Affordable care and better information: what Americans want from a new-and-improved US health system

Anxiety about health care costs tops American citizens' concerns about health care in the U.S. Rich, poor, insured or un-, 2 in 3 Americans worry about the affordability of health care in America.

So it follows, then, that among those without health insurance, 57% blame their uninsured state on the fact that they simply cannot afford it, as shown in the table on the right. Beyond this group, 30% of the uninsured cite the employer's role in health insurance: 14% aren't employed, 9% have employers who don't offer coverage, and 7% are "between jobs."

These findings come from Accenture's report, The American Public on Health Care: The Missing Perspective, which sets out the major concerns of Americans and their views on reforming the U.S. health system. The report aggregates results from national and local Gallup polls, along with town hall meeting input from citizens in Detroit, Miami and San Francisco.

The middle aged are the most concerned about cost. 56% of Americans ages 40 to 64 cite cost as the top most concerning health issue; 47% of younger and older Americans put cost as #1.

This survey echoes what others I've written about here have addressed: the problem of putting off medical treatment due to lack of affordability. 1 in 4 Americans (26%) in this poll say they've done so, which includes 58% of those who are uninsured. But even 20% of the insured have put off treatment because they couldn't afford the out-of-pocket costs.


The second major finding in this study is that Americans see information as a powerful force in addressing quality and efficiency in U.S. health care. Citizens are seeking very specific kinds of information about providers -- both physicians and hospitals -- to help them navigate the complex health system. The chart on the left inventories the kinds of data citizens seek about doctors and hospitals, including but not limited to:

- Records of medical errors
- Whether the provider follows guidelines and standards
- Patient satisfaction survey results.

Furthermore, most Americans see the benefit of sharing their personal health data. 78% favor giving physicians access to their medical records, and 2 in 3 see value in submitting their data into an anonymized database for mining clinical effectiveness information.

This initiative was convened through a collaboration between the Council for Excellence in Government, the Accenture Institute for Public Service Value and the Institute of Medicine at the National Academies.

Health Populi's Hot Points: The American citizen's voice is indeed "missing" from the larger discussions on health reform that get wonky very quickly. I recommend your taking a look into this report -- especially paying attention to the color commentary of the three-city 'tour' of Detroit, Miami, and San Fran. While very different metro communities in terms of demographics, employer base, and economics, they share the concerns of all Americans when it comes to access, cost and quality of health in America. The fact that most Americans appear to be willing to share personal health information with the larger goal of establishing clinical effectiveness and measuring quality for the public's health is a key finding in this analysis that can empower the incoming Obama administration's commitment to bolstering the national health information infrastructure and enabling data-driven health care in the U.S.