Most Americans Support Health Care System Reform
Amid concerns that health care delivery in the United States is becoming increasingly inefficient and unsafe, as many as three-quarters of Americans are in favor of fundamentally changing or completely rebuilding the U.S. health care system, according to a report released by the Commonwealth Fund, a health care policy think tank.
Researchers asked 1,023 adults for their views on how patient care and health policy could be improved. Results showed that most respondents believe it is important to have a long-term relationship with a single primary care physician who manages their care (92%) and that care from different doctors is well-coordinated (96%). Respondents also overwhelmingly told researchers they value easy access to medical records for themselves (94%) and all their physicians (96%).
In addition, most respondents said they think it is important to have information about the costs of care prior to receiving treatment (91%) and about care provided by different doctors and hospitals (95%). A further 87% of respondents said they would like insurance companies to identify and reward health care providers who achieve excellence in quality and efficiency of care.
Researchers observed, however, that patients face a very different reality. According to the report, most patients have short-term relationships with physicians and rarely have easy access to their own medical records. Moreover, most patients have little or no access to reliable information on quality and costs of care, and health insurance providers frequently lack the information needed to offer incentives to providers for better or more efficiently delivered care.
When asked what measures they believe would help improve the quality of care, most respondents said they are in favor of computerizing medical records (92%), expanding the role of nurses in delivering care (90%), widening the use of reminders for preventive care (88%), and encouraging physicians to practice in groups (81%).
Survey participants were also asked about their experiences and concerns relating to health care access, costs, and quality. Respondents reported experiencing serious problems over the past two years paying for medical bills (38%), paying for health insurance (38%), getting a doctor's appointment quickly (38%), obtaining information on caring for an aging or ill family member (36%), and having to spend time on paperwork or disputes related to medical bills and insurance (39%).
When asked about whether they had received unsafe, poorly coordinated, or inefficient care over the past two years, 42% of respondents said they had experienced at least one of the following problems: duplication of a test, a medical or lab test error, failure by a provider to pass on important medical information to another provider, or a recommendation of unnecessary care or treatment.
More than three-quarters of those surveyed said they believe the U.S. health care system needs fundamental reform (46%) or should be completely rebuilt (30%). Researchers noted that these views are remarkably similar across income groups and regions of the country, though negative assessments of the current system were found to be more prevalent among Democrats than Republicans, as well as among those who reported having a negative health care experience.
When asked what policy actions they would like to see at the federal level, large majorities of respondents said they believe it is very important that Congress and the president ensure that Medicare remains financially sound in the long term (84%), control the rising cost of health care (84%), ensure that all Americans have adequate and reliable health insurance (80%), lower the cost of prescription drugs (78%), improve the quality of nursing homes and long-term care (75%), reduce the complexity of insurance (71%), and reform the medical malpractice system (65%).
"Overall, the survey reveals a high level of shared public values, experiences, and concerns regarding the current U.S. health care system," the report said. "Worries about the future combined with experienced-based concerns about quality, access, and costs are fueling negative overall views of the current system and stimulating calls for fundamental change."
