Following widespread media coverage of health care reform, political debates, and legislative initiatives over the past year, consumers still say they know very little about the health care system in the United States, according to the third annual Deloitte Center for Health Solutions Survey of Health Care Consumers.

Less than a quarter (23 percent) of consumers surveyed said they understand how the health care system works, but 76 percent grade the system a “C” or below, and nearly half (48 percent) believe that 50 percent or more of health care dollars are wasted.

More than half (57 percent) of consumers surveyed said they are satisfied with their health plan, yet less than half (46 percent) said they understand their health insurance coverage, and one in four does not know how much they are paying for health insurance.

“While consumers tend to rate the ‘system’ low, when it comes to their own personal experience with their health insurance plan, doctor, or hospital, they are much more likely to say they are satisfied, even if they do not know how much they are paying,” said Paul H. Keckley, executive director of the Deloitte Center for Health Solutions. “It will be interesting to see how this might change in the years to come as systematic reforms are implemented.”

The survey also identified a number of contradictions when it comes to consumer perception, attitude, and behavior about health care decisions and personal health status.

  • Consumers perceive themselves to be healthy, yet suffer from chronic conditions. Seven out of eight (88 percent) consumers surveyed believe they are in “excellent,” “very good,” or “good” health, yet more than half (54 percent) have been diagnosed with one or more chronic conditions, and of the 56 percent who take prescription medications, almost half (47 percent) take three or more daily. In addition, only one in five surveyed said they participate in a wellness program.
  • They’re split on the government’s role in health care, but prefer private competition. Consumers also have mixed emotions over the government’s role in the health care system. Forty-two percent support government-mandated health insurance, compared with 38 percent who oppose it. However, 42 percent of consumers would choose an employer-sponsored plan versus the government’s (25 percent), all other factors being equal. Less than half (46 percent) believe the competition from the government would be fair to private insurance plans, and one in three consumers believe that the market needs 10 or more insurance companies competing in order to ensure consumer choice.
  • They’re financially confident, yet forego care because of cost. Despite economic uncertainty and high unemployment rates, one in four (24 percent) respondents reported feeling confident about how to manage their future health care costs. While this might seem like a reflection of economic stabilization, consumers’ actual behavior tells another story – of the people who skipped care when sick or injured (19 percent), four out of 10 did so because of cost.
  • They’re interested in health records, but slow to use them. One in five consumers said they have high interest in accessing personal health records through a secure Internet connection, would switch physicians to obtain access, and would be very likely to use a mobile communication device to access them. However, only 10 percent report actually having a computerized personal health record.

Additional key survey findings include:

  • Compared with last year, fewer respondents (43 percent to last year’s 47 percent) said that their health care costs increased, and more said that costs stayed the same (46 percent to last year’s 42 percent).
  • Consumers are receptive to medical tourism, but only 7 percent said they sought health care services outside their local community in the last 12 months.
  • Confidence in prescription medications remains high and unchanged from 2009 survey results – three in four consumers are confident that the medications they take are effective.
  • Sixty-seven percent of consumers indicated that they would choose a generic medicine over a brand name if given a choice, a slight decrease from 2009, when it was 71 percent.
  • Two in seven respondents asked their doctor to prescribe a generic therapy because of cost concerns.
  • More consumers are seeking alternative or natural remedies before seeing a physician (17 percent in 2010 compared with 12 percent in 2009), and more consumers are supplementing their current regimens with alternative remedies (20 percent in 2010 compared with 16 percent in 2009).
  • Fourteen percent said they delayed or forewent treatment recommended by a doctor or medical professional.

Source: Deloitte Center for Health Solutions