Sixty-three percent of Americans describe the U.S. healthcare system as being in a “state of crisis” (14%) or having "major problems" (49%), according to a new Gallup poll, which is one of the least negative assessments in Gallup’s trend since 1994.
According to Gallup's annual Health and Healthcare poll, conducted November 1-14, 2019, the 63% currently rating the system negatively is below the average of 69%, tracked by Gallup since 1994. Only once, in November 2001, did the figure stray far from the average when it dropped to 49%. That record low came just after the 9/11 terrorist attacks when Americans' views were temporarily more positive on a variety of measures.
“The system continues to do pretty well in crisis—but fails in prevention, promotion, costs, and access,” says Jay Wolfson, DrPH, JD, associate vice president for health law, policy, and safety at the Morsani College of Medicine at the University of South Florida. “Access—getting an appointment to receive specialty treatment and services, has declined, even for those with insurance. For many with Obamacare—if they are not subsidized, then the premiums and copayments can be crippling. Both parties favor more transparency and more controls with respect to value for the trillions spent each year on healthcare. Healthcare executives need to get in front of these demands lest the government impose additional regulatory requirements upon them.”
The treatment of healthcare as a strict business versus healthcare as a community asset—“healthy people equals a healthy economy—should not be an ‘either/or’ but an ‘and,’” according to Wolfson. “Healthcare is a serious and complex business. But it also is a community trust. Healthcare executives can help to lead healthcare toward being more than just a business, or they may find governments and consumers finding greater displeasure at the lack of transparency in the face of manifestly poor cost, quality, and outcome data.”
Although Democrats’ and Democratic-leaning independents’ negative ratings of the healthcare system are lower this year than last (at 77% compared with 84% in 2018), they continue to be more negative than Republicans' and Republican-leaning independents. Meanwhile, Republicans' negative ratings of the system are at their lowest point since 2001, having dipped substantially each year since their peak of 80% in 2016.
Perception of the state of the U.S. healthcare system have been steady, with between 60% and 70% Americans assessing it as having at least major problems. This has been consistent across four presidencies with differing approaches to healthcare policy.
The poll also found:
- Democrats were more negative about the system during Republican George W. Bush's presidency and each year since Republican President Donald Trump has been in office.
- Republicans held more negative views during the latter years Democratic President Barack Obama was in office, from 2012 to 2016.
- The pattern was different in the first few years of Obama's presidency. During this time, Democrats' belief healthcare had major problems or worse remained elevated, but this subsided after the ACA passed in 2010, and fell further once major provisions of the ACA started taking effect in 2014.
The passage of the ACA demonstrably lowered the uninsured rate and expanded coverage for pre-existing conditions. But the political parties’ polarized reactions to the bill's passage suggest that a truly bipartisan effort at reform may be what's needed to assure the majority of Americans that the system's problems have been addressed.