Ratings of U.S. Healthcare Quality, Coverage Best in 10 Years

PRINCETON, NJ -- Americans' assessments of healthcare quality and coverage in the U.S. are the most positive Gallup has measured in the last 10 years. The public continues to be much more optimistic about quality than about coverage.

These results are based on Gallup's annual Health and Healthcare poll, conducted Nov. 4-7 this year, and mark the first updates on these questions since the Obama administration and the Democrats in Congress passed major healthcare legislation earlier in 2010. Some of the provisions of this legislation have already taken effect, though many others will not be in place for a few years.

The legislation's passage does not appear to have had a large, short-term impact on how Americans view the U.S. healthcare system, given only at best modest increases since last year in ratings of U.S. healthcare coverage and quality. However, Americans' perceptions of both healthcare quality and coverage are the best Gallup has measured since 2001, the first year the Health and Healthcare poll was conducted.

The 62% of Americans who now rate the quality of healthcare in the U.S. as excellent or good is four percentage points higher than last year. A majority of Americans have consistently rated the quality of U.S. healthcare positively, though in 2005 and 2006, a low of 53% held this view.

Meanwhile, the 39% of Americans who rate healthcare coverage as excellent or good is essentially the same percentage as last year (38%), though it is nearly double the 2005 percentage (21%). The increase in positive ratings occurred largely between 2008 (26%) and 2009 (38%), coinciding with the Democratic efforts to expand healthcare coverage to more Americans that began in earnest in the summer of 2009, though the legislation did not became law until March of this year.

The poll also finds that healthcare costs remain a concern for Americans -- 23% are satisfied and 76% dissatisfied with the total cost of healthcare in the U.S. On a relative basis, Americans are somewhat more satisfied with U.S. healthcare costs than they have been in recent years, but only as many as 28% have expressed satisfaction with U.S. healthcare costs in the past 10 years.

Lawmakers' passage of healthcare reform has apparently done little to ease Americans' minds about the problems facing the healthcare system. The 72% of Americans who this year say the system is in a state of crisis (17%) or has major problems (55%) is similar to what Gallup measured last year and in most years since the question was first asked in 1994. The exception was in late 2001, when Americans' surge in support for government leaders and public institutions after the Sept. 11 terrorist attacks may have led to a more upbeat assessment of the healthcare system.

Implications

Americans' assessments of the healthcare situation in the United States have improved in comparison with prior years in some respects, particularly in terms of healthcare coverage.

The new law should expand coverage to a larger percentage of Americans, though its impact on healthcare costs and quality is far less predictable. To the extent the law is implemented in the coming years, and depending on how effective it ultimately is in achieving its goals, it certainly could affect Americans' perceptions of healthcare quality, coverage, cost, and whether the system continues to have major problems.