Americans' Satisfaction With Health Care Rises, But Pessimism About Future Remains

October 9, 2001
Paul Fronstin
(202) 775-6352, EBRI

WASHINGTON, DC—Despite conventional wisdom and the managed care backlash, Americans appear to be increasingly satisfied with the health care they are receiving, the costs they are paying for health care, and managed care plans, according to the 2001 Health Confidence Survey (HCS) released today. However, as past HCS results have found, many Americans continue to be pessimistic about the future of the nation's health care system, about their future ability to choose the doctors they want, and about their ability to afford prescription drugs.

And while Americans appear to be getting somewhat more knowledgeable about managed health care plans-which cover the vast majority of people with employment-based health insurance and many with Medicare or Medicaid-more than half the population is unfamiliar with managed care. Similarly, almost two-thirds of Americans don't know that they will be eligible for Medicare, the nation's health insurance program for the elderly and disabled, at age 65.

These and other findings are contained in the 2001 Health Confidence Survey (HCS), released today by the nonpartisan Employee Benefit Research Institute (EBRI), Consumer Health Education Council (CHEC), and Mathew Greenwald & Associates. The HCS examines a broad spectrum of health care issues, including Americans' satisfaction with health care today, their confidence in the future of the health care system and Medicare, and their attitudes toward health care reform.

"The results of this survey show that Americans are largely satisfied with the health care they have received, but they are concerned about the future, especially about being able to choose their doctor and afford prescription drugs," said EBRI President Dallas Salisbury.

Ray Werntz, president of CHEC, noted that some HCS findings indicate that consumers have serious and deep misunderstandings about the fundamentals of health insurance coverage. In particular, he cited the survey's findings of public confusion over managed care and Medicare eligibility. He also noted that another finding challenges arguments that consumers would be better off without employer involvement in their coverage: "Most Americans get their health coverage through the job, and for the most part believe employment-based coverage to be more reliable than other options," Werntz said.

Among the major findings of the 2001 HCS:


  • Forty-six percent of Americans are extremely or very satisfied with the health care they have received in the past two years, up from 39 percent in 2000.
  • Only one-third of Americans are extremely or very confident that they will be able to get the treatments they need during the next 10 years (34 percent), and only 21 percent are extremely or very confident that they will be able to get needed treatments once they are eligible for Medicare.
  • Thirty-eight percent each are not too or not at all confident in being able to afford prescription drugs without financial hardship and being able to afford health care without financial hardship in the next 10 years.
  • Two in 10 name health care as the most critical issue facing America today (20 percent), placing health care behind the top-rated issue, education (23 percent), and about even with crime (19 percent) as the issue considered to be most critical.
  • One-half of Americans not yet eligible for Medicare are not too or not at all confident that they will be able to afford prescription drugs (51 percent) or health care (49 percent) without financial hardship once they are eligible for the Medicare program.
Managed Care:
  • Only 19 percent of Americans say they are extremely or very familiar with managed care (an increase of 5 percentage points from 14 percent in 2000). More than half (52 percent) say they are not too or not at all familiar with managed care.
Employment-Based Health Coverage:
  • More than half of Americans with employment-based health insurance are extremely (11 percent) or very (41 percent) satisfied with their current health plan. Only 1 in 10 say they are not too (7 percent) or not at all (4 percent) satisfied.
  • Forty-seven percent of those with employment-based coverage are extremely or very confident that their employer has selected the best available health plan for its workers. Only 32 percent are extremely or very confident that they could choose the best available health plan for themselves if their employer stopped offering health insurance.
  • Sixty-three percent of Americans under age 65 prefer the current employment-based system, in which employers choose the plans and pay many of the health insurance costs, over a system of "defined contribution," in which they would be given the money their employers currently spend on health care to purchase insurance on their own.
The Uninsured:
  • Of Americans without health insurance, 32 percent have delayed seeking health care since they lost their coverage, and 22 percent have decided not to get health care they thought they needed.
  • Only 31 percent of those without coverage are aware of low-cost or free insurance programs for uninsured adults or children in their state, down from 37 percent in 2000.


HCS materials and a list of underwriters may be accessed at the EBRI Web site:

EBRI is a private, nonprofit, 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 public policy through objective research and education. EBRI does not lobby and does not take positions on legislative proposals.

CHEC is part of the Employee Benefit Research Institute Education and Research Fund (EBRI-ERF), a 501(c) (3) organization. Like its parent organization, CHEC is a nonpartisan group that does not lobby and does not take positions on specific policy proposals.

Mathew Greenwald & Associates, Inc. is a full-service market research company with an expertise in financial services research. Founded in 1985, Greenwald & Associates has conducted public opinion and customer-oriented research for more than 100 organizations, including many of the nation's largest companies and foremost associations.

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