, 89% of Americans report their health as being “good,” “very good,” or “excellent” — the third highest of the many advanced countries comprising the Organization for Economic Development.

Despite the spin on this latest study, most Americans still rate their health as good and their personal experiences with the health care system as positive.

Recent Posts by Stanley Goldfarb

18 Comments so far ↓

  • TerryF98

    Why don’t you get into the real world Stanley? Your apologist mentality and defense of a broken system is getting way old.

    Get out and ask those bankrupted by their health provider what they think.
    Get out and ask those who have reached their lifetime cap what they think.
    Get out and ask those who have been the victim of rescission what they think.
    Get out and ask those who have been denied coverage because they had a trivial condition what they think.

    Just get out more.

    • Smargalicious

      I’m sure the Obama voters, illegals, and their anchor babies enjoy their American healthcare.

      They simply walk into any hospital ER and demand free services from birthing, injuries, and primary care.

      This parasitic process destroys communities by forcing hospitals to close due to lack of funds.

      • Rob_654

        Hey – if you want to push Republicans to order hospitals to not treat people who show up without medical coverage or the ability to pay up front that is fine with me – just make sure it is for everyone – illegal or not because maybe we shouldn’t be paying for those people at all.

        Just a few nights of seeing people pushed back onto the sidewalks and suffering and dying – particularly kids – would be the fastest way to a single payer plan that I can think of.

        • Smargalicious

          Nice try.

          But we can’t support the parasites any more.

          We’re broke.

          What can’t you understand about that?

        • Rob_654

          Nice Try? For what? I get that we are broke – so why don’t you push the Republicans to enact your desires?

          Don’t you get it? We are BROKE? It is time for bold and drastic actions and the Republicans are the ones to take those actions forward!

          Don’t back down just because its tough.

        • Houndentenor

          so, Smarg, who is your insurer?


    “There’s clearly a disconnect between how respondents view their own personal healthcare experiences and what they imagine the experience of others with the system to be.”

    This is just the medical equivalent of Americans roundly hating Congress but liking their own individual congresscritters.

    Incidentally, since he’s so impressed with “65% gave it an A or B”, would Dr. Goldfarb like to give any examples of companies or other organizations that would be satisfied with 35% of their customers rating them a C or below?

  • forgetn

    About a year ago, Glen Beck went on a rant that America had the world’s best health care system, and that no other system gave people as much choice and quality — this in contrast to a You tube video of Beck raging against health care after a wisdom tooth operation faced complication.

    In reality, asking anyone to grade their health care system is pointless. You may feel that your health care system is the best/worse in the world, but its meaningless in theres of the reality of each health care system.

    What is useful, it to use metrics that show if people are actually getting good health care compare to other country. What is the survival rate for breast cancer? quality of life during the treatment (yes it can be measured). Hard empirical data is what is needed.

    the American health care system has qualities and challenges:

    As a proportion of GDP by far the most expensive in the world
    Affords patients the highest level of choice
    50% of all personal bankruptcy are caused by medical bills — for people who have insurance
    Medical cost inflation is very high (true in many countries).

    These are the issue on which Americans can begin to pass judgment on their medical system. Even then the issues are very complicated. However, one thing for sure that screaming from the roof tops that “We’re #1″ is probably not the answer.

    Finally, 90% of Americans don’t encounter the medical system in any meaningful way. It’s a bit like asking them How good is America’s prison system!

  • oldgal

    We do not have a health care system. We have a hodge-podge of hopitals, doctors and insurers, with a few health systems (Mayo, Cleveland, Kaiser) thrown in the mix. I made an appointment ( preference) with my Dr. at Kaiser 5 days ago for a physical, went in yesterday, spent an hour with the Dr., got some lab tests, and picked up a prescription. Last evening I got an E-mail that my lab tests were available, signed on, reviewed the tests, reviewed explanations of the tests, charted results for the last 10 visits, and checked messages from my Dr. explaining changes to dosage for one prescription and why, as well as follow-up actions she wanted me to take. This insurance is the cheapest offered by my employer and is about half the cost of the others…because they offer a health care system that is focused on keeping you healthy instead of just getting you well. The other members of my family who don’t live where such a plan is available are quite jealous even though they are happy with their physicians.

    Most Americans don’t have a clue what a health care delivery system is.

  • Elvis Elvisberg

    Americans are one of the ricchest countries in the OECD, and they grade their health care mid-low relative to the rest of the OECD:

    Not that it matters a whole ton, as forgetn points out– we don’t have much frame of reference for this sort of thing. Public opinion polls are a pretty lousy metric for evaluating our health care system.

    Instead, facts.

  • Frumplestiltskin

    More dribble from the hack. Hey, I can be totally honest and say I was perfectly happy with my company provided health insurance plan because….I NEVER had an occasion to use it beyond an occasion bug. And being that my plan was a fairly hidden purchase done by my employers I never had cause to analyse the hidden costs…such as how much higher my salary could have been if there were state sponsored insurance exchanges where I could take the money my employer was deferring towards insurance and use it myself to purchase a plan that was right for me and my family. Exchanges that had the purchasing power of hundreds of thousands if not millions of people instead of 60 employees. Or go even further and be like the rest of the OECD and have some variant of UHC, like Japan which pays half of what we pay yet has better outcomes.

    These issues are what is important not whether the fact that I am happy with something I have been lucky enough not to need to use. Hey Goldfarb, why don’t you do a study comparing satisfaction of people with chronic or serious diseases from country to country?

    This guy is such a hack, so clueless and out of touch. Hey Goldfarb, ask your gardener how happy he is…oh wait, you don’t speak Spanish and you only hire illegals, right?

  • Frumplestiltskin

    let me add, in all the time I have been reading this hack I don’t think I have ever read a single post where a single commentator actually agreed with him, his arguments are always so specious.
    I wish David would realize this and get a decent Conservative health care writer who can not be so easily vivisected.

  • hisgirlfriday

    I’m curious about the age breakdowns of the people who took this poll.

    What percentage of respondents are on Medicare and what percentage are in private healthcare?

  • budgiegirl

    As a physician, and at the risk of sounding like a total snob (go ahead say it), I would say that it really does not matter what Americans think of their healthcare. In my opinion, Americans are notoriously bad at assessing what constitutes good care. As a generality, they think that more tests, more medicine, more referrals, more treatment constitutes good care. Actually, less is often more. The doctor that is a good listener and a good diagnostician often does not need to order so many tests or treat with bogus meds just to appease their patients. We are bankrupting the medical system in part because of caving into “the customer is always right” school of medicine. There are much better measures of quality of healthcare than popular opinion. We have become the American Idol society!!

    • oldgal

      Seems like there is a trend anymore to democratize science…why mess with scientific method when you can just have folks polled?

  • Rob_654

    US health care is great if you can afford it or have a good health insurance policy.

    That fact is that most people don’t really interact with the health care system beyond a basic level.

    I had a friend who was found in a very bad state last year and spent some time in ICU and the out of pocket costs for her are really incredible – even with health insurance and most likely she will simply have to file bankruptcy and see what she can do as with what she makes she is already having to decide which bills to pay and which not to pay to pay these medical costs and can’t afford the medicine that she needs so she is rationing that – and this is just a crap shoot for many people if they ever have to use the very costly medical procedures, etc…

    She said that before this she thought health care was fine but after this suddenly her point of view is a bit different – oh and by the way she is originally from Canada so the idea of going broke and filing bankruptcy because of a stroke of bad health luck is something quite foreign to her.

    I suspect that many Americans who rate their Health Care as good or better might have a different point of view if they ever have to go beyond a simple health care issue and are not covered by an excellent health care plan or are wealthy enough to pay out of pocket.

  • COProgressive

    Stanley wrote;
    “Despite the spin on this latest study, most Americans still rate their health as good and their personal experiences with the health care system as positive.”

    The bait and switch here is the merging of “Healthcare” and Healthcare System”.

    I agree that the “Healthcare” I receive is excellcent. What I disagree with is that the “Healthcare System” I have is excellent.

    Let me explain. I’m retired and my “Healthcare System” is one where my former employer pays for 2/3 the cost of my Sickness & Injury insurance and I pay for the other 1/3 of the S&I insurance. It’s a good deal for me and my family, but had I not retired from a good company with good benefits my “Healthcare System” would be grim. My former employer and I combined pay $14,600 a YEAR for S&I insurance. On top of that my family has a $2,700 deductable I need to pay before the S&I insurance is of any use to me.

    Each December 31st that $14,600 is gone never to be of any use to me or my family in the future. If, for some reason, I miss a payment or my payment arrives late, my S&I insurance “Healthcare System” is cancelled. For people who are still working, the loss of a job will generally mean loss of their “Healthcare System” as well.

    The current “Healthcare System” of S&I insurance companies is expensive because it has to support two complete wholesale profit systems that is funded by the patient. That’s right two complete profit systems. The healthcare providers have a profit system and the cost of care plus the cost of the overhead and profits are added to the care costs and passed along to the S&I insurance companies who add their overhead and profits and then bill all the uses to cover both sets of overhead and profit. The S&I insurance companies in this picture provide NO HEALTHCARE. They are simply money handlers passing through the funds from a pool of people and paying the care givers, all the while paying themselves 15-25% of every healthcare dollar spent.

    There is simply a difference between “Healthcare” and the “System” by which most Americans receive it. “Healtcare” good, “System” bad!

    We need to stop thinking of healthcare as insurance and start thinking of healthcare as a legacy we leave to our posterity.

  • COProgressive

    “I still don’t get how my health care should be controlled by a system that was invented to compensate shippers for losses incurred due to storms and pirates.” – RUCerious – Think Progress dot Org