As Health Care Costs Take a Toll, Some Changes Win Broad Backing

Cost -- The overall cost of health care in this country is a very broad concern. Eighty percent of Americans are dissatisfied with the level of total health care spending; 58 percent are "very dissatisfied." And while 57 percent are satisfied with their own current costs, that's far lower than the level of personal satisfaction with other aspects of health care, such as coverage and quality.

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Additionally, two-thirds of those who are insured say their costs for health insurance premiums have been rising lately. (These results are about the same now as in a 2003 ABC News/Washington Post poll that asked many of these same questions.)

One likely reason discontent with personal costs isn't higher is because employers, rather than their insured workers, bear most of those costs. Just three in 10 insured Americans say their premiums have been rising "a lot." Fewer than half, 48 percent, say their deductibles and co-pays have been rising at all, and just 19 percent say these have been rising a lot.

Nonetheless, as noted, 60 percent are worried about their future costs for health insurance. And people who are worried are much more likely than others to support the most fundamental change, a shift to a universal coverage system.

The Uninsured -- The uninsured, who lack employer-provided insulation from rising health costs, are far more vulnerable. Thirteen percent of Americans in this survey say they currently lack health insurance, and an additional seven percent say they've gone without insurance at some point in the last year. (In recently released data from the U.S. Census Bureau, 17.4 percent of adults lacked coverage in all of 2005.)

It's clearly a public health concern: Uninsured people are far more likely to have had problems paying medical bills in the past year, and to have put off treatments because of costs. And even though they're younger (in general a healthier group), people who lack health insurance are much more likely than others to say their own health is bad --28 percent vs. 10 percent.

Income is a key factor in being insured. Among people with household incomes of $50,000 a year or more, just three percent report being currently uninsured, compared with nearly one in four among those with household incomes under $50,000. And among just the lowest-income Americans, those earning less than $20,000, more than one in three say they currently lack coverage.

There are vast differences in the type of coverage for those who are insured. Among better-off Americans, 87 percent report having private health insurance. Among those with less than $50,000 in household income, this falls to 48 percent. And in less than $20,000 households it bottoms out at just two in 10.

Lack of insurance also peaks among younger adults, 22 percent of those under age 30.

Uninsured Americans are far more likely than insureds to express dissatisfaction with the U.S. health care system and their personal situation alike. The largest gap, naturally, is in ratings of their own health care costs: Eight in 10 of the uninsured are dissatisfied, compared with a third of insured people.

More uninsureds also are more worried about the future, and more deeply so. Six in 10 insured people are worried about affording their health insurance over the next few years, including about a quarter who are very worried. But 85 percent of the uninsured are worried about being able to afford health care, with more than six in 10 very worried.

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