When Americans need health care services, they’ll ask about the nature of the service and the recovery from it. But about the only time most ask about the cost is after the bill comes, and it seems like a whopper.

That’s what a survey by Benz Communications and Quantum Workplace found. The survey queried 2,000 employees about health care services and cost information. Not surprisingly, they learned that, the more someone makes, the less likely they are to ask about the cost of care. But even among those in lower pay categories, a general reluctance to discuss cost of care emerged.

The average response to questions about health services and cost went something like this: 69 percent of those surveyed said they had the information they needed to get proper health services, but only 48 percent said they ever asked a doctor or other medical professional what the services cost ahead of receiving them.

In the $125,000-$169,000 income bracket, less than a third asked questions about cost.

“For decades, it’s been clear from health claims data that employees lack understanding around how to connect care to cost,” said Jennifer Benz, founder and CEO of Benz Communications. “However, this data finally gives us that information from employees' own mouths.”

Cost of care aside, the survey revealed other employee attitudes about health and wellness services. Employees are far more likely to make healthy lifestyle choices if their employer offers a wellness plan — 60 percent of workers who have access to wellness programming feel inspired to make healthy choices. But for employees of companies that don’t have a wellness option, only 15 percent said their company health plan inspired them to make healthy choices.

Even without a wellness plan in place, any sort of health coverage offered by an employer matters. About seven in 10 said they depend on employer sponsored benefits for all their health care needs, and nearly nine in 10 said employer sponsored health coverage played a role in their decision to continue working for the same employer. (Nearly half said it played a major role in retention.)

Asked if they’d work for a company that didn’t offer health coverage, 73 percent said non.

They survey also asked respondents to describe their attitudes toward health care reform.

“Among employees who say the Affordable Care Act changed their benefits, 73 percent say the change made a negative impact. Employers didn’t exactly do their best to turn the tide: Barely half of workers (52 percent) say ACA-related benefit changes were adequately explained by their employer,” the report said.

And that old bugaboo, benefits communications, reared its dismal countenance again. Communications failures around benefits package contents are still rampant, according to this survey.

“Among employees who trust their company leaders, 49 percent say they receive frequent health and wellness communication. Among those employees who do not trust company leaders, only 28 percent receive frequent communications. Among those who say their manager supports their efforts to be healthy, 83 percent say there is open communication between employees and managers,” the report said.

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.