Workers Rank Health Care as the Most Critical Issue in the United States

The EBRI/Greenwald & Associates Health and Workplace Benefits Survey (WBS) examines a broad spectrum of health care issues, including workers’ satisfaction with health care today, their confidence in the health care system, and their attitudes toward benefits in the workplace. It is co-sponsored by the Employee Benefit Research Institute (EBRI) and Greenwald & Associates with support from five private organizations.

The 2018 survey was conducted June 21–27, 2018, using Research Now’s online consumer research panel. A total of 1,025 workers in the United States ages 21–64 participated in the survey. The data are weighted by gender, age, and education to reflect the actual proportions in the employed population.

Health care most critical issue: Workers rank health care as the most critical issue in the nation. In 2018, 26 percent of workers rank health care as the most critical issue in the United States. And more concretely, 73 percent of workers report that health insurance is one of the top three most important benefits when considering whether to stay in or choose a new job, whereas only 57 percent report that a retirement savings plan is in the top three.
Health care system poor or fair: In 2018, one-half of workers describe the health care system as poor (22 percent) or fair (28 percent).
Confidence about the health care system is mixed and declines looking into the future: Workers’ confidence about specific aspects of the health care system is mixed and falls the further out into the future one looks.
- For example, only 45 percent of workers indicate they are extremely or very confident about their ability to get the treatments they need today, and even fewer (36 percent) are confident about their ability to get needed treatments during the next 10 years.
- Similarly, 34 percent of workers say they are confident that they are able to afford health care without financial hardship today, but this percentage decreases to just 30 percent when they look out over the next 10 years.

Confidence in workers’ own health plans remains high: Workers tend to be more favorable about their own health plans than they are about the health care system overall. One-half of workers with health insurance coverage are extremely or very satisfied with their current health plan. Workers are generally confident that their employers or unions will continue to offer health insurance in the future. Nearly two-thirds (65 percent) of workers report that they are extremely or very confident.

Workers concerned about cost: Workers’ dissatisfaction with health insurance is focused primarily on cost: Just 22 percent are extremely or very satisfied with the cost of their health insurance plan, and only 21 percent are satisfied with the costs of health care services not covered by insurance. Approximately one-half of workers (47 percent) report having experienced an increase in health care costs in the past year, about the same percentage since 2015, but down from 61 percent in 2013.
Workers satisfied with quality: Workers are generally satisfied with the quality of medical care received. One-half of workers (47 percent) say they are extremely or very satisfied with the quality of the medical care they have received in the past two years, 35 percent are somewhat satisfied, and 13 percent are not too (7 percent) or not at all (5 percent) satisfied.
Rising health care costs have implications for financial wellbeing: Of the one-half of workers reporting cost increases, 24 percent state they have decreased their contributions to retirement plans, and 41 percent have decreased their contributions to other savings. Nearly one-third also report they have had difficulty paying for basic necessities such as food, heat, and housing, while 39 percent say they have had difficulty paying other bills. At least one-third say they have used up all or most of their savings or have increased their credit card debt, 25 percent report that they have borrowed money, 30 percent have delayed retirement, 17 percent have dropped other insurance benefits, 17 percent have taken a loan or withdrawal from a retirement plan, and 18 percent have purchased additional insurance to help with expenses.

Figure 12 Figure 5 Figur Figur e 14 e 1 Changes in Health Care Usage Resulting From Cost Increases, Among H Fi C Confide g o e ur nclus alt ?e 7, nc h Care Wor P er ion e in ha fe kers c re v nc C ing eo o for s n enoug t c s erne H eah ch ltd h B aoic bo ene eu fit a t c bs a out os nd t: w W ho Wa or g pk e re ov s, 201 rs’ ide ds m is8sa ................................ e tis dfic aa cl c tioa n w re a itls h he o re am lth in a................................ inssu fa riarnc ly e s tis ea fo dyc. us In ed 2 01 p ...................... rim 8, a 42 ril y p e on rce cnt os t10 of : Paul Fronstin is director of the Health Research and EducFigur ation e 3 Program at the Employee Benefit Research Institute Workers Rank Health Care as the Most Critical Issue in the Confidence in Selected Aspects of the Health Care System, Today and Shifts in Resources ResultingFigu From Cos re 7 t Increases, Among Those Most Critical Issue in the United States, 2018 Those Experiencing Increase in Costs, 2018 workers J aus re te 22 xtr e pm ere cly en or t a v re e re yxt cronfide emelynt or t ha vetr y the sayt is hfied ave Figu w enoug ith th reh ch 9 e cost oic e of atb he ou irt he who alth in prov su ide ras t nche e p irla m n, ed aic nd al only care 21 . percent (EBRI ). Lisa Greenwald is executive vice president for Greenwald & Associates. This Issue Brief was written with Ma App ny roxim wora kteerls y ro ane nk- ha the lf of hea w ltor h ca kRa errs e ti (ng sy 47 s of Health Car tp ee m rc a es ntt)he re m por ost te S ha cry it vs ing icta em l p expe olic in A ryie imeric ss ncue ed c aonf a, n inc 2013 ron reta ing se –2018 tin he he U. aS. lth c and are he ca os ltth c s in t arehe a s ptahe st During the Next 10 Years, 2018 Preference for Health Benefits and Wages, 2018 United States Experiencing Increase in Costs, 2018 Figure 8, Top Three Most Important Benefits When Considering Job Decision, 2018 ................................................. 10 are satisfied with the costs of health care services not covered by insurance. Approximately one-half of workers Try to take better care of yourself 72% y m ae ss ost airst . a iThi m nc ps is e or ftr a om a nbtou c the onsi t t Sat he In dst e sa irs ia tfm ut tacti ion a e e ’s r aon s it b eout sea Wi ha rw s b th ch a he e Se tend he n le r si e c Ea nc d xce tnd e ite lle d or n20 As w ia t he l s 15 p Ve rte , e a ry c b ff t gts u o s. oo t d tof d a Ak ow ny e Hea G on fr a v o d ie ne lw om th C w s e Fair j61 ob xpress ar . Po p eD o e R ris rce e te ur d c n e b tin t iingl in 2 ve hi d y s r 01 ,i n m e 3 P p ost (or as Fitg t w u aT or r re e w k 11 to e hose rs ). aThe re of dtp is he e sra c a te iu sf nt thor ie ad g e s 30% Confidence in workers’ ability to afford health care without financial hardship is up since 2013. In 2013, 25 percent of Decrease your contributions to a retirement plan, such as a 401(k), 403(b), or 457 plan, (47 percent) report having experienced an increase in health care costs in the past year, about the same and should not be ascribed to the officers, trustees, or other sponsors of EBRI, Employe 24% e Benefit Research Institute- r w eit ph th orting e U. th S. athe the alt yh c did arnot e s ye sxpe temr ie ov nc er ea a ll a ch nd ange , whil in he e Y e the ar alt y s, 2013 hp ut ca rre e la c –o t2018 iv ste s in ly m cror eae sed va lue from on 3a 6 p nd ea rc re ent m or to e51 sap tis efied rcen tw b ite h th tweeeir n or an IRA By Paul Fronstin, Ph.D., Employee Benefit Research Institute, and Lisa Greenwald, Greenwald Figure 9, Satisfaction With Selected Aspects of Health Care Received in Past Two Years, 2013-2018 ......................... 11 September 20 101 0% 0 • No. 346 September 24, 2018 • No. 459 Choose generic drugs more often 56% workers were extremely or very confident that they could afford health care without financial hardship. By 2018, it was 45% percentage since 2015, but down from 61 percent in 2013. 20 E ow d14 uc n he a a tion a nd alth p 20 nd 1 la 8n Re . , c sea ostrs ch Fun are a d p r(im EBa RI ry- E so RF) urc , e o rof the dis irsa stta isff fa s. c tN ion. eithe r EBRI nor EBRI-ERF lobbies or takes positions on 26% (Percent Extremely or Very Satisfied) & Associates Decrease your contributions to other savings Ability to get needed treatments 41% up to 34 percent. specific policy proposals. EBRI invites comment on this research. 90% Figure 25 10 60% %, Confidence 21% That Employer or Union Will Continue to Offer Health insurance, Selected Years, Go to the doctor only for more serious conditions or symptoms 36% 52% 25% 25% 22% Quality of Medical Care Received Cost of Health Insurance Health Costs Not Covered by Insurance ? Work Yoers s u woulda rat ti hs efied r have w feweit r h quality: Workers are generally sat 27% isfied with the quality of medical care received. Have difficulty paying for basic necessities, like food, heat, and housing W Giv or ek n etrha s w t ho ther e m pa or jor teid ty c of ostw ior nckre eras ses ge ne also ralc lyont acic nue ept tto he re cpur orrte n th t ab t atla he ny c ea rbee tcw ha ee nging n wa g th ee s a wnd ay he the a 31% y lt h c use a rte he c ohe sts, alt h pla cn ar e 29% 2013-2018................................................................................................................................................... 11 health benefits and higher 80 One % -half of workers (47 percent) say they are extremely or very satisfied with the quality of the medical care sponsor system. s Nm ea aryly b tehr aebele -q tua o inc rter rs e a(se 72 ov peerrca ell s nt)a tsa isfya tche tion b se inc y s rupp eased ort ing coste s m lepaloy d tehe es d m ur to ing try m to om tae knt e b s of ettefin r c aa nrc ei aof l stress. wages, 24% Delay going to the doctor 45% 50% CopWo yright In rke form rs a Ra tion: n Thi ks r He eporta islt cop hy rCa ighter d e by ta hes E th mploy e e M e Beo nes fit t Re C searriti ch Ic nsa titul teI (s EBs RI u ). e It i mn ay be Introduction Have difficulty paying for other bills 49% 39% Confidence in the Future Health Care System 50% they have received in the past two years, 35 47% percent are somewhat satisfied, and 13 percent a 47% re not too (7 themselves, and 56 percent indicate they choose generic drugs more often (Figure 12). About one-half also say they go Figure 20 11 %, Percentage of Individuals With 46% Private Insurance Reporting an Increase or Decrease in Premiums or used without permission but citation of the source is required. 45% This t Ish su 70 e e % U Briefn eite xamine ds S wot rka ert s’ e op s ini ons with respect to various aspects of the United States health care system Talk to the doctor more carefu 18% lly about treatment options and costs 43% Co Furnfi the de rm ncoer ein , p the lan sp hea onso lth ca rs re tha sytst w ea m n td te o c Inr in ce rec a ar sses ee yo ause r cre as w diw t ca or or rd k d k e ee r b r tsa s look t tisfacto ion c the afut n foc ureu . s t Whe hile ir 4 e5 ffor pe tr s on centhe of lping work e em rs pindic loyee as te percent) or not at all (5 percent) satisfied. 36% to the doctor only for more serious conditions or symptoms (52 percent) and 45 percent delay going to the doctor. The Cost Sharing, 2013-2018............................................................................................................................. 12 42% Today using data from the 2018 EBRI/Greenwald & Associates Health and Workplace Benefits Survey (WBS), as well as from 28% navigate the broade 34% r financial pressures arising 16%from health care needs. Strong well-being support can help employees they are extremely or very confident about their ability to get the treatments they need today, only 36 percent are 30% 30% RecomEm nou en gh ch do ed ice a Ci boutatio t who pro nv:id P esa m ul Fr edicalon carestin and Lisa Greenwald. “Workers Rank Health Care as the Most Critical Issue in prevalenc 60 Oe % b tai of n manu all fac of turt ehe r couse ponsa oc r d tions iscount ca — rd se foxc r bran ep dt -n ame p for rt ea sck riping tion better care of themselves — has declined since 2017. Many have 40% Use up all or most of your savings 31% 35% By Paul Fronstin, Ph.D., Employee Benefit Research Institute, and Lisa Greenwald, the 2013–2017 WBS. The WBS examines a broad spectrum of health care issues, including workers’ satisfaction with medications ? Rising health care costs have implications for financial w 33% ellbeing: Of the one-half of workers reporting 34% c aonfide djust for 15 nt % a une bou xpe t the cte ird a he biliatly th t o ca gre et cne ost es b ded a sed trea on tmetnt hes d ir p ur er ing sonta he l sit ne uxt at ion. 10 y Ie n a ars ( ddFi ition, guresom 5). e plan sponsors may want to Figure 12, Changes in Health Care Usage Resulting From Cost Increases, Among Those Experiencing Increase in the United States.” EBRI Issue Brief, no. 459 (Employee Benefit Research Institute, Sept. 24, 2018). declined since 2013 (Figure 13). 32% Greenwald & Associates 13% health care today, their confidence in the future of the health care system and the Medicare program, and their cost increases, 24 percent state they ha De ve lay re de tirc eme re na t sed their contributions to retirement plans, and 41 percent 50% 30% consider promoting other voluntary benefits, such as hospital indemnity, accident insurance, critical illness insurance, Costs, 2018 ............................................................................................................................................ 13 Look for less expensive health care providers 12% 33% attitudes t 30%oward benefits in the workplace. It also examines worker interest and attitudes towa Du rrin d g n ot ehe xt 10 r employee Similarly, 42 percent are confident they have enough choice about who provides their medical care today, but only 34 have decreased their contributions to other savings. Nearly one-third also report they have had difficulty Report availability: This report is available on the Internet at www.ebri.org a The nd c ris an ing cerc os insu t of ranc hee a, ltw h ca herre e caov lso ercaagus e e ra s m tes aa ny re w gor ene kerra s lly to in t enc he ount 5–e 15 r fin pearnc ceia ntl d raiff nge icul , ta ie s t s. he Of th y coul e 47 d he pelp rce em ntp of loyw eor es kers Borrow money 25% years 40% benefits. percent 10 a %re confident about this aspect of the health care system over the next 10 years. Figure 13 pa , C ying hange fors in He basic ne altc he C ssi ar te ie L os s Us ok foa uc r ch gh a e eap Re ers food hesu althlt ining s, uran he Fr ceao t, ma nd Cost hous Incirng, eases, whilA em 39 ong 31%pe Thos rcente sa E 9% xpe y the rie ync ha ing ve Iha ncd re d aiff se icin ul ty d re ep aor l w ting ith une costxpe incc rteead se he s a in t lth hc ea irr e p lc an ost s s. in t he past year, 24 percent state they have decreased their contributions to 22% 22% 28% A T A G L A N C E 2018 Health and Workplace Benefits Survey Partners Purchase additional insurance to help with expenses 34% 18% Costs, 2013-2018 ................................................................................................ 28% .................................... 13 paying other bills. At least one-third say they 29% have used up all or most of their savings or have7% increased their retirement plans, and 41 percent have decreased their contributions to other savings as a result (Figure 14). Nearly 20% 30% Ability to afford31% health care without financial You are satisfied with the 17% 17% The 2018 survey was conducted June Switch to 21 ove –r-t 2h 7 e, -co201 unter8 dru , gus s ing Research Now’s onlin 30% e consumer research p21% anel. A total of Finally, 34 percent of workers say they are confident that they are ab25% le to afford health care without financial hardship hardship health benefits you receive credit card debt, 25 percent report that they have borrowed money, 30 percent have delayed retirement, 17 one-third (31 percent) also report the 27% y have had difficulty paying for basic necessities such as food, heat, and housing, Drop other insurance benefits 13% 13% 17% 30% 18% This survey is made possible with funding support from the following organizations: Cigna, Mercenro w L,L 58% C, Prudential The 1,025 w EBRI or /Gr ker es in t enwa he ld Unit & Ass edo c St iaatteess a He ga els 21 th and –64 p Wo arrktp iclip acaet eBde ne in t fit he s Sur surv ve ey y . (The WBS) d aetxa a a m re ine ws a eight bre oa d d b y spe gecnd trum er, of age he , a and lth today, b 5% ut this decreases to 30 percent when they look out over the next 10 years. Figure 14, Shifts in Resources Resulting From Cost Increases, Among Those Experiencing Increase in Costs, 2018..... 14 20% Appendix—The 2018 WBS percent have dropped other insurance bene15% fits, 17 percent ha 15%ve taken a loan or withdrawal from a retirement while 39 percent say they have had difficulty paying other bills. Nearly one-third (31 percent) say they have used up all Not fill or skip doses of your prescribed medication 28% Financial Inc., The Segal Group, Inc., and Voya Financial. e ca druc e a istsu ion 10% es, inc to r Tae kflec luding e a loan t otr w he w ith or a draw ckte u al fro ras’ l p m sa a r rop et tiire sf or me atc ni t p tons in th io lann w , suchit as a 401(k) h he e ea m p ltp lan h ca loy or IRer Ad e p tod opa ula y, ttion. heir confidence in the health care system, and their 17% 14% plan, and 11% 18 percent have purchased additional insurance to help with expenses. The 2018 EBRI/Greenwald & Associates Health and Workplace Benefits Survey (WBS) examines a broad spectrum of or most of their savings or have increased their credit card debt (36 percent), 25 percent report that they have 10% 13% 13% Figure 15 10, %Shifts in Resources Resulting From Cost Increases, Among Those Experiencing Increase in Costs, attitudes toward benefits in the workplace. It is co-sponso 0% red 10% by the 20% Employ 30%ee Be 40% nefit Re 50% search I 60%nstitut 70%e (EB80% RI) and You would rather have more 12% 12% 0% 10% 20% 30% 40% 50% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% health care issues, including workers’ 10%satisfaction with health care today, their confidence in the health care system and borrowed monehy e, alt30 h be p nee fits rc an ent d lo w ha er ve delayed retirement, 17 percent have dropped other insurance benefits, 17 percent 0% 2% 1% Satisfact 201ion 3-20 1 Wit 8 ................................ h Their Own H ................................ ealth Plans ................................................................ 7% ............. 14 Greenwald & Associates with support from five private organizations. 5% wages, 18% 4% 3% 0% Health care Immigration Role of federal Unemployment/jobs Terrorism Education Taxes the Medic 0% are program, and their attitudes toward benefits in the workplace. It also examines worker interest and have taken a loan or withdrawal from a retirement plan, and 18 percent have purchased additional insurance to help Source: Employee Benefit Research Institute and Greenwald & Associates, 2018 Health and Workplace Benefits Survey. C Tabl ritic eal of Is Cs ou nt es e nt in st he United States 2013 2014 2015 2016 2017 2018 In contrast to the ratings for the health care system overall, workers continue to rate their own health plans as 2013 2014 government 2015 2016 2017 2018 Source: Employee Benefit Research Institute and Greenwald & Associates, 2018 Health and Workplace Benefits Survey. Source: Employee Benefit Research Institute and Greenwald & Associates, 2018 Health and Workplace Benefits Survey. attitudes towards other employee benefits. with expenses. Since 2012, the percentage of workers reporting 1that they have reduced contributions to a retirement The 2018 survey was conducted June 21–27, 2018, using Research Now’s online consumer research panel. A total of Introduction .......................................................................................................................................................... 5 Workers rank health care as the most critical issue in the nation. In 2018, 26 percent of workers rank health care as generally favorable. One-half (49 percent) of those with health insurance coverage are extremely or very satisfied with Source: Employee Benefit Research Institute and Greenwald & Associates, 2018 Health and Workplace Benefits Survey. Source: Employee Benefit Research Institute and Greenwald & Associates, 2018 Health and Workplace Benefits Survey. plan or other savings has fallen, while the percentage reporting that they have increased credit card debt has risen 1,025 worSo ke ur rcs in t e: Emplhe oye eUnit Benefie t d Res St eaa rct he In s a stitug tee as 21 nd Gre– e6 nw4 p ald & aAs rtsic ocip iate ast, e 2d 01 3in t -201he 8 Hea su lthr av ne d y W. ork The placed Be antea fits a Su re rv ew y.eighted by gender, age, and the most critical issue in the United States (Figure 1). After health care, the 2018 WBS finds that workers are most their current plans, and 38 percent are somewhat satisfied (Figure 6). Only 13 percent say they are not too satisfied (9 Source: Employee Benefit Research Institute and Greenwald & Associates, 2013-2018 Health and Workplace Benefits Survey. C The riticW al I BS ssis ue cs in t o-sponsor he Unit ede d b ySt the ate E s m ................................ ployee Benefit Resea ................................ rch Institute (EBRI), a ................................ private, nonprofit, nonp .......................... artisan, public- 5 ( Figure 15). education to reflect the actual proportions in the employed population. likely to identify immigration (18 pe rcent), the role of the federal government (16 percent), and jobs (13 percent) as percent) or not at all satisfied (4 percent). These figures are essentially unchanged from 2016. policy research organization, and Greenwald & Associates, an independent market research firm focused on health Satisfaction With the Current Health Care System .................................................................................................... 5 the most critical issues in the nation. Twelve percent identify terrorism as the most critical issue, followed by education care, benefits, and retirement issues. The 2018 WBS data collection was funded by five private organizations. Staffing ? Health care most critical issue: Workers rank health care as the most critical issue in the nation. In 2018, D espite the consistent high levels of satisfaction with personal health insurance plans, 18 percent of workers report that Confidence in Specific Aspects of the Current Health Care System ............................................................................. 5 (9 percent), and taxes (7 percent). In 2017, only 7 percent identified immigration as the most critical issue in the U.S. was donated by EBRI and Greenwald & Associates. WBS materials may be accessed at the EBRI website: FigurFigur e 15 e 6 26 percent of workers rank health care as the m Figur ost ce 4 ritical issue in the United States. And more concretely, 73 Figu Figu rr e 1 e 8 3 Figure 11 they would give up wages for more health benefits. Conversely, 24 percent report that they would give up health C htonfide tps://ww ncew in t .eb he ri.or Fu gt/s uru er v H eeya s/ lthc h C s/a r e System .......................................................................................................... 8 Shifts in Res Sa our tisc fes act R ion Wi esulting th Fr Curr om Cos ent Ht Incr ealth ea Plse an, s, 2013 Amon –2018 g Those percent of Con wor fiden kers r ce e por in S t telect hat he ed alt As h insu pec ra ts of nceFigu is Toda one rey 2 of ’s t H he ea tlop th tCar hree e m Sy os sttem, 2013 important – b2018 enefits when Top Ch Th an rg ees e Mos in Healt t Imp hort Caant re Us Be ag ne e fit Res s Whe ultinn g Co From nside Co ri sn t In g Job crea De sec s, ision Am, on 2018 g It is not known if health care is the most critical issue because of workers’ attitudes towards the Patient Protection and benefits for higher P wer agc een s (t Fi ag gur e e of I 7). nd Yet ividuals , health insu With raP nri ce v a ct ont e Iinu nsur es t ance o be R bep y fa ort r tihe ng m an ostIn im cr pea ortse an t or employee benefit. considering whether to stRa ayExperi ti in n or g of cen hoose (P Hea er cing cl en th C a In ne t Ext car w rea e job r S se eme , y s w it n Cos he e ly m re or V a in ts, 201 s only Am ery e Sa 57 ri 3c - ti a, p 2018 s efied) r2018 cent report that a retirement savings Satisfaction With Their Own Health Plans ................................................................................................................ 8 Those(P Expe ercen rien t Ext cin rg eme Incr ly ea or V se ier n Co y Con sts, fiden 2013 t) –2018 Affordable Care Act of 2010 (ACA) and health care in general, or simply because of the attention the issue has been When considering whether to sta Decr y in a ea cu se rr e in Pr nt job emiums or choos or e a Cos net Shari w one, ng 73 ,p 2013 ercent -2018 of workers report that health The 2018 survey was conducted June 21–27, 2018, using Research Now’s online consumer research panel. A total of 60% 57% 80% plan is in the top three. receiving. However, as will be seen below, workers’ opinions about specific aspects of the health care system and their insurance is impor At ba ilin ty to t g in t et nehe edeidr tr d eatme ecis ntion s ; 57 Enp oue ghr cc he oin cet a bof out w w hor o pro ke vidres r s mee dp ical ca ort re that aA b rie litt y to ire afm fore d h nt ealt sa h care vings p without fin la an n is im cial hardshp iportant (Figure 60% Confidence in Their Own Future Health PlansIn ................................ creased Stayed the same ................................ Decreased .......................................... 8 1,025 w 60% orkers in the United States ages 21–64 participated in the survey. The data are weighted by gender, age, and Health insurance 73% own health insurance and health care have not changed since 2016 Exce . lle Thi nt,s 7%suggests that the underlying reasons for 8). The other benefits examined are far less important than health insurance and a retirement savings plan. 70% 51% education to reflect the actual proportions in the employed50% population. 50% Healt ?h Ca Hrea e C lt os ht car s ................................ e system poor or f ................................ air: In 2 50%018, one-half of ................................ workers describe t................................ he health care system................ as poor (22 12 49% 49% 70% Retirement savings plan 57% workers’ concern about health care are fundamental and not swayed by the current political debate. 50% 48% 50% Figure 10 61% 47% percent) or fair (28 percent). 59% 48% Satisfac 50% tion with health care quality remains consistently strong. Forty-seven percent of workers say they are extremely Conclusion .......................................................................................................................................................... 15 47% 47% No theoretical basis exists for judging the accuracy of estimates obtained from non-probability samples such as the one 60% 46% Dental or vision insurance 26% 43% 43% 45% 45% Confidence That Employer or Union Will Continue to Offer Poor, 22% or very satisfied with the quality of the medical care they have received in the past two years (Figure 9). 60% 40% 41% used for the WBS. However, there are possible sources of error in all surveys (both probability and non-probability) that Appendix—The 2018 WBS .................................................................................................................................... 15 ? Confidence about the health care system is mixed and declines looking into the future: Workers’ 51% Very good, 14% 50% 50% Traditional pension or d H ee fina edl bt eh ne fit I p n lan surance, Selected Years, 2013–2018 22% 49% Satisfaction With the Current Health Care System 40% may affect the reliability of survey results. These include imperfect sampling frames, refusals to be interviewed and 50% 40% confidence about specific aspects of the health care system 36% is mixed and falls the further out into the future 42% 42% 42% N Wot orekse ................................ rs’ views are consisten................................ tly worse with respect................................ to cost, however. For................................ example, just 22 perc ................................ ent are extremely or . 15 2013 2014 2015 2016 2017 2018 30% 34% When ask 50%ed to rate the health care system, a majority of workers (50 percent) describ 40% e it as poor (22 percent) or fair Try to take better care of yourself other forms of nonresponse, the effec Lt ife i s of nsuran qcue e stion wording 14%and question order, interviewer bias, and screening. While 33%39% one looks. 48% 48% 38% 32% 47% 47% very satisfied with the cost of their health insurance plan, and only 21 percent are satisfied with the costs of health care 31% Extremely confident 28% 29% 29% 25% 30% 28% (28 percent) (Figure 2). One-quarter (28 percent) consider it good, while only a small minority rate it as very good (14 attempts are made to minimize these factors, it is impossible to quantify the errors that may result from them. 40% Choose generic drugs more often 34% Retiree health insurance 10% services not 30% covered by insurance. This is interesting in light of their overall acceptance of current trade-offs between 32% 30% 20% Very confident 37 35 35 32% 38 33 37 percent) 40% or excellent (7 percent). The percentage of workers rating the health ca Inrcre e asy se yo st ue r cre m d ia t car s fa d deibr t or poor was 50 26% o For example, only 45 percent of workers indicate they are extremely or very confident about their 30% 30% wages and health care costs discussed above. Workers may begrudgingly accept that these costs must be borne. 36% 36% 28% Go to the doctor only for more serious conditions or Disability insurance 9% percent in 2018, down from 60 percent in 2016 (Figure 3). ability Sto o m 27% ge et w th he at tcro en at fim de en nt ts they 28 need tod 27 ay, and 27 even few 28 er (36 29 percent)27 are confident about their 30% 26% Des cymp reasto e yo ms ur contributions to other savings Figures 25% 10% Notes 24% 24% 30% ability N to otg te oto ne co en dfe id d 23% e tn re tatments dur 6 ing the7 next 105 years. 5 Delay go 5 ing to the d 6octor 20% 20% Long-term care insurance 7% Decrease your contributions to a retirement plan, such Still, considering the longer-term, the percentage of workers rating the health care system as excellent or very good, Figure 1, Most Critical Issue in the United States, 2018 ............................................................................................ 6 as a 401(k), 403(b), or 457 plan, or an IRA Not at all confident 2 2 4 4 3 2 20% Confidence in Their Own Future Health Plans Talk to the doctor more carefully about treatment Supplemental health, critical ill0% ness, cancer, or accident insurance 6% while still low, has increased since 2014, the year that most major provisions of the ACA took effect. In 2018, 21 1 o Similarly, 34 percent of workers say they are confident that they are able to afford health care without 20% options and costs 2013 2014 2015 2016 2017 2018 Health care has been included in this question each year since the survey began in 1998. However, questions on other Source: Employee Benefit Research Institute and Greenwald & Associates, 2013- Fi Wg or ur ke e r2, s aRatin re geg ne orf H allyealth C confide are Sy nt thastte the mir in A emm plo eric yera, 2 s or0 u 1nion 8 ................................ s will continue to offe ................................ r health insurance ......................... in the future. In 6 percent 10% of workers r Fair,a 28% te the health care system as excellent or very good, up from 11 percent in 2014. Extremely satisfied 12% 11% 12% 11% Swi13 tch % to over-the-counte 16 r d % rugs financial hardship today, but this percentage decreases to just 30 percent when they look out over the 10% Other benefits 4% critical issues are included in years when they are appropriate to ask. The range of issues and the years in which they have 2018 Health and Workplace Benefits Survey. 10% 2018, 28 percen Ve t ry of satw isfor iedkers repor 39t% that they a 39 re % extremely 38 c %onfident the 38% ir employer 37 s% or unions w 33ill % continue to offer next 10 years. 4% 10% 3% 3% been included in the questions asked is available upon written request. Figure 3, Rating Som of ew H he ata slt ath isfieC dare System in America, 2013-2018 ................................................................................. 7 37% 38% 2% 41% 2%39% 39% 38% 2% None of these 11% coverage, 37 percent say they are very confident, and 27 percent indicate they are somewhat confident (Figure 10). Not too satisfied 8% 9% 7% 9% 9% 9% Good, 28% 0% 0% Confidence in Specific Aspects of the Current Health Care System ? 0% Confidence in workers’ own health plans remains high: Workers tend to be more favorable about their 0% 10% 20% 30% 40% 50% 60% 70% 80% Not2013 at all satisfied 2% 2014 2% 2015 2% 2016 3% 3% 2017 4% 2018 0% 2013 2014 2015 2016 2017 2018 Figure 4, Confidence in Selected Aspects of Today’s Health Care System, 2013-2018 ................................................. 7 2013 2014 2015 2016 2017 2018 The percentages of those who are not too or not at all confident their employers or unions will continue to offer health own he 2013 Ea xtlt reh p melyla or ns very 2014 than the 51y % a 2015 re about50 the % 2016 health c50 2017 ar %e system2018 ov 49e %rall. One-ha 50% lf of worker 49 s w % ith health Confidence in various aspects of the health care system has been fairly level or higher since 2013. According to the Source: Employee Benefit Research Institute and Greenwald & Associates, 2018 Health and Workplace Benefits Survey. ins urance hav Soe u rce: be e Em n low ployee his Benefit toric Rese ally arch , a Innd stitute 201 an8 d Gree is no nwald exc & e Asso ption. ciates, Only 2013 -2 6 0 1p 8e Hr ealth cent an are d Wo not rkplace too Benefits confide Survey nt . and 2 percent are insurance coverage are extremely or very satisfied with their current health plan. Workers are generally 2018 WBS, ne So Sou u a rce: rce: rly Em Em one p plo lo- y yha ee ee Benefit Benefit lf (45Rese Rese pearch r arch cent In Institute stitute ) of w an anor d d Gree Gree kers n nwald wald are & & e Asso Asso xtrciates, e ciates, mely 2 20 0 1 or 13 3- - 2 2v 0 0e 1 18 8 r y H H ealth ealth confide an and d W W nt o orkpl rkpl thace ace at Benefits Benefits they aSu Su re rv rv a ey eyb ..le to get the Figure 5, Co Source: nfid Em ence ployeein Benefit Sele Rese cte arch d Asp Institute ects an do Gree f the Heal nwald & Asso th ciates, Care Sys 2013-2te 018m Health , Toan da d W y and orkplace Du Benefits ring t Su hrv eey . EBRI Issue Brief is registered in the U.S. Patent and Trademark Office. ISSN: 0887 ?137X/90 0887 ?137X/90 $ .50+.50 not at all confident that their employers or unions will continue to offer health insurance. Source: Employee Benefit Research Institute and Greenwald & Associates, 2013-2018 Health and Workplace Benefits Survey. confident that their employers or unions will continue to offer health insurance in the future. Nearly two-thirds treatments they need (Figure 4). Next 10 Years, 2018 ...................................................................................................................................... 9 Source: Employee Benefit Research Institute and Greenwald & Associates, 2018 Health and Workplace Benefits Survey. © 2018, Employee Benefit Research Institute ?Education and Research Fund. All rights reserved. (65 percent) of workers report that they are extremely or very confident. Figure 6, Satisfaction With Current Health Plan, 2013-2018 ..................................................................................... 9 e e e e e e e e e e e e e eb b b b b b b b b b b b b br r r r r r r r r r r r r ri. i. i. i. i. i. i. i. i. i. i. i. i. i.o o o o o o o o o o o o o or r r r r r r r r r r r r rg g g g g g g g g g g g g g IIIIIIIIIIIIIIs s s s s s s s s s s s s ss s s s s s s s s s s s s su u u u u u u u u u u u u ue e e e e e e e e e e e e e B B B B B B B B B B B B B Br r r r r r r r r r r r r rief ief ief ief ief ief ief ief ief ief ief ief ief ief • • • • • • • • • • • • • • S S S S S S S S S S S S S Se e e e e e e e e e e e e ep p p p p p p p p p p p p ptttttttttttttte e e e e e e e e e e e e em m m m m m m m m m m m m mb b b b b b b b b b b b b be e e e e e e e e e e e e er r r r r r r r r r r r r r 2 2 2 2 2 2 2 2 2 2 2 2 2 24 4 4 4 4 4 4 4 4 4 4 4 4 4,,,,,,,,,,,,,, 2 2 2 2 2 2 2 2 2 2 2 2 2 20 0 0 0 0 0 0 0 0 0 0 0 0 01 1 1 1 1 1 1 1 1 1 1 1 1 18 8 8 8 8 8 8 8 8 8 8 8 8 8 • • • • • • • • • • • • • • N N N N N N N N N N N N N No o o o o o o o o o o o o o.............. 4 4 4 4 4 4 4 4 4 4 4 4 4 45 5 5 5 5 5 5 5 5 5 5 5 5 59 9 9 9 9 9 9 9 9 9 9 9 9 9 15 10 11 12 14 13 4 3 5 7 6 8 2 9 A research report from the EBRI Education and Research Fund © 2018 Employee Benefit Research Institute