Health Care Is Unaffordable For Half the Country; Consumers & Physicians Agree On Why

"It's heartening to see physicians and consumers agree that people should take more responsibility for their health, and a new kind of insurance product should be examined closely," said Dr. Arthur "Tim" Garson, Jr., director of the Texas Medical Center Health Policy Institute.

"The Nation's Pulse: The Texas Medical Center's Consumer & Physician Survey" questioned more than 9,000 consumers across 15 states, as well as 450 physicians nationwide. Consumers were surveyed in five red states (Arizona, Georgia, Indiana, Texas and Tennessee), five blue states (California, Illinois, New Jersey, New York and Washington) and five swing states (Florida, Michigan, North Carolina, Ohio and Pennsylvania).

Consumers and physicians agree on why costs are rising and how to fix it

Forty-seven percent of physicians surveyed blamed insurance companies for rising health care costs, compared to 28 percent of consumers. Nineteen percent of physicians and 30 percent of consumers blamed drug and device manufactures for rising costs. However, relatively few respondents from both categories blamed hospitals or physicians.

"It's interesting that both groups blame insurers for high costs because doctors and hospitals – not insurance companies – are the ones sending the bills," said Garson, a cardiologist and former medical school dean.

Consumers and doctors were also largely in agreement on which reforms were most likely to decrease health care costs. The leading solution from both groups was to increase costs for smokers and obese people via higher health insurance costs and taxes on unhealthy food. Forty percent of physicians and 28 percent of consumers believed that is the most likely way to reduce health care costs. Twenty-three percent of doctors and 23 percent of consumers surveyed believe the creation of affordable catastrophic health care plans would be the most likely way to reduce health care costs.

A catastrophic health care plan could be offered at an affordable price and primarily offer coverage for only the most critical situations such as accidents, pregnancy and major illness, Garson said.

Consumers value health insurance, and they struggle with affordability

The study also revealed that 98 percent of consumers surveyed consider health insurance important to them and their families.

"Americans are more united on this issue than our federal policymakers might realize," Garson said.

The surveys were conducted over the summer as the U.S. Senate debated – and ultimately failed to pass – legislation that would have repealed the Affordable Care Act, also known as Obamacare.

The responses indicate many Americans consider their health care costs unaffordable. For example, 49 percent of consumers surveyed say they're forced to cut back on spending in other areas in order to pay for their health care.

"Health care continues to be unaffordable for half the country," Garson said. "American families are desperate for relief, and our leaders need to seriously consider strategies to reduce the growing cost of health care."

The majority of the uninsured consumers surveyed – regardless of income – said they consider spending 2 percent of their income on health care to be affordable. The Affordable Care Act's individual mandate requires people to obtain health insurance or pay a penalty. Those who lack access to "affordable" coverage under that law are exempt from that penalty. But under ACA, coverage is only considered "affordable" if it doesn't cost more than 8.2 percent of income.

"The survey findings are significant, since they show the public's view of what's affordable is vastly different from lawmakers' view of affordability," Garson said.

Cost reduction strategies

To help Americans who are struggling to afford health care, Garson said, it's important to address the root issue – rising health care costs – and consider innovative ways to reverse that trend.

One way to reduce costs could be by shifting a greater portion of physicians' compensation to salaries. Today, much of physicians' earnings come from incentive pay based on the volume of care they provide. Meanwhile, it has been estimated that nearly $200 billion per year is spent on overtreatment – enough to cover all the uninsured. If more doctors were salaried, the volume of procedures would likely decrease, reducing costs, Garson said.

The survey found that 69 percent of physicians said their preferred way of being paid would be through a high proportion of their compensation being salary – with a low proportion of their pay based on incentives – or a straight salary with no incentives.

"I think the simplicity and assurance of a salary are attractive to physicians," Garson said. "Data from other studies suggest that the number of tests and procedures will also decrease if more doctors were salaried."

Reporters may arrange interviews with Health Policy Institute Director Dr. Arthur "Tim" Garson, Jr. by contacting Ryan Holeywell, [email protected].

The results of the survey are posted to tmc.edu/health-policy.

About the Texas Medical Center:
The Texas Medical Center (TMC) in Houston, home to 59 member institutions, is the world's largest medical city. Since opening in 1945, TMC has been pioneering patient care, research, education, and prevention. Today, TMC continues its dedication to reinventing life sciences to improve the health and wellness of Houston, and the world. More info at tmc.edu.

About the Texas Medical Center Health Policy Institute:
The Texas Medical Center Health Policy Institute was established to inform, define and lead health policy with the goal of developing the most effective solutions to improve the health of diverse populations around the globe. By driving innovative, evidence-based health policy initiatives across the Texas Medical Center's 59 member institutions, the Texas Medical Center Health Policy Institute addresses fundamental health policy issues important to Houston, Texas and the nation. More information at tmc.edu/health-policy.

SOURCE Texas Medical Center

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