October 20, 1999
Paul Fronstin
(202) 775-6352, EBRI
Danny Devine
(202) 775-6308, EBRI


WASHINGTON, DC--Nearly 60 percent of Americans are extremely or very satisfied with the quality of the medical care they have received, according to results of the 1999 Health Confidence Survey, released today by the nonpartisan Employee Benefit Research Institute (EBRI).

An additional 32 percent of Americans said they are somewhat satisfied with their health care, while 10 percent are not satisfied. Furthermore, 57 percent are extremely or very confident that they will be able to see a health care specialist if they need one, while 33 percent are somewhat confident and 10 percent are not confident. These are among the findings of the second annual Health Confidence Survey (HCS), which measures public attitudes on various aspects of health care and is sponsored by EBRI, the Consumer Health Education Council (CHEC), and Mathew Greenwald and Associates.

Concerning public confidence in the health care system, the 1999 HCS found:

  • More than one-half (53 percent) are extremely or very satisfied with their ability to choose their doctor; while 23 percent are somewhat satisfied, and 21 percent were not satisfied;
  • Three-quarters (74 percent) are extremely or very confident that their pharmacist will fill their prescription correctly, while 20 percent are somewhat confident and 5 percent are not confident;
  • Just under one-half are extremely or very confident (48 percent confident) that they are able to choose their own doctor or hospital, 34 percent are somewhat confident, and 17 percent are not confident;
  • Just under one-half are extremely or very confident (46 percent confident) that their doctor's treatment will be based on their health care needs rather than on the cost of their care, 36 percent are somewhat confident, and 18 percent are not confident.

While the HCS continues to find that overall confidence in the U.S. health care system remains high, it also continues to find the public has several areas of concern when it comes to health care. As did last year's survey, the 1999 HCS found widespread public confusion about managed care.

First, there is a great deal of confusion about what managed care is and whether or not individuals are enrolled in managed care programs. The 1999 HCS confirms last year's findings that most people are extremely confused about what is meant by the term “managed care.” Among those reporting that their insurance plan has one or more managed

"The Health Care Financing Administration (HCFA) recently estimated that total national health spending will be $1.15 trillion for 1998 and $2.13 trillion by 2007,” commented EBRI President Dallas Salisbury. “Health care is a key domestic issue, and public or private spending could be greatly affected by Medicare reform initiatives and other legislation. Yet many Americans are not able to identify their health care plan, making a difficult issue more complicated by this basic lack of knowledge.” Salisbury added that, “The results of the HCS can be a step in the direction of greater education for both the consumer and for the policymaker.”

More details about the 1999 HCS are contained in the executive summary posted at EBRI's Web site, or by contacting Danny Devine, 202/775-6308;

The 1999 HCS was sponsored by EBRI, the Consumer Health Education Council, and Mathew Greenwald & Associates, and examines Americans' satisfaction with health care today, their confidence in managed care, Medicare, and the system's future, and their attitudes toward health care reform. The survey was conducted within the United States between May 13 and June 14, 1999, through 20-minute telephone interviews with 1,001 individuals ages 21 and older. Random digit dialing was used to obtain a representative cross section of the U.S. population and interview quotas were established by sex of respondent to reflect the actual proportion in the population.

In theory, a sample of 1,001 yields a statistical precision of plus or minus 3 percentage points (within 95 percent certainty) of what the results would be if the entire population ages 21 and older were surveyed with complete accuracy. However, there are other possible sources of error in all surveys that may be more serious than theoretical calculations of sampling error. These include refusals to be interviewed and other forms of nonresponse, the effects of question wording and question order, interviewer bias, and screening. While attempts are made to minimize these factors, it is difficult or impossible to quantify the errors that may result from them.

EBRI is a private, nonprofit, nonpartisan public policy research organization based in Washington, DC. Founded in 1978, its mission is to contribute to, to encourage, and to enhance the development of sound employee benefit programs and sound public policy through objective research and education. EBRI does not lobby and does not take positions on legislative proposals.

CHEC is a private, nonpartisan, nonlobbying council of private and public organizations formed to undertake and encourage initiatives aimed at raising public awareness about health care coverage. CHEC is part of the Employee Benefit Research Institute Education and Research Fund (EBRI-ERF), a 501(c)(3) organization.

MGA is a full-service market research and consulting firm located in Washington, DC, that specializes in all aspects of survey research design and analysis, focus group and one-on-one qualitative research; new product development and testing; marketing, communications and advertising research; attitude tracking surveys; market segmentation; and database marketing and analysis.

# # #