Patients' Perspectives on the State of Healthcare in America

Despite big changes in the American healthcare system over the past 2 years, most US residents report that the healthcare they personally receive has remained about the same. In addition, while most adults view the costs as reasonable at the moment, they believe healthcare costs are getting less affordable, according to findings of a survey sponsored by National Public Radio, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health.

The survey also found that far more adults rate the care they personally receive as excellent than rate the healthcare system in their state or the nation similarly. However, less than half of recent patients believe the healthcare they personally received was excellent. The survey revealed a gap in quality depending on income: low-income individuals (annual household income less than $25,000) are far more likely to say the care they got was fair or poor than those with higher incomes. However, 62% of low-income adults say they received good or excellent care.

The survey also showed that healthcare costs cause serious financial problems for more than one-fourth of Americans, more than 40% of whom report spending all or most of their personal savings on large medical bills. Approximately 1 in 5 adults do not believe they get good value for what they pay toward the cost of their care, and about 1 in 5 say they struggle to afford prescription drugs. More than a third believe their health insurance co-pay, deductible, and premium costs have increased in the past 2 years, while only 1 in 6 say the same of their benefits.

The survey asked if respondents faced barriers to accessing healthcare, and whether adults experience care at different sites, including doctor’s offices, 
hospitals, the emergency department (ED), urgent care centers, and retail or drugstore mini-clinics. Nearly 75% of respondents said they have a regular healthcare professional who provides most of their care when they are sick or have a health concern.

One in seven adults reported they were not able to get the care they needed at some point in the last 2 years, but 4 in 5 were able to see a different provider, most commonly in the ED. One in 7 was unable to the healthcare they needed at some point in the past 2 years.

The survey is based on self-reported experiences of healthcare consumers across the country and in 7 states: Florida, Kansas, New Jersey, Ohio, Oregon, Texas, and Wisconsin. These states were selected because they represent a geographically diverse group of states that have, and have not, expanded Medicaid. Interviews of approximately 1000 persons in each state were conducted in Spanish and English by an independent research company between September 8 and November 9, 2015. An additional 1002 people were surveyed nationally.