EBRI Issue Brief

Public Attitudes on the U.S. Health Care System: Findings from the 1999 Health Confidence Survey

Nov 1, 1999 20  pages


  • This Issue Brief presents the findings from the 1999 Health Confidence Survey (HCS), which focuses on Americans' satisfaction with the health care system today and their confidence in the system's future. It compares findings from the 1999 HCS with those from the 1998 HCS, the first year the survey was conducted. In addition, it includes recent findings from EBRI's 1999 Health Insurance Preference Survey.
  • The 1999 HCS finds that, in many ways, Americans appear happy with their experience of the health care system. Among those respondents who have received care in the past two years, 57 percent are extremely or very satisfied with the quality of the medical care they received; 32 percent are somewhat satisfied. More than one-half (53 percent) are extremely or very satisfied with their ability to choose their doctor, while 23 percent are somewhat satisfied. Close to one-half are extremely or very satisfied, and 41 percent are somewhat satisfied, with the care they received in general. One-half of Americans with health insurance are extremely or very satisfied with their current health insurance plan. Almost four in 10 are somewhat satisfied.
  • Confidence in many aspects of the health care system is high: 74 percent of Americans are extremely or very confident that their pharmacist will fill their prescription correctly, and 20 percent are somewhat confident. Almost six in 10 are extremely or very confident, and 33 percent are somewhat confident, that they will be able to see a health care specialist if they need one. Just under one-half are extremely or very confident that they are able to choose their own doctor or hospital (48 percent confident, 34 percent somewhat confident); that their doctor's treatment will be based on their health care needs rather than on cost (46 percent confident, 36 percent somewhat confident); and that doctors are up-to-date on information about medicine and medical conditions (46 percent confident, 41 percent somewhat confident).
  • The results of the HCS also reveal several areas of concern. First, there is a great deal of confusion about what managed care is and whether or not individuals are enrolled in managed care programs. As a consequence, many Americans' opinions of managed care are based on what they have been told by others, rather than on their own actual experience with managed care.
  • A second area of concern is that several key groups tend to be less satisfied and less confident about the American health care system. These include individuals in managed care, those in poorer health, and women.
  • While many are satisfied with the health care they have recently received, Americans do not rate the overall health care system highly. They are concerned about escalating health care costs, and they lack confidence in the future of health care in America.