Short Takes On News & Events

Few Americans Think Health Is Improving In The U.S.

By Jordan Rau

November 7th, 2011, 6:00 AM

Public skepticism about health isn’t confined to doubts about last year’s health care law:  Most Americans also think the overall health of the public isn’t improving, according to a new poll commissioned by the Robert Wood Johnson Foundation.

The poll found that 45 percent of people thought the health of Americans had become worse during the past five years, and 40 percent thought it had stayed about the same. Only 13 percent thought it was better.

Blendon

“Americans are convinced not only that the health care systems are not working, but health in the country is deteriorating,” said Robert Blendon, a professor at the Harvard School of Public Health who conducted the poll.

Blendon said the public view doesn’t square with most health barometers from the federal Centers for Disease Control and Prevention, which show many improvements.  “If you called the CDC today, they wouldn’t tell you that” Americans’ health is getting worse, he said.

Blendon attributed much of the sour mood to the public’s larger concerns about the economy. “I think the economy is weighing it down,” he said.

Financial worries showed up elsewhere. Twenty percent of people polled said during the last 12 months they could not afford to pay for health insurance premiums, and 22 percent said they could not afford to pay medical bills.

On a policy level, health care costs were brought up most often as the greatest concern about the medical system, with 51 percent of respondents mentioning costs as one of their two top worries. Eighteen percent cited lack of insurance or access to care, and 14 percent mentioned low quality care.

Improving Medicare, the health program for the elderly, and Medicaid, the joint federal-state program for the poor, ranked at the top of health priorities people listed for the government to focus on. A total of 63 percent cited Medicare as a top priority and 56 percent cited Medicaid. Both ranked above preventing the spread of diseases, preparing for natural disasters or terrorist attacks, and combating chronic illnesses such as cancer and diabetes.

The poll found obesity was a major public health concern, rising above diabetes, HIV and smoking as a condition people named as a top health threat. One out of five respondents mentioned obesity as one of the top two diseases or health conditions they consider a threat, about the same as mentioned heart disease. Only cancer was mentioned more frequently.

The poll found 52 percent of the public favored a bigger government that provides more services for health, while 37 percent favored smaller government that provides fewer health services. Also, 60 percent of the public believed that if the country spent more on efforts to improve health and avoid disease, it would save money in the long run.

“Even if  it may be costly, they understand it’s going to pay off later,” said Fred Mann, a spokesman at the foundation, which gives out more than $380 million annually in grants to fight obesity and improve health.

The poll was conducted by SSRS/ICR from Sept. 19 to Oct. 2 and surveyed 1,598 adults. The margin of error was +/- 2.8 percentage points.

jrau@kff.org

4 Responses to “Few Americans Think Health Is Improving In The U.S.”

  1. Tony says:

    Erskine Bowles testified before the Debt Super Committee last week and told them that America’s health care system ranks somewhere between 25th and 50th worldwide and yet America pays about 17 percent of GDP for its health care system. That is almost twice what any other industrialized nation pays. Mr. Bowles also said that more than 50 million of Americans have absolutely no health care insurance. That’s about 16 percent of the population. Yet, Mr. Bowles told the committee that these 50 million uninsured people aren’t without health care. They simply get their health care at the hospital emergency room, at taxpayers expense, where the costs could be as much as 7 times what they would pay at a doctor’s office. These facts are real! These facts are true! Nobody can dispute these facts! With those glaring statistics, how can anyone possibly think that our health is improving?

  2. Ken Mooney says:

    Professor Blendon makes the following observation:

    “Americans are convinced not only that the health care systems are not working, but health in the country is deteriorating,” said Robert Blendon, a professor at the Harvard School of Public Health who conducted the poll.

    How can you not agree with the convictions of those Americans who who believe that the systems are not working and the national health is deteriorating. You just have to look around.

    There are more and more dollars being drained from the health care system to pay for treatments that are not medically necessary. Examples include cesarean sections that are performed for the convenience of the physician and/or the patient, sex change operations, cosmetic surgery (usually thinly disguised as being medically necessary), procedures performed as part of so-called “defensive medicine” to protect against so many frivilous malpractice suits, narcotics that misprescribed, and so on. These are dollars that are not available to pay for medical care that is truly necessary.

    Then there are patient lifestyles that are detrimental to people’s health: smoking, the use of illegal narcotics, overeating, lack of exercise, etc. These behaviors go unpenalized, so there is no impediment to their continuation. But they add to the cost of health care in this country, and the behaviors continue. Many of these costs occur as a result of the failure by the political class to take effective action to change the behaviors and reduce the cost.

    And, finally, there is a huge amount of fraud that occurs in the system, especially in those programs operated in the public sector: Medicare, Medicaid, etc. The dollars wasted by the failure to prevent fraud, or the failure to detect and prosecute fraud, adds to the cost without improving health care.

    Unfortunately, the situation is unlikely to improve until the political class takes effective action to stop the many drains from the system. But that takes courage and leadership, which appears to be in short supply these days.

  3. Tony says:

    Health is not improving. Fee-for-service medicine is the problem. Fee-for-service medicine rewards sickness. In the fee-for-service model, providers get paid regardless of patient wellness. Sickcare also rewards Big Pharma because a sick person needs more medicines. Suggesting that healthy lifestyles can be incentivized under the fee-for-service model is totally absurd. Healthy lifestyles reduce office visits. Healthy lifestyles reduce the use of prescription medicines. With less office visits and less prescriptions, how could providers and Big Pharma make a profit? We need to find a way that rewards wellness and good outcomes. Until wellness and good outcomes are incentivized, nothing will change. In spite of The Hippocratic Oath, costs are skyrocketing because doctors and drug companies are rewarded to keep patients sick.

  4. Jake says:

    Tony has a point. Major research institutions profit from sicknesses. Until the biomedical industrial complex can earn revenue through preventing disease and instead of treating it, medicine as it is in the US will continue unabated. How can pharma and biotech companies continue to earn profit while doctors are simultaneously financially rewarded for preventing sickness?

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