Causeway Solutions Outlooks and Insights: Volume 3, 11/21 - Instant Insights

Tim Duer

Newsletter, Polling, Healthcare, Analytics

October 27, 2021

Instant Insights

Lowering the Bar: Mixed Feelings about the State of US Healthcare and Insurance

The most recent Causeway Solutions Instant Insights focused on healthcare and insurance in the United States. The promising news is that out of 600 respondents, 94% are somewhat or very satisfied with their health insurance; BUT these responses do not necessarily indicate that patients are really happy with the care that they receive or the associated costs.

Although respondents said that they are satisfied with their health insurance, 38% reported a recent occurrence where care they believed was covered by insurance was covered at a lower level than expected. An additional 31% noted a situation where their care was unexpectedly not covered at all. So, while respondents' express satisfaction with their insurance, more than two thirds have also experienced recent incidents when they had unanticipated charges for care received.

Given that these two findings do not align, what other findings could we use to explain satisfaction with coverage?

Maybe the people are generally happy with their covered health expenses, and the reported surprise charges were just an anomaly in an otherwise good health plan, BUT most of them report that they recently had to modify a doctor’s recommendations due to cost.

More than 50% of respondents indicated that cost alone had caused them to avoid some recommended healthcare. Which healthcare or service were they most likely to go without? 54% skipped filling a prescription, followed by 46% going without a recommended X-Ray or MRI.

OK, so given that information, may feel that they are generally satisfied with their coverage, but they do not have a great understanding of what the coverage includes, BUT this does not appear to be the situation either, as 55% expressed moderate or strong agreement that they understand their insurance well. Further investigation showed that this confident group is well represented as more than 50% of both men and women indicated that they understood their coverage well.

If they indicated that they understand their coverage, are satisfied with the coverage, but have had surprise financial responsibilities and are even skipping recommended care due to cost, then maybe the explanation for such an inconsistent set of responses is that people have just come to expect confusion and excessive costs associated with healthcare. This assessment is further illustrated by the results where 46% of the respondents feel that the US spends too much on care, compared to only 17% who think the country does not spend enough. These responses appear to demonstrate a recognition that excessive costs are present in the system and how it impacts their care but accept it as generally satisfactory.

What could make people feel better about coverage as it relates to the financial unease that they have indicated? Quality.

When asked what they valued most from healthcare, 70% named quality of care as most important. Cost was the driver for 18% and 12%, valued service or the way they are treated as a patient/customer. While many people may not be happy with the price of healthcare and have had to make difficult choices about which care to omit due to price, the satisfaction in health insurance coverage may really be driven by an appreciation for the quality of care that is received.

So, what does the more dissatisfied group look like? Although they were a small group, accounting for only 5% of the respondents, this group had a vastly different perspective than the overall group. Only 18% of the overall group saw cost as the most valued aspect of healthcare while more than 56% of those that were dissatisfied with their coverage valued cost most. To make matters more confusing, only 50% of this group had ever called a hospital/provider with concerns about a medical bill, as compared 57% of the overall group.

This confusion and inconsistency in response demands that we might be best to step back and look at a distinct perspective on healthcare... TV viewership preferences of the various segments may provide the clearest assessment of health:

Even when accounting for any age or sex discrepancies, those who reported being dissatisfied with healthcare also favored MASH as their #1 medical TV show. Maybe wartime medicine viewing has given the former group a Hawkeye Pierce-like mix of morality, cynicism, and reality, driving their expectations. The overall respondent group was overwhelming in their choice of Grey’s Anatomy as their favored medical show. And so, it might be Dr. Meredith Grey that deserves some thanks, or blame, for promoting the ongoing resilience needed to accept the challenges associated with healthcare and health insurance in the United States.

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