The Public's Perception of the U.S. Health Care System

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Examine the public's view of healthcare and analyze how that perception was shaped by the primary actors within the U.S. health care system. In particular, you are to consider, respond to, and support your answers to each of the following questions:

What is the public's view of the U.S. health care system?

How was that perception shaped by the insurers?

How was that perception shaped by provider groups?

How was that perception shaped by the purchasers of healthcare?
Let's look at these interrelated and complex set of questions:

1. What is the public's view of the U.S. health care system?

- The public's view is reported in various ways. For one, public polls are one way to determine how the public views the US health care system. However, public opinion polls are often a product of the type of question asked and may not be a good representative of the population at large. Thus, research and other media coverage are also necessary for a more representative perception of public opinion.

- Taken together, despite Americans' willingness to say they are "satisfied" with their health care plans, they harbor a lot of worries about the future—about treatment that could be denied them, about costs that could ruin them, and about loss of coverage—that make health care a tremendously potent political issue. For example, Teixeira (2005) reports that HMOs are therefore whistling in the dark when they try to convince politicians that people don't care. On the contrary, not only is the public likely to look unfavorably on those who stand in the way of a patients' bill of rights, they are likely to demand more change even if such a bill actually passes. In that case, HMO lobbyists will be scrambling for new arguments—though if past experience is any guide, they will rely on the misrepresentation and misuse of polling data to make their case (for full article see http://www.prospect.org/web/printfriendly-view.ww?id=4459)

- Mainly, as a result of managed care in 1990s, the U.S. health care system is perceived to be on the decline, which adds to the publics' perceptions of a lack of trust in the system (i.e., increased cost, poor quality care, increased number of uninsured, mistrust amongst the providers and insurers, unethical behavior by both insurers, and providers, to name a view)

- Negative perceptions of the public, with overall lack of public trust in the health care system (e.g., rising costs, and large number of uninsured Americans). For example, trust goes down when leaders are not seen as addressing the major issues in society, Blendon (2002) said. Since the 1970s, the two biggest things that worry Americans are the rising health care costs and uninsured people. http://www.hsph.harvard.edu/trustinhealthcare/publicity.htm).

- In debates about national health insurance and efforts for cost containment, medical leadership was not only reported as not being supporting to them, they were opposing them. http://www.hsph.harvard.edu/trustinhealthcare/publicity.htm).

- Drug companies are widely perceived as greedy and insensitive (http://www.hsph.harvard.edu/trustinhealthcare/publicity.htm).

- The US health care system has reached a tipping point, where public trust has eroded to record low levels, said David Shore, associate dean and executive director of the Center for Continuing Professional Education (CCPE) at HSPH, at a national symposium organized by CCPE in Boston from November 13 to 15, 2002. The eroding trust has created problems throughout the health sector, he said. "The Public's Health: A Matter of Trust" is a multi-dimensional initiative to restore Americans' flagging confidence in their health care and public health systems. The recent symposium covered causes, ...