HEALTH CARE QUALITY: Most Americans Satisfied

      A new Associated Press poll indicates that while a majority of Americans are very satisfied with their health care, significant distrust of managed care is apparent in those who are dissatisfied. The survey, conducted by Media, PA-based ICR, found that with 51% of those polled "very satisfied" and 37% of respondents "somewhat satisfied" with the quality of health care, nearly 9 in 10 Americans expressed some degree of contentment with their care. Thirty-six percent and 24% said care was as good or better, respectively, than it was five years ago, while 34% said it was worse. As to perceived control over health care decisions, 48% said doctors have "the bigger say" in providing care, compared to 41% who say insurers have a larger impact. (AP/NewsEdge, 2/8). However, "among those with concerns about health care, much ... dissatisfaction focuses on the growing loss of control people feel over their medical care."

Doctor is Key
      The AP/Baltimore Sun reports that those who were dissatisfied were most likely to blame managed care, while those who were satisfied thought their doctor had the primary role in providing care. When people were asked their biggest health care concern, "the most-mentioned complaint was limits on their ability to pick the doctor of their choice ... followed by concerns about cost and quality."

Other Key Findings
      According to the survey, women in general are more likely to be critical of the health care system, with 40% saying it "is in worse shape than it was five years ago." Seniors are the most likely to express contentment with their health care, while "well-educated people between the ages of 35 and 64 were more likely to have concerns with health insurance." The Kaiser Family Foundation's Larry Levitt "suggested that those with more education probably have higher expectations." ICR interviewed 1,008 adults from all states except Hawaii and Alaska between Jan. 29 and Feb. 2. The poll has an error margin of +/- three percentage points (2/6).

Medicare HMO Poll
      A new Towers Perrin and CareData Reports poll shows that Medicare HMO members, despite the well-publicized managed care withdrawals that have stranded many seniors, are satisfied with their plans and would re-enroll. However, the Colorado Springs Gazette reports that the results should be taken "with a grain of salt" as "the responses come only from those who felt motivated to fill out the survey. ... CareData counts 'managed care organizations' among its varied clients," and the poll was conducted before some of the most visible HMO pullouts. The 1998 survey was mailed to 19,000 Medicare HMO enrollees, had a 52% response rate, and found that 66% of respondents were "extremely" or "very satisfied" with their plan, 82% were extremely or very satisfied with their quality of medical care and 80% said their Medicare HMO was as good or better as their previous insurance. CareData CEO Tod Cooperman said, "These Medicare HMO enrollees are generally very satisfied. The percentage of Medicare HMO members reporting being highly satisfied is a full 10 points higher than what we see in CareData's surveys of commercial HMO and [POS] plan members." Jim Hertel, editor of a Denver-based managed care newsletter, noted that the most popular benefits cited by the respondents -- such as prescription drug coverage and vision care -- "are the ones that will be cut if [HCFA] continues to limit reimbursements" to HMOs (Fletcher, 2/8).