New Survey Finds Socioeconomic ‘Medical Divide’ in Access to Care

Results of a survey released today by the Kaiser Family Foundation, Harvard University Kennedy School of Government and NPR indicate a "significant medical divide" along socioeconomic lines in the United States. Researchers conducted a nationwide telephone survey between March 28 and May 1 of 1,205 individuals ages 18 or older. The survey finds that people in the top income categories have "very few problems" accessing or paying for health care, while those in the lower income categories are "burdened" by such problems. Forty-four percent of families surveyed said they had had at least one problem with access to health care, medical bill payment or perceived quality of care in the last year. People who are uninsured, who have lower incomes and who have not graduated from high school were more likely to report such problems, the survey indicates. For instance, 38% of families with annual incomes lower than $25,000 experienced problems paying medical bills, compared to 23% of families with annual incomes between $25,000 and $50,000 and 9% of families with annual incomes higher than $50,000. Other survey findings include:

• Among the 10% of respondents who said they did not receive needed care in the last year, 84% reported "seriously increased" stress as result; 52% reported a "significant" loss of time at work, school or other activities; 44% reported a temporary disability including "significant pain and suffering" and 29% reported long-term disability.
  
• Nearly half of respondents (46%) worry about being able to afford health services, and 41% worry about the cost of prescription drugs. The survey also found that 51% of respondents who are insured worry about not being able to afford health coverage and that 50% are concerned about a reduction in benefits in the next year.
  
• Respondents cited rising health costs (44%) and access to health services (43%) as the two most important health care problems in the United States. Nineteen percent of respondents said health care is "one of the two most important" issues that the U.S. government should address, following the economy (23%) and terrorism (20%). However, only 10% said health care is one of the two most important overall issues facing the nation, compared with 37% citing the economy, 29% terrorism, 21% the war and 16% crime.

The survey also asked participants about their opinion on health system reforms. The results appear below:

• Fifty-seven percent of participants said that while there are some "good things" about the nation's health system, it still needs "major changes"; 23% said there is "so much wrong" with the system that it should be "completely rebuil[t]"; and 20% said the system "works pretty well" and needs only "minor changes." Respondents, however, seem to not favor making "sweeping changes," such as moving from an employer-based health insurance system to a defined contribution system, under which individuals would receive money -- either from the government or an employer -- to select a health plan.
  
• Sixty-seven percent of participants believe the government should expand Medicare to cover prescription drugs, and 26% support an approach under which the government would help seniors purchase private insurance to cover drug costs. While most respondents support a Medicare drug benefit, they are "divided" on whether the benefit should cover only the "lowest-income" seniors (44%) or all seniors (46%), as well as how much seniors should have to pay for a drug benefit.
  
• As for ways the government can guarantee health care, 84% of respondents favored expanding state government programs for low-income people, 80% said expanding health clinics, 76% favored requiring employers to offer health insurance to their employees, 73% supported the government offering tax credits to assist individuals in purchasing health insurance and 40% said instituting a national, single-payer health system.

NPR's "Morning Edition" today examines the survey's results, including comments from KFF President and CEO Drew Altman, Rep. Nancy Johnson (R-Conn.), Rep. Edward Markey (D-Mass.) and Marilyn Moon of the Urban Institute. The full segment will be available online in RealPlayer Audio after noon ET (Rovner, "Morning Edition," NPR, 6/5).