The 2008 Health Confidence Survey: Rising Costs Continue to Change the Way Americans Use the Health Care System

October 2008, Vol. 29, No. 10
Paperback, 16 pp.
PDF, 720 kb
Employee Benefit Research Institute, 2008

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Executive Summary

11th annual HCS: Findings from the 2008 Health Confidence Survey (HCS) continue to demonstrate that rising health care costs are connected to changes in the way that Americans are using the health care system. Most Americans continue to view the country’s overall health care system negatively, feeling it needs a major or even a complete overhaul.


Rising costs widely felt: Roughly half of Americans with health insurance coverage (55 percent) report having experienced an increase in health care costs in the past year.


Higher costs are changing medical behavior: Insured Americans who have experienced an increase in health care costs in the past year are more likely than those who have not to say they now choose generic drugs more often, talk to the doctor more carefully about treatment options and costs, and go to the doctor only for more serious conditions or symptoms.


Savings and household finances being pinched by health costs: Those experiencing health cost increases are also likely to report that these increases have negatively affected their household finances. In particular, they indicate that increased health care costs have resulted in a decrease in contributions to retirement and other savings and in difficulty paying for basic necessities and other bills.


Most rate the U.S. system poorly: A majority of Americans rate the nation’s health care system as fair or poor. Only a small minority give it excellent or very good marks. Half agree that “there are some good things about our health care system, but major changes are needed.”


Quality and coverage are top goals: Virtually all Americans say that extremely or very important goals when reforming our nation’s health care system should be to provide high-quality health care and making health care more affordable. There is strong support for tax incentives to help expand health insurance coverage.


Electronic medical records supported but distrusted: Americans generally feel centrally maintained electronic medical records that can be shared by authorized health care providers are important, but they have reservations about confidentiality. Sixty-two percent indicate they are not too or not at all confident that such records would remain confidential.