Lots of surveys on how its constituents view the US health system. Here is a summary of a recent one from Leavitt Partners. (Leavitt Partners Survey) Leavitt surveyed 621 doctors, 538 employers and over 5000 consumers. On overall view of the system, few think it is working well, needing only minor changes–10% of physicians, 26% of employers and 17% of consumers. 75% of doctors say the system works pretty well, but needs fundamental change, as do 50% of employers and 44% of consumers. The system needs a complete rebuild, according to 13% of doctors, 215 of employers and 24% of consumers. Insurance companies and government get the highest ratings for blame for current problems, with doctors and hospitals getting little credit for the problems they are largely responsible for, so that is a huge problem. Prices charged by these providers are the single biggest issue in the current system. 52% of doctors place the largest blame on insurers and 47% of consumers on government. Employers are more likely than physicians to believe that a variety of cost-control techniques, like narrow networks, bundled payments and cost transparency, will reduce spending. Both groups are way too accepting of the notion that wellness and prevention and cost transparency can control spending. The research simply doesn’t support that.
While being discontent with the system, most consumers, 72%, find their current health plan works well for them. And of course, despite their unhappiness about the system, large numbers of consumers are unwilling to accept restrictions that might control spending even if it results in lower premiums. So none of you people should complain about costs. There tends to be limited believe that various approaches will result in better outcomes, and that skepticism is warranted. Only a minority of employers, physicians or consumers think any of these approaches, like pay for performance, episode payments, or physician/hospital integration, will improve outcomes. And there is little agreement on what tactics might lower prices and spending and on who is responsible for pushing these tactics. There is also little common ground on what is the most significant burden to payment reforms, although a majority of physicians blame regulatory burdens. High majorities of consumers had little or no understanding of basic concepts like integrated delivery networks, ACOs, bundled payments or medical homes. Like other surveys, this one suggests that ignorance of the workings of the health system is not bliss and that people are hypocrites when it comes to being dissatisfied but unwilling to contribute to making necessary changes.