American Satisfaction with the Health Care System

[On the Road]

April 18, 2005

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This paper includes some survey data about how satisfied people are with their country's healthcare system (see Exhibit 1). The United States rates pretty low on this scale (14th out of 17 countries), but it turns out the survey includes something even more interesting: separate satisfaction ratings for the poor and the elderly (see Exhibit 3). It takes a bit of interpolation to extract all the numbers, but that's not hard to do. So with that in mind, here are the percentages of Americans who say they are "fairly or very satisfied" with their own health system:

    -Poor: 45%
    -Elderly: 61%
    -Everyone else: 34%

This is pretty remarkable. First, the elderly in America, who are covered by a state-run national healthcare system (Medicare and Medicaid) are way more satisfied with their healthcare than everyone else. As it happens, the elderly in other countries also tend to report higher satisfaction levels than other people, but usually by just a few percentage points. In America, where the elderly are covered by a national system and others aren't, the elderly are more satisfied by a whopping 27 percentage points.

Second, even the poor are more satisfied with their healthcare than the rest of us. The poor generally rely on a combination of Medicaid, emergency rooms, and free clinics for their healthcare, a system that's hard to beat for sheer inefficiency and appalling service. But even at that, the rest of us, who are mostly covered by employer-provided health insurance, are less satisfied than the poor. The system of health coverage provided to the vast majority of American citizens is so bad that we like it even less than the jury-rigged system the poor are forced to use.

http://www.washingtonmonthly.com/archives/individual/2005_04/006142.php