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Consumers dislike managed care, but most are happy with their HMOs

Dubbing it the "managed care paradox," a study by Harris Interactive finds while there's been a sharp increase in public hostility toward managed care and the health insurance industry, most consumers are satisfied with their own health plans.

A majority of consumers (69 percent) give their health plans a grade of A or B.

A majority of consumers (69 percent) give their health plans a grade of A or B, while only 8 percent give their plans a D or F, according to the survey titled "The Managed Care Paradox."

When asked whether the trend toward more managed care is "a good or bad thing," more than half the consumers polled (52 percent) said it's a bad thing, up from 28 percent who said the same in 1995.

Harris Interactive, a market research company, conducted the telephone poll of 1,025 adults (of whom 929 had some form of health insurance). Harris researchers conclude the decline in consumers' attitudes toward managed care and the health insurance industry is not based on the personal experience of health plan members.

Rising drug costs raise concerns

The rising cost of prescription drugs is a reason many consumers are worried about the future of their health insurance. A study by the Centers for Disease Control and Prevention (CDC) finds physicians are prescribing medications to their patients at a far greater rate than they did just two decades ago, at a time when drug costs are soaring.

"The study data show that there are a number of reasons why prescription rates are soaring," said study author Catharine Burt of the CDC. According to the study, if the current drug increase rate continues, drug spending will likely double in the next five years.

Burt says changes in drug coverage, drug research and development, faster Food and Drug Administration approval, and increased drug marketing to physicians and consumers are cited as likely contributors to increased use of medications by doctors. The CDC study also shows physicians were 43 percent more likely to prescribe multiple drugs per patient visit in 1999 than in 1985.

"Some might assume that the likely driver of such an increase in prescriptions is an aging population, but our study shows that only about 20 percent of the observed increases can be attributed to this," said Burt. "Other factors – more patients with multiple conditions, new drugs for chronic conditions, increased health insurance and prescription drug coverage, increased focus on managed care including the use of treatment guidelines, and direct-to-consumer advertising – appear to play a role."

Is public perception worse than reality?

National Public Radio, the Kaiser Family Foundation and the Kennedy School of Government at Harvard University conducted a survey to learn about the concerns of consumers about health coverage.

The survey found the number of people who worry about health care cost and access in the future is even greater than the number currently experiencing problems. Nearly half of those responding to the survey are worried about being able to afford health care services and prescription drugs. About half of respondents with insurance coverage are worried about the future affordability of their insurance or having their benefits reduced.

Harris researchers conclude the decline in consumers' attitudes toward managed care and the health insurance industry is not based on the personal experience of health plan members.

"We believe that these deteriorating public perceptions of managed care are due to fears that are media-driven or physician-driven, and are not experience-driven," says Humphrey Taylor, chairman of the Harris Poll for Harris Interactive. "Managed care horror stories and word-of-mouth reports may also play a role in creating misperceptions among consumers.”

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