Consumers worry as health costs rise

39% say they know nothing about managed care

Health care costs continue to rise while access to health care continues to decline — a combination that has made many Americans increasingly critical of some aspects of the health care delivery system, according to a new study by the Employee Benefit Research Institute, a Washington, DC-based public policy research organization.

Perhaps the most surprising finding of the 2000 Health Confidence Survey is that, at a time when industry data indicate 90% of American workers are participating in managed care plans, only 10% of survey respondents report believing that they currently are enrolled in a managed care plan. Another 11% report they believe they previously were enrolled but currently are not, and another 11% are not sure whether or not they have ever been enrolled in a managed care plan. Further, more than 66% of Americans surveyed report believing they have never been enrolled in managed care.

The percentage of respondents who describe themselves as "somewhat familiar" with managed care dropped from 29% in 1998 to 23% in 2000. Similarly, the percentage of Americans who report being "not at all" familiar with managed care increased from 28% in 1998 to 39% last year.

While 25% of Americans are "extremely confident" or "very confident" of their ability to afford health care without hardship during the next 10 years (up slightly since the 1998 survey), many respondents, particularly women and those in poorer health, express concern about escalating health care costs and a lack of confidence in their ability to afford medical expenses in the future.

Specific findings include:

• Roughly 25% are "extremely confident" or "very confident" of their ability to afford prescription drugs without financial hardship in the next 10 years.

Worried about Medicare

• Half of respondents who are not yet eligible for Medicare are "not too" or "not at all" confident that they will be able to afford health care without financial hardship once they are eligible for Medicare. A similar percentage are "not too" or "not at all" confident they will be able to afford prescription drugs without financial hardship under Medicare.

• Just 20% of Americans are "extremely confident" or "very confident" that they will be able to get the treatments they need once they are eligible for Medicare.

• Thirty-nine percent of those who received health care in the past two years say they are "not too" or "not at all" satisfied with health insurance costs, up slightly from 33% of respondents in 1998.

• Nearly 50% of respondents covered by employment-based health insurance are "extremely satisfied" or "very satisfied" with their current health insurance plan. Another 40% are "somewhat satisfied" with their plan, and 11% are "not satisfied" with their plan.

• One-quarter of respondents report that if their employer stopped offering health insurance they would not be likely to purchase coverage on their own.

Full-text printed copies of the executive summary are available for $25 prepaid, and Portable Document Format (PDF) files are available for $7.50. To order, call (202) 775-9132.