New NPR/Kaiser/Harvard survey examines the public’s views and experiences with nation’s health care system, including attitudes towards health care delivery reforms

For immediate release: Wednesday, April 22, 2009

Boston, MA — As President Obama and the U.S. Congress continue health care reform discussions, a new survey, The Public and the Health Care Delivery System, by NPR, the Kaiser Family Foundation, and the Harvard School of Public Health highlights the public’s attitudes and experiences with the American health care delivery system.  The new survey sheds light on Americans’ experiences with issues more typically discussed by health policy experts – including electronic medical records (EMR), coordination of care and comparative effectiveness – all of which have become serious components of reform plans and some of which have been signed into law this year. It also covers public opinion on possible policy changes.  Beginning today NPR is reporting findings from the survey on its programs Morning Edition and All Things Considered.

The survey’s findings include:

  • While three in four Americans say it is important for their health care providers to use EMR and large proportions see a broad range of benefits in terms of better coordination of care, improving quality, avoiding unnecessary care and medical errors, a majority of the public do not think it will lower health care costs. More than half have little or no confidence that EMR systems would be able to protect the confidentiality of their personal health information and three times as many say it will increase their own health costs as say it will reduce them (39% versus 12%, with 43% saying they expect their costs would stay about the same).
  • While half of the public say it isn’t a problem at all, a substantial proportion of Americans report at least minor problems (44%) with coordinating care between their different doctors. Those who see more doctors report experiencing more coordination of care challenges.
  • Patients generally do not ask about the costs of medical or lab tests they receive. Only 22 percent say they have done so in the past two years.
  • Half of the public believes the American health system has a “major problem” with patients receiving unnecessary tests and treatments and even more, two-thirds, say the system has a major problem with “too many patients not getting medical tests and treatments they need.” But far fewer believe that they have ever experienced an unnecessary test or treatment (16%) or been undertreated (14%).
  • Seven in ten Americans believe that there is not always clear scientific evidence about which treatment is likely to work best for any one patient. And about half report that they have talked to their doctor about scientific evidence (48%) or how well a treatment works compared to other less expensive treatments (46%) as reasons for their doctors’ treatment recommendations. But the public is guarded about the idea that government agencies, independent scientific bodies, or insurers could make decisions about which tests and treatments should be covered by insurance. For example, less than half (41%) would trust experts from an independent scientific organization appointed by the federal government “a great deal” or “a fair amount” to make such a recommendation.

The telephone survey of a nationally representative sample of 1,238 adults was conducted between March 12 and March 22.  The margin of sampling error is plus or minus 3.5 percentage points for the full sample. For subgroups, the margin of error may be higher.

The survey is the latest in a series of projects about health-related issues by NPR, the Henry J. Kaiser Family Foundation, and the Harvard School of Public Health. Representatives of the three organizations worked together to develop the survey questionnaire and to analyze the results, with NPR maintaining editorial control over its broadcasts on the surveys.

Full results are available online: