|Consumers Rate U.S. Healthcare System Poorly, According To Deloitte Survey
As healthcare reform heats up in the White House, nearly
40 percent of consumers have expressed discontent with the status quo,
rating the U.S. healthcare system a D or an F.
A quarter of consumers have skipped care when they were
sick or injured; 2 in 5 of those consumers have done so because they
simply could not afford it, were not covered by insurance or thought
the costs were too high, according to the results of the 2009 Deloitte
Survey of Health Care Consumers.
In addition to skipping or delaying care, the high cost
of healthcare is prompting many consumers to switch their physicians,
prescriptions or health plans to save money.
Of the 16 percent who switched physicians in the last
year, 1 in 4 switched due to costs. Three in 10 switched medications in
the past year; 38 percent switched to save money. Seventeen percent of
enrollees changed health plans in the past year; 29 percent were
seeking a lower cost plan.
"The current economic climate is taking a toll on
American consumers prompting them to increasingly make decisions about
healthcare that are married to their pocketbooks," said Paul H.
Keckley, executive director, Deloitte Center for Health Solutions.
"Consumers want a bigger say in their healthcare decisions. More than
half believe that 50 percent or more of the dollars spent on healthcare
in the United States are wasted. The time for healthcare reform could
not be more pressing."
More than 4,000 U.S. consumers 18 and over were surveyed
as part of Deloitte’s second annual study examining healthcare
consumers’ attitudes, behaviors and unmet needs conducted by the
Deloitte Center for Health Solutions. The survey offers healthcare
industry leaders and policymakers a timely look at how healthcare
consumerism is evolving and provides a comprehensive perspective about
how Americans approach their health, healthcare and health insurance.
Based on a unique segmentation scheme that goes beyond
the conventional boundaries of what health and healthcare are commonly
thought to encompass, the survey provides a framework based on the
expanding spectrum of treatment alternatives, delivery settings,
information sources, technology innovations and programs.
"The results of our survey are conclusive –
consumers want better performance from their health system," said John
T. Bigalke, vice chairman and U.S. health sciences and government
industry leader, Deloitte LLP. "They want better value for the dollars
they spend and believe fundamental changes are necessary to achieve
As the new administration moves forward to tackle
healthcare reform, it may not have to look too far to see what is
currently working with the system.
Fifty-three percent of insured consumers are satisfied
with their plan, an increase from 44 percent from last year’s
survey. Surprisingly, those that are most satisfied include Medicare
(70 percent) and military health (67 percent) enrollees, compared with
only 45 percent of individual policy holders that are satisfied with
their health plans.
The Deloitte survey also reveals many gaps between what
consumers think about their health status and the effort they put into
improving their health and adhering to medical treatment. While 7 out
of 8 Americans believe they are healthy, the reality tells a different
Chronic conditions are becoming more mainstream in
America, with more than half (55 percent) of survey respondents
reporting at least one or more chronic conditions.
Additionally, 57 percent indicated that they take one or
more medications; however, only 4 in 10 say they take their medications
as directed. This is coupled with the fact that less than half of
consumers surveyed say they act in ways to make themselves healthier:
44 percent are trying to reduce stress, 44 percent are focusing on
eating a healthy diet, 39 percent are putting an effort into managing
weight and only 35 percent are exercising.
Additionally, consumers are beginning to test alternative sources for care often driven by lower costs.
For example, 13 percent of consumers surveyed have
visited a retail clinic this year and 30 percent said they would do so
if it cost 50 percent or less than seeing a doctor in a doctor’s
office. Eight percent of consumers have traveled for care outside of
their local community as "medical tourists," and 43 percent said they
would be likely to do so if it would cost 50 percent or less than
staying in their local area.
However, only 1 percent said they have traveled offshore
to receive care; and 1 in 10 say they would consider doing so if they
could save money. One in 5 consumers also used an alternative or
natural therapy to treat a health problem in the past year.
The framework of the study reflects a broad-based view of consumerism in six zones:
(1) wellness and healthy living, including self-care and health management;
(2) information sources helpful in consumer decision-making;
(3) traditional health services provided by medical
professionals, hospitals and retail clinics, as well as prescription
medications and medical devices;
(4) alternative health services sometimes described as complementary medicine;
(5) insurance coverage and other financial considerations; and
(6) opinions about health reform.
Data across these six zones uncovered a variety of
trends that influence how consumers view the healthcare system and
areas they are willing to consider for future changes:
- Fifty-three percent would like employers to be required to provide health insurance for employees (17 percent oppose).
- Thirty-seven percent favor a mandate requiring every
American to obtain health insurance either through direct purchase or
through an employer or government program.
- Twenty-five percent favor increasing taxes to help cover the uninsured (43 percent oppose and 32 percent are lukewarm).
- Cost concerns (52 percent) and loss or lack of
employer sponsorship (52 percent) are major reasons for not having
coverage among the uninsured.
- Almost half (47 percent) of those who dropped their
coverage in the last year did so because they couldn’t afford or
didn’t want to pay the high cost of insurance; Thirty-three
percent did so because they switched jobs and 10 percent did so because
their employer dropped their plan.
- Most (94 percent) believe healthcare costs are a
threat to their personal financial security – only 6 percent say
their household is completely prepared financially to handle
anticipated healthcare costs.
- Eighty-four percent believe current economic
conditions will make it harder for consumers to pay their medical
bills; 28 percent had problems paying medical bills in the past year.
- Seven in 10 say they would participate in a wellness
program if they were given financial incentives, such as a reduced
insurance premium or monetary reward.
- Forty-two percent want access to an online personal health record connected to their doctor’s office.
- Fifty-five percent want to be able to communicate
with their doctor via e-mail to exchange health information and get
answers to questions.
- Sixty-eight percent of consumers are interested in
home monitoring devices that enable them tocheck their condition and
send the results to their doctor.
Privacy and security of personal health information is an issue:
- Thirty-eight percent are very concerned versus 24 percent who are not at all concerned.
- Seventy-four percent of recent hospital users were
satisfied with their most recent experience – a significant
increase from 60 percent who said they were satisfied in last
- Six in 10 prefer generic drugs over branded drugs to
save money, unless they believe a specific condition warrants a branded
Address: Deloitte Center for Health Solutions, 555th 12th St. NW, Washington DC 20004; (202) 879-5600, www.deloitte.com.