In the lull between the Supreme Court arguments over the federal health overhaul law and the decision expected in June, we thought we'd ask Americans who actually use the health system quite a bit how they view the quality of care and its cost.
Most surveys don't break it down this way.
When the results came back, we found that people who have a serious medical condition or who've been in the hospital in the past year tended to have more concerns about costs and quality than people who aren't sick. No big surprise there.
But what was notable: 3 of 4 people who were sick said cost is a very serious problem, and half said quality is a very serious problem.
Nearly half of those with recent serious illness say they felt burdened by what they had to pay out of their own pocket for care.
The recently ill are more likely to say the cost and quality of care have worsened over the past five years, compared to people who weren't sick.
Among people who've recently required a lot of care, significant proportions say their treatment was poorly managed, with nearly a third complaining of poor communication among their caregivers. One in eight believe they got the wrong diagnosis, treatment or test.
Those findings led us to investigate the problems people are having, both in our poll and in a series of stories on the radio and the Web we're calling "Sick in America."
The poll, a joint venture of NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health, is one of very few focusing on people who've actually been seriously ill, injured or hospitalized in the past year.
"This poll listens to the voices of the sick," says Robert Blendon of Harvard. "That provides a good barometer of what's happening in health care in America."
The poll randomly surveyed 1,508 adults across the nation. A little more than a quarter of them had a serious illness, injury or disability requiring "a lot of medical care," or overnight hospitalization within the past 12 months.
If you want to dive deeper, here's a summary of the poll findings, plus the topline data and charts. And you can meet some of the real people who shared their experiences of being sick in America with NPR in this post.
AUDIE CORNISH, HOST:
Now to a poll that explores what sick people in America think of their health care and the costs of care. NPR, along with the Robert Wood Johnson Foundation and Harvard, surveyed 1,500 people across the country; about a quarter of them self-identified as sick. And the report found that those sick people have a more negative view of the cost and quality of health care than people who are not sick. Among the sick, three out of four said costs are quote, "a very serious problem." And nearly half said the quality of care is a very serious problem.
For more on the study, we're joined in the studio by its author, Robert Blendon, professor of health policy and political analysis at the Harvard School of Public Health. Hi there, Robert.
DR. ROBERT BLENDON: Pleasure to be here.
CORNISH: So first of all, what's the significance of focusing on the views of sick people, in particular?
BLENDON: First is, because they have real experience, you get views of people who are actually living with health care as it's provided; rather than many of us who haven't been ill, giving views that are just very removed from what might go on. And secondly, they are more worried about these problems in this country. And so it gives a chance for them to have voice.
CORNISH: And what's the definition of sick? Obviously, these people self-identified. So what does that really mean?
BLENDON: So the - we asked people if they had a serious illness, medical condition, injury or disability that led them to have a lot of medical care - and that's over the last year - or hospitalized.
CORNISH: So let's talk a little bit about the quality of care because the survey asked a lot of questions about people's perception of - you know, their doctors, the tests, everything. What stood out for you, in those findings?
BLENDON: Well, about half the people were very satisfied with what they received. But for the other half, the issues that emerged are - people who thought their care wasn't well-managed, as a whole, were concerned that the communication between physicians and nurses and themselves really didn't work out very well. And a share of people - and they are not the largest - were really concerned that their diagnosis was not correct, or they got the wrong test or treatment, and something had gone wrong. And so what you have is, is a - half of people who were very satisfied, and the other had very real problems about the care they got. And that's the principal concerns that people who just lived through a year of illness reported to us.
CORNISH: And then on the issue of the cost of care, I want you to help - sort of explain something. We've got here in the study that 73 percent of sick Americans said health-care costs are a very serious problem. And yet among these same people, 63 percent said that they get a good value for what they pay for, when it comes to their health care. And I was wondering if you could help us understand that divide; of essentially saying. we're all paying too much but is it worth it, is it not worth it?
BLENDON: These findings were surprising. You have - sort of these conflicting feelings - I think it's too expensive; it's going to be hard for me to afford; the impact on my family. At the same time, people think that the charges are reasonable given, I think, so many people think most of the care worked out to be very good. But it looks like you're worried about the increasing cost of what things are, but you're not as critical about the services that you're getting - and even the charges for individual services.
CORNISH: Robert Blendon, thank you for talking with us.
BLENDON: Thank you very much for having me.
CORNISH: Robert Blendon, of Harvard's School of Public Health. He's a lead researcher of the Sick in America poll. You can find the entire survey at npr.org. Transcript provided by NPR, Copyright NPR.