Most Americans still get health care coverage through their employer. How do they perceive the health system, their health plans and their health care? A survey of 1500 employees aged 21 to 64 from the Employee Benefits Research Institute provides some answers. (EBRI Survey) They don’t think much of the overall health system: 27% say it is poor, 33% fair, and only 12% rate it very good and 3% excellent. The dissatisfaction is focussed on cost, only 17% say they are satisfied or very satisfied with the cost of their health plan and 15% with costs outside of the plan. Despite this negative view of the health system, half of respondents said they were extremely or very satisfied with their own coverage and 45% say they are extremely or very satisfied with the quality of their medical care. Respondents also generally expressed concern about the future of the health system and their own health coverage, with most perceiving that it will get worse in the next ten years. Ratings of the overall health system have fluctuated slightly over the last ten years, to some extent tied to economic conditions. Satisfaction with quality of care and with the individual’s own health plan have also been stable, but satisfaction with costs has declined in the last 15 years.
In response to health care cost increases, workers say they are doing things like take better care of themselves, 73%, use generic drugs, 55%, go to the doctor only for serious problems or delay going to the doctor, about 50% and talk to the doctor about treatment options and costs, 43%. Interestingly, however, those reporting taking these actions has generally declined over the last ten years, for example 85% said they were trying to take better care of themselves in 2009 and 80% said they were using generic drugs more in 2006. Employees are also responding to health care cost increases by reducing spending in other areas, for example, 28% say they have reduced retirement savings, 48% have reduced other savings and between 25% and 36% say they have difficulty paying for even basics like food and housing and for other bills. 30% said they will delay retirement due to health care cost growth. These levels of financial stress are somewhat reduced from a few years ago, but still indicate ongoing financial pain for a substantial portion of the working population.