Americans' Disconnect Over Health Costs
A new survey finds they're fearful but not doing much to trim their medical bills
Nine out of 10 Americans over 50 agree: Health care in the United States is too expensive. But they aren’t sure what they can do about it.
Those are among the findings in our newly-released Altarum Institute Survey of Consumer Health Care Opinions, the fifth in a series. (Altarum Institute is a nonprofit health systems research and consulting group.) The survey of 1,974 Americans age 25 to 64 was conducted online in October 2013.
(MORE: 5 Ways to Make Your Doctor Your Partner)
Health Costs Take a Toll
With the average cost of employer-sponsored health insurance up dramatically — from roughly $9,000 in 2003 to $16,000 in 2013 — the high price of medical care is taking a toll on many households. Our survey found that almost two in three consumers are concerned about their ability to pay medical bills if they experience a serious health problem.
This financial vulnerability is likely to carry over into retirement, according to respondents. When asked whether they’d have $220,000 saved for medical expenses after they retire, as recommended by some experts, only 16 percent said yes (65 percent said no and 18 percent weren’t sure).
(MORE: A Health Economist Confronts His Family’s Medical Costs)
People approaching retirement — those age 45 to 64 — were less confident about their ability to cover medical expenses than their younger counterparts; most of the pre-retirees said they would definitely not have $220,000 set aside for health costs in retirement.
Few Trying to Get Top Value
Are high medical charges driving patients to ask for cost estimates, compare doctors and health services and try to get the greatest value in health care? Not so much — especially older patients.
Fewer than a third of those between age 45 and 64 said they looked for information about cost or quality before visiting a health care provider in the past year, for example. And just 23 percent of people 55 or older looked for healthcare quality ratings; by contrast, roughly half (51 percent) of those 25 to 34 did.
(MORE: 5 Ways to Avoid High Retirement Health Costs)
Slightly less than half of consumers have ever asked about the cost of treatment before going to the doctor. And those over 55 were the least likely to do so.
Dangerous Health Mistakes
Sadly, excessive health costs may be causing some people to avoid going to the doctor or the drugstore in the first place. Three out of five survey respondents said they sometimes choose to forgo healthcare because of the price. But skipping medications, delaying medical appointments and missing preventative screenings can have serious long-term implications.
Why aren’t many patients shopping for lower-cost care? In general, they’re not convinced it would make a difference. Only 6 percent said they felt very confident that they could take steps to find less expensive care.
That said, consumers — especially older ones— said they want a place at the table when it comes to decisions about their health.
Almost 90 percent of respondents age 55 or older noted that they prefer to take an active role in making choices regarding their health. They want to be given treatment options by physicians, for instance, and then play a part in deciding among those options.
A Shift in Attitude
This view actually represents a shift. In the past, patients typically preferred to leave most of the decision-making power in the hands of their doctors.
So there’s an underlying gap between what people say they want and what they actually do.
Because Americans aren’t accustomed to acting as healthcare consumers and information about medical fees and quality has been hard to find, it may take time for the public’s actions to match their preferences.
How the Tide is Turning
But the tide is turning, which is a positive sign.
Four out of five respondents said they’d feel comfortable talking with their doctors about the cost of their medical treatment. And half believe that they may be able to make their healthcare more affordable by asking for, and comparing, prices.
One of the biggest challenges in the evolving healthcare environment is helping people take the next step. Hopefully, they’ll increasingly see that they have more power than they realize — if they ask the right questions.
Wendy Lynch, Ph.D. is Director of Altarum Institute's Center for Consumer Choice in Health Care, runs Lynch Consulting and is senior scientist at the Health as Human Capital Foundation. Kristen Perosino is manager of advocacy partnerships at Altarum Institute.