Have Americans reached a breaking point with our health care system?

A new survey from Gallup and West Health finds stress over health care at an all-time high among consumers in the U.S. The report outlines concerns about affordability, access, and inequities—issues that have been raised before but are even more pressing after nearly two years of the COVID-19 pandemic. The survey polled 6,600 U.S. adults, seeking a comprehensive overview of opinions on health care.

The analysis estimates that nearly 100 million Americans regard their health care system as “expensive” and “broken.” The poll found that 59% of Americans say they are more worried about the cost of health care services than in the past, and 45% are more worried about the cost of prescription drugs. More than half say the high cost of health care contributes some (36%) or a lot (15%) of stress to their daily lives. And nearly a quarter of Americans (23%) say that health care costs are a major financial burden.

“Americans have reached their breaking point,” said Shelley Lyford, president and CEO of West Health. “Between March and October, the percentage of people reporting trouble paying for health care, skipping treatments, and not filling their prescriptions spiked to their highest levels since the pandemic began, exacerbating another public health threat borne out of cost rather than illness.”

A changed landscape

Americans’ attitudes about health care have been changed by the pandemic, the report found. Nearly half (48%) said their view of the U.S. health care system is worse after the emergence of COVID-19. Only 7% said their opinion of the health system had improved since the beginning of the pandemic.

In addition to cost issues, concerns about equity in health care have also grown: 60% of respondents say they are now more concerned that some Americans have unequal access to quality health care services. The report found that one out of every 20 adults reported a time in the past year when a friend or family member died after not receiving treatment for a condition due to their inability to pay for it. Black Americans were twice as likely as Whites to know someone who died because they could not afford care.

The survey found that in the past year, the portion of Americans reporting their health care costs have increased has reached 50%, up 21 percentage points from six months ago. The rate of Americans borrowing money to pay for needed care has also risen, from 7% in December 2020 to 11% in October 2021.

And although worries about the high cost of care was reported in all income brackets, more than a quarter of households with annual incomes below $48,000 (28%) reported going without prescribed medications in recent months.

Pessimism about the future

The bleak outlook isn’t just about the current state of affairs—those surveyed reported little faith that the situation will improve. Although nearly half (46%) said addressing health care cost was a major priority when it came to supporting political candidates, 72% said they were pessimistic the government would act in the next year to bring down costs.

Overall, respondents seemed to feel they lack power to affect changes to health care: 11% said voters have a lot of power to reduce health care costs, with 23% saying they had some power. They judged Congress to have more power (52% said a lot, 32% said some), along with President Biden (23% and 43%). The respondents said that corporations and businesses have the most power to bring down health care costs—with 65% saying businesses have a lot of power and 25% saying they have some.

The political divide almost disappears on the issue of health care costs: 94% of Democrats and 91% of Republicans agree that health care costs are too high.

The report concluded by noting that Americans had been concerned about health care issues before the pandemic, but that they are now are more focused than ever on health care and its high costs.

“The sharp worsening in public opinion regarding the affordability of care and medicine is startling, and likely a result of myriad factors related directly and indirectly to the COVID-19 pandemic,” said Dan Witters, a senior researcher for Gallup. “From rapidly rising inflation, to deferred care pushed into 2021, to more people having to pay for COVID-19 care itself, the U.S. health care cost crisis is now coming to a head.”