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Deloitte survey: Consumers say they pay too much for medical care, question their ability to handle future medical costs


New York - Consumers in six Western countries say their medical costs are too high and share concerns about their ability to meet future financial demands resulting from health care costs, a new survey by the Deloitte Center for Health Solutions (Deloitte Services LP, a subsidiary of Deloitte LLP in the U.S.) reveals.

The results of the 2010 survey of global health care consumers indicate that the majority of consumers in the Canada, France, Germany, Switzerland, the United Kingdom and the United States do not understand their health care systems. The perceived performance of each system varies widely from country to country, with the French and Swiss rating their systems highest overall.

“Consumer satisfaction with a population system of care is based on expectations,” said Paul Keckley, executive director of the Deloitte Center for Health Solutions. “In the United States, expectations are quite dissimilar from those of the French and others, posing incredible challenges to policy-makers seeking system change.”

The survey is the first comprehensive global study of health care attitudes, behaviors, and unmet needs of consumers globally. The findings show that consumer satisfaction or discontent is not always a reflection of a particular national system. For example, the French and Swiss systems are different structurally and in terms of funding, yet respondents in both countries are generally happy with their care.

“This survey presents a framework within which to study and contrast views across health systems and geographic borders, and, in the long-term, provides a basis from which to understand how policy changes affect consumer preferences and opinions,” observed Dean Arnold, Deloitte Touche Tohmatsu Healthcare Industry Leader.

Overall, many consumers admit they aren’t healthy enough, don’t participate in wellness programs, and are wary of technological advances that might better connect them to their doctors, insurers and other industry stakeholders. Satisfaction with primary care physicians and hospitals is high and extends across all survey borders. Two in three respondents overall believe they are adequately insured, the survey found.

As part of its study, the Deloitte Center for Health Solutions surveyed 1,000 consumers apiece in Germany, Switzerland, France and the United Kingdom. The Canadian survey was built from interviews with 2,304 people, while the United States results were collected from 4,001 participants. The surveyed countries have a mix of public and private health care systems; the U.S. percentage of health care as a proportion of gross domestic product is the highest, at 16 percent.

The survey was conducted across six discrete zones of health care consumerism – wellness and healthy living, traditional health services, alternative health services, information resources, health insurance and health policy.

Other key findings:

* 37 percent of Canadians and the French reported a “complete” understanding of their health care system. In each of the other four countries, the figure was below 30 percent.
* 61 percent of Canadians and 60 percent of Americans rate their overall health as excellent or very good; only 23 percent of Germans do.
* More than 65 percent of consumers in all countries are satisfied with their primary care provider; the rate is highest in Canada and Switzerland.
* Canadians and the Swiss are the highest users of alternative health care services; the French are the lowest.
* 2 of 3 consumers in most countries report being adequately insured, but fewer than 30 percent say they are well-insured – except in the U.S., where 39 percent describe themselves as well-insured.
* Fewer than 1 in 5 respondents participate in health and wellness programs, except in the United States. 59 percent of Americans would participate in such a program at no cost; only 44 percent of the French would.
* Americans and Canadians are most interested in online personal health records connected to their doctor’s office (more than 40 percent apiece). Germans and Swiss are least interested, at less than 30 percent.
* 59 percent of Swiss respondents say their health care spending increased in the previous 12 months, the highest of any country. Less than 7 percent in each country report that their health spending decreased.
* Americans, Germans and the French are most concerned about their ability to manage future health care costs. Canadians are the most secure about it.

Keckley said health care leaders and government officials can use the survey data to build better, more adaptive systems that raise the quality bar while containing costs. “These findings suggest to us significant opportunity for innovation across all borders, by leveraging industry relationships with government leaders and building on the public’s trust and positive support of its system,” he said.

The Deloitte Center for Health Solutions study identified three areas in particular that should receive the attention of political leaders, regulators, and industry stakeholders:

* Consumer awareness and understanding: Useful report cards that measure system performance must be developed and made accessible to providers and consumers. Regulators and health plans should align financial incentives with optimal performance, an effort that requires investments in information systems, operational procedures and oversight.
* Self-care support and health coaching: Chronic illnesses are prevalent in all six countries. The majority of consumers say they need help in managing their diagnosis, but use of information technologies to deliver coaching and self-care support to consumers is lacking. Capitalizing these efforts will be a key priority.
* Leadership and vision: Political priorities often challenge investments in health care system transformation. However, the rate of system spending growth poses a fiscal challenge to these countries. A concerted campaign to transition from patient passivity to active engagement of consumers will require political leadership and vision.

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