Americans happier with public health insurance programs than private plans, study finds

Americans covered by some form of public health insurance have better access to care, are more satisfied with the care they receive and are less likely to be burdened with medical debt than those with employer-sponsored or individually purchased commercial health plans, according to results of a recent study.

The findings could provide ammunition to lawmakers and health policy experts who have argued that the way to improve health care access and outcomes is to expand public insurance programs, rather than trying to reduce individuals’ costs associated with private insurance.

The study looked at care access, cost and satisfaction among the approximately 149,000 respondents. Respondents were grouped according to whether they had a public form of insurance (Medicare, Medicaid, or VHA/military) or private coverage (employer sponsored or individually purchased.) The largest segment—63.9%--had private coverage, followed by Medicare (23.8%), Medicaid (8.9%), and VHA/military (3.4%).

Data for the study came from the CDC’s Behavioral Risk Factor Surveillance System annual telephone survey for the years 2016 through 2018. Among the study’s findings:

• People with Medicare coverage were more likely to have a personal physician, stability in insurance coverage and be satisfied with their care than those with private insurance,
• Medical debt was more common among people with private insurance than those covered by any form of public insurance,
• Medicare beneficiaries had less difficulty seeing a doctor or taking medications due to cost considerations than individuals with private coverage,
• People covered by VHA or military insurance had better experiences related to care access, cost and satisfaction compared with people with private insurance coverage, but were less likely to have a personal physician; and
• Individuals with private insurance were more likely to have a private physician and less likely to experience instability in coverage than those with Medicaid coverage

The authors note that their findings are consistent with earlier research, including a 2015 Gallup poll showing that individuals with Medicare and VHA or military coverage were the most satisfied with their care, and surveys from 2000 and 2010 suggesting Medicare beneficiaries were more satisfied with their care than were individuals with private coverage.

The study, “Access to Care., Cost of Care, and Satisfaction With Care Among Adults with Private and Public Health Insurance in the US” appeared June 1 on JAMA Network Open.