U.S. residents’ satisfaction with health care may have peaked in 1998, before the managed care choice movement gathered steam.[@@]

The rise of tightly managed health maintenance organizations helped decrease the cost of health coverage in the mid-1990s and expanded access to basic health coverage.

Starting in the late 1990s, complaints about problems with access to specialists, hospital care and primary care doctors of the patients’ choice started making headlines. HMO companies responded by relaxing care utilization rules and procedures and increasing costs enough to pay for the added flexibility.

Now a new survey backed by Ceasefire on Health Care, Washington, a health policy group founded by John Breaux, a Democrat who once represented Louisiana in the Senate and now appears to be positioning himself for a run for the White House in 2008, shows that the 800 likely voters polled in late September and early October said they were far more worried about the cost of health coverage and access to basic health care coverage than they were about provider choice or health care quality.

The polling firms that conducted the survey, which have been asking voters about health insurance for other clients for years, found that the percentage of voters who say the health care system is meeting their needs has increased to 70%, up from a nadir of 60% in January 2004 but down from a high of 81% in October 1998.

Only 13% of the voters surveyed were uninsured, but they believed, incorrectly, that 43% of children and 47% of adults lack health coverage.

Among the voters surveyed, 85% agreed that giving all children access to basic health care services is the most important issue to them personally.

When the pollsters asked the participants about a list of 6 other health care goals, 37% ranked “providing basic health insurance coverage to all Americans” first, and 33% ranked “making health care more affordable” first. Fewer than 10% ranked “people can select their doctor or hospital,” “develop and adopt new medical technologies” or “maintain high quality of American health care” first.

Breaux’s group released the survey results shortly before Breaux appeared at a presidential tax reform advisory panel that is considering the possibility of capping the tax exemption on employer expenditures on group health insurance.