Soundbite: Does America Hate Its HMOs?


Conventional wisdom in Washington holds that Americans are angry about managed health care and want the government to do something about it. But when American Enterprise Institute Fellow Karlyn Bowman examined public polling data, she found Americans to be content with their own managed care plans.

Upwards of 80 percent of Americans in managed care are satisfied with the quality of their care, their ability to get appointments, and their access to specialists, according to Roper and ABC polls. And it's not just the healthy who are happy. One ABC poll found 88 percent of people who suffered, or had a family member who suffered, a serious injury or illness were satisfied with the care they received. More revealing, 79 percent of those polled by ABC said they would recommend their plan. Yet for all their personal satisfaction, Americans still seem to feel that there's something wrong with managed care. A Princeton Survey Research Associates poll found that when asked to ponder managed care in general, most Americans say HMOs have generally restricted access to specialists and decreased the quality of health care.

Karlyn Bowman discussed the data with Washington Editor Michael W. Lynch.

Q: There seems to be an "I hate Congress but love my congressman" phenomenon. Now it seems people dislike HMOs in general but like the HMO they're enrolled in.

A: This is true in many areas. We think race relations in the nation have enormous problems, but we think race relations in our own communities are pretty sound. We're worried about the moral fiber of the country as a whole, but we're not worried about the moral fiber of our community. I tend to trust and put most emphasis on what people are saying about their own circumstances. And that tends to be very positive in managed care, even from those people who have been sick.

Q: Politicians seem to think there is support for more government regulation of health care. What do the data show?

A: People seem to like the idea of a quasi-governmental agency, something like the Securities and Exchange Commission or the Federal Reserve [to keep tabs on managed care providers]. They don't want Washington directly involved in health decisions, but they think government must play an oversight role. They also want government to provide care for those who can't afford it. They just don't want a governmental role that would make their care more expensive.

Q: What are the chief concerns of Americans when it comes to health care?

A: Cost, cost, cost. Cost is first, cost is second, cost is third. It swamps all other concerns.