EBRI Issue Brief

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

Sep 24, 2018 15  pages


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.