Many high-income U.S. workers and U.S. residents with chronic health problems are more willing to consider limits on which doctors they can see.[@@]

Ha Tu, a researcher at the Center for Studying Health Care Change, Washington, has published data supporting that conclusion in a report on a 2003 survey of 20,500 adults ages 18 to 64 with employer-sponsored health coverage. Tu compared the 2003 results with results from a similar health care system center survey conducted in 2001.

Although 21% of survey participants were still “strongly unwilling” to accept limits on provider choice in exchange for lower costs, that percentage was down from 25% in 2001.

Higher-income workers, who may have a particularly strong appeal for employers, and chronically ill workers, who tend to run up high claims costs, continue to be most resistant to the idea of limits on provider choice, but they were about as likely as other survey participants to shift toward a willingness to consider limits.

The percentage of participants with incomes over 400% of the federal poverty limit who were willing to consider limits rose to 54%, from 50%.

The 400% of poverty level income cut-off varies from community to community. In big, expensive cities such as San Francisco, for example, the cut-off exceeds $75,000.

“Employers and insurers have been reluctant to risk employee discontent by returning to restrictive networks, but with health costs continuing to outpace wage growth, resistance to these products may lessen,” Tu writes in the health care system center report.