Americans more concerned about health care costs than universal coverage

FAN Editor

Most Americans think the nation’s health care system needs fundamental changes or to be completely rebuilt, and costs are what concern them most. More than four in 10 are dissatisfied with their health care costs and say affording basic medical care is a hardship. Many have had problems paying medical bills and more than a third say they have gone without medical treatment because of the costs.

Overall views of the U.S. health care system have been largely consistent for many years: most want fundamental changes or a completely rebuilt system.

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Two-thirds of Americans are very concerned with keeping costs down, more than ensuring everyone has health care coverage (56%). They are comparatively less concerned about improving the quality of the care they receive.

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This may be because Americans are largely satisfied with the quality of their own health care. Seventy-nine percent say they are satisfied, including 42% who say they are very satisfied. Americans have shown a high level of satisfaction with the quality of their health care for a number of years.

But Americans have greater reservations about their health care costs. Just over half of Americans say they are satisfied. 

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And many – more than four in ten – find affording basic medical care a hardship. Lower-income Americans are particularly likely to feel this way:  More than half of those earning less than $50,000 a year describe the affordability of basic medical care for their family as a hardship.

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When asked about some specific ways the cost of their medical care may have affected them, 43% of Americans say they or someone in their household has had problems paying medical bills in the last few years, and 38% have gone without medical treatment they thought was needed. Another 31% have not filled a prescription or have cut pills in half because of costs.

Here again, lower income Americans are far more likely to have done these things in the past few years than Americans who earn more, as are those who don’t currently have health insurance.

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Generally, most Americans with health insurance say they like the coverage they have.  Nonetheless, some have experienced difficulties with their insurance. Fifty-five percent of Americans with health insurance report receiving medical bills or paperwork that was confusing and almost half have received a medical bill in which their plan paid less than expected. About a third each have had trouble getting a doctor’s appointment in a timely manner or have had their plan not cover a particular doctor they wanted to see.

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Different types of insurance seem to have different problems. Sixty percent of Americans with private insurance (and 51% of those on Medicare) report confusing paperwork. Half of those with private insurance say they have experienced their plan paying less than they expected for a medical bill. Fewer Americans on Medicaid or those who get their insurance through a public exchange have experienced these problems, though 54% say they have wanted to see a particular doctor only to find that the doctor was not covered by their plan.  


This poll was conducted by telephone September 26 – October 2, 2019 among a random sample of 1,292 adults nationwide.  Data collection was conducted on behalf of CBS News by SSRS of Glen Mills, PA.  Phone numbers were dialed from samples of both standard land-line and cell phones.

The poll employed a random digit dial methodology. For the landline sample, a respondent was randomly selected from all adults in the household. For the cell sample, interviews were conducted with the person who answered the phone.

Interviews were conducted in English and Spanish using live interviewers. The data have been weighted to reflect U.S. Census figures on demographic variables.

The error due to sampling for results based on the entire sample could be plus or minus three percentage points. The error for subgroups may be higher and is available by request. The margin of error includes the effects of standard weighting procedures which enlarge sampling error slightly. This poll release conforms to the Standards of Disclosure of the National Council on Public Polls.

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