Most Americans give healthcare affordability a failing grade, Gallup shows

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Most Americans give healthcare affordability in the U.S. a failing grade, and a plurality gives failing marks to the healthcare system as a whole, according to the latest results from a Gallup poll, conducted in partnership with West Health.

Three-quarters of respondents – representing more than 190 million Americans – give healthcare affordability a D or F. And more than half of Americans (56%) report poor or failing grades on health equity as well.

The overall U.S. healthcare system fared slightly better, but still, 44% of Americans give the healthcare system an overall grade of D (poor) or F (failing), while half that number (22%) give it an A (excellent) or B (good).

A number of factors are driving these poor ratings. More than one-quarter of adults (27%) – representing about 70 million Americans – report that if they needed access to quality care today they would not be able to afford it, for example. And 13% report there was a time in the past three months when they could not afford needed medicine.

Americans largely see affordability and the value of care as inconsistent. One in 14 adults – approximately 18 million Americans – are classified as Cost Desperate, meaning they avoid treatment, forgo medication and cannot afford needed healthcare due to cost. Today, nearly two in five Americans are considered either Cost Desperate or Cost Insecure, unchanged from a year ago despite an overall improvement in the country's economic outlook.

Only 7% of American adults indicate the U.S. health system is high-value.

Disparities emerged when it comes to affording care. Nearly one in five Americans report they or a member of their household have had a health problem worsen after being unable to pay for needed care. More women and Black and Hispanic adults report this has happened to them. In fact, women, Black and Hispanic adults, and younger Americans were most likely to forgo dental, primary and preventive care due to cost.

Americans also appear to be concerned about the future. Two in three Americans under 65 are worried Medicare will not exist when they reach the age of eligibility, and three in four aged 62 or younger say the same about Social Security. Majorities of Americans not yet eligible for Medicare or Social Security say they will depend on these programs (60% and 56%, respectively), even though they are unsure the programs will be available to them.

Seventy-one percent of women and 75% of Hispanic adults are worried Medicare will not be there for them when they reach eligibility, the poll showed. Overall, half of all American adults – an estimated 129 million people – have low confidence that they will be able to afford healthcare as they age.

Older people, in particular, are concerned about accessing needed care and prescriptions. One in three over age 50 have forgone basic necessities such as food and over-the-counter drugs to pay for healthcare. One in seven – including 17% of those aged 50 to 64 – consider healthcare costs a major burden for their household. And nearly one in three Americans aged 50 to 64 and 20% of those aged 65 and older are concerned about being able to afford needed medicine in the coming months.

WHAT'S THE IMPACT?

On Aug. 16, President Biden signed the Inflation Reduction Act of 2022 into law, which Gallup considers a possible means of alleviating affordability hardships. The legislation contains several provisions to lower healthcare costs for people with Medicare, such as allowing the government to negotiate prescription drug costs and caps on the cost people pay for insulin.

Medicare only covers about a quarter of the adult population, however, and provisions to aid non-Medicare patients were removed from the bill. As previous West Health‑Gallup studies have suggested, the healthcare cost crisis is far from over. 

"It's critical to continue documenting Americans' struggle to afford needed care to inform policies that will improve the public's experience with the U.S. healthcare system," Gallup wrote.

THE LARGER TREND

Affordability struggles were highlighted in June when Willis Towers Watson released a survey showing 40% of employees deferred medical care over the past year, including 28% who delayed or canceled a medical procedure or appointment.

At the same time, 17% failed to fill at least one prescription, while 20% said their healthcare provider delayed or canceled a procedure or appointment. When asked what prompted them to defer care, 25% said they couldn't afford it and 23% were unsure of the costs.

The survey also revealed that employees with significant difficulty paying for healthcare are more likely to suffer due to deferred care.

Deferred care is still an issue, even with the pandemic beginning to wane somewhat. The lingering effect on hospitals has been low patient volume. Significant decreases in patient volume, with just a slight downturn in expenses, is having a negative impact on revenue and operating margins, according to a recent Kaufman Hall flash report.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com