Most in Health Poll Satisfied; Concerns Build

Americans are generally happy with their health insurance coverage, but four in 10 adults say insurers have a bigger say than doctors in the care they receive, according to a new poll.

Women are more critical than men, with 40% saying the health-care system is in worse shape than it was five years ago, said the poll conducted for Associated Press. The biggest complaint was that managed-care organizations limit the number of doctors from which people can choose.

As these concerns grow, Congress is again considering how to give people more control over their own health care without substantially increasing costs.

Nine out of 10 Americans said they were very satisfied or somewhat satisfied with their health insurance coverage, the survey found.

But among those with concerns about health care, much of that dissatisfaction is centered around the growing loss of control people feel over their medical care, an intensely personal issue.

The poll of 1,008 adults, randomly selected from all states except Alaska and Hawaii, was taken at the end of January through early February. ICR of Media, Pa., conducted the poll.

Making some changes in the system sounds like a good idea to Thomas Feagley, a 42-year-old father of three, whose health plan required him to change family doctors last year.

“There needs to be an investigation or some kind of fine-tuning,” said the custodian of athletic fields at schools near Huntington, Pa. “I would have been a happy camper if I could have gotten my insurance and kept my doctor.”

When people were asked their biggest concern about health care, the most-mentioned complaint was limits on their ability to pick the doctor of their choice, cited by 28%, followed by concerns about cost and quality.

The findings reflect continued frustration with managed care, such as health maintenance organizations, which have controlled health-care costs by restricting access to specialists and preventing unnecessary treatment. But Americans worry they may not get treatments that they someday need.

A big movement to HMOs has taken place over the last two decades. (In California, 17 million are enrolled in HMOs.) Most Americans who get insurance from an employer are now enrolled in an HMO, said Larry Levitt, director of the changing health-care marketplace project at the Kaiser Family Foundation in Menlo Park, Calif.

Of the people in the AP poll who said they were very satisfied, the majority said they felt their doctor had the bigger say in their care. And three-fourths of those who said they were dissatisfied cited insurers as more likely to have the leading role.

Older people were among the most satisfied with their health care, while well-educated people between the ages of 35 and 64 were more likely to have concerns with health insurance.

Levitt suggested that those with more education may have higher expectations, and middle-aged adults grew up with conventional insurance and now must contend with a more restrictive system.

Almost two-thirds of the people covered by a government plan said they were very satisfied with their health insurance coverage, said the poll, which had an error margin of plus or minus 3 percentage points. Levitt said government plans such as Medicare often offer the freedoms of more conventional insurance plans.

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Calling the Shots

Responses to a question posed in a nationwide poll:

Question: In your view, who has the bigger say in your health care: your doctor or your insurance company?

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Doctor 48%

Insurance company 41%

Neither 6%

Don’t know 4%

Other 1%

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Based on telephone interviews with 1,008 randomly selected adults from all states except Alaska and Hawaii, conducted Jan. 29-Feb. 2.

Source: Associated Press