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2011 U.S. and Global Survey of Health Care Consumers: Key Findings

Global economic uncertainty makes affordable health care a challenge for consumers and has impacted health care spending


The cost of health care, coupled with the state of the economy, is of growing concern to consumers, according to Deloitte's 2011 Survey of Health Care Consumers. Across the globe, many consumers are delaying care, altering household spending, and worrying about their ability to pay for future health care costs.

Conducted annually since 2008, Deloitte's longitudinal study of heath care consumers seeks to provide a comprehensive view of health care consumerism that goes beyond the conventional boundaries of what health and health care are commonly thought to encompass. In addition to the traditional services that doctors and hospitals provide, the study's framework takes into account the expanding spectrum of treatment alternatives, delivery settings, information sources, and programs that are coming into existence to promote wellness and self-care, address health needs, and finance health care.

In addition to cost concerns, three shared core beliefs are apparent in this year's global survey: Consumers remain largely confused about their health care system; grade their system as underperforming relative to what they know of other systems; and believe spending is wasteful in their country's health system.

Surveys Conducted in 12 Countries

In tandem with this year's U.S. study, Deloitte surveyed health care consumers in Belgium, Brazil, Canada, China, France, Germany, Luxembourg, Mexico, Portugal, Switzerland, and the United Kingdom. Across these countries there are many differences in health care systems' structures and operations as well as in the political and economic thrusts of national health care reforms. Citizens in each of these countries differ widely in their social, cultural, economic, and generational viewpoints; however, they are all end users of health care and hold strong views on the performance of their respective systems and what they expect to receive from health care.

2011 surveyed countries

2011 Survey Highlights

Impact of the economy and rising health care costs

  • In the United States, three in four (75 percent) consumers say the recent economic slowdown has impacted their health care spending.
  • Forty-one percent are more cautious about spending, 20 percent have cut back on spending, and 13 percent say they have reduced their spending considerably.
  • Sixty-three percent say their monthly health care spending limits their household's ability to purchase other essentials, such as housing, groceries, fuel, and education.
  • In an effort to save money, 36 percent of prescription medication users say they asked their doctor to prescribe a generic drug instead of a brand name drug.
  • One in four (25 percent) U.S. consumers skipped seeing a doctor when sick or injured.

Which of the following have you done in the last 12 months

  • Between 4 in 10 and 5 in 10 respondents experienced an increase in household spending on health care in the past year with the exception of the United Kingdom (22 percent), Canada (29 percent) and China (37 percent).
  • Consumers are mixed in assessing their household capacity to handle future health care costs. Least confident are consumers in Portugal (18 percent), Mexico (22 percent), Brazil (22 percent), and the United States (23 percent).

System satisfaction varies widely

  • Consumers grade the overall performance of their health care systems very differently. The health care systems in Luxembourg (69 percent), Belgium (57 percent), Switzerland (52 percent), France (51 percent), and Canada (50 percent) all received a grade of “A” (excellent) or “B” (very good) from more than half of consumers in those countries. Only 22 percent of U.S. consumers, 18 percent of Portuguese, 15 percent of Mexican, and 8 percent of Brazilian consumers graded their country's health care systems in similar fashion.
  • Conversely, 57 percent of consumers in Brazil, 44 percent in Mexico, 38 percent in the United States, and 33 percent of consumers in Portugal rated their health care system's performance as failing (“D” or “F”).
  • Consumers are uniformly negative in their judgment about the success of respective governments in balancing priorities in their health care systems, with less than 1 in 5 consumers in all countries agreeing with the proposition that `'government is doing a good job balancing priorities in the health care system.”

Consumers identify waste in the system

  • Consistently throughout the 12 countries surveyed, many consumers see their health care systems as wasteful, with redundant paperwork, individuals not taking responsibility for their own health, and defensive medicine being the top causes of wasteful spending.

Consumers seek technology solutions to manage their health

  • Consumers are highly interested in using medical devices to monitor their condition and send information electronically to their doctor, ranging from a low of 46 percent consumers in Belgium through to a high of 79 percent of consumers in Mexico. (Sixty-one percent of U.S. consumers are interested in doing so.)
  • Over half (52 percent) of U.S. consumers say they would use a smart phone or PDA to monitor their health if they were able to access their medical records and download information about their medical condition.
  • Less than one in five consumers surveyed say they maintain a personal health record (PHR) electronically, with the exception of consumers in China where one in three have such a record.
  • Consumers are concerned that an Internet-based PHR might put privacy and security of personal health or medical information at risk.

How concerned are you that the privacy and security

  • Consumers are open to alternative approaches to traditional health care, such as visiting retail clinics or traveling outside their local community for care.

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