As lawmakers discuss comprehensive health reform legislation amidst the backdrop of a struggling national economy, the Robert Wood Johnson Foundation (RWJF) released the first-ever monthly measure of consumer confidence in American health care. The Robert Wood Johnson Foundation Health Care Consumer Confidence Index (RWJF Index) is conducted by the same researchers who oversee the well-known monthly consumer confidence index, reported each month since the 1940s.

The survey found that Americans’ confidence in their health insurance coverage and access to health care fell 1.3 points last month to 98.7, down from its baseline of 100. The RWJF Index is created from data collected by the Surveys of Consumers, a monthly survey of 500 households conducted by the Survey Research Center at the University of Michigan. The survey evaluates consumer confidence along a spectrum of economic issues including American health care. Analysis of the data is provided by the University of Minnesota’s State Health Access Data Assistance Center (SHADAC).

The survey also shows that an overwhelming 86 percent of Americans believe health reform is an important part of addressing the nation’s economic crisis.

“While a great deal of attention is being given in Washington to health reform, we don’t hear enough about the concerns of everyday Americans on these important issues. We need to know more about how health care is affecting people’s daily lives and track that information over time,” said Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation. “The RWJF Index shows that Americans feel vulnerable about their health care and want reform. Tracking consumer confidence in health care over time will be an important national indicator for whether we are genuinely improving health care and ultimately the health of all Americans.”

The RWJF Index ranges from 0 to 200. Baseline was established at 100 in spring 2009. Highlights show:

• Dramatic differences in confidence among insured and uninsured people. Insured people have health care confidence index of 104.1 points, compared with 57.3 points for the uninsured. There is virtually no difference in the indices for people who are privately insured (105.6 points), versus those insured through government insurance programs, such as Medicaid and Medicare (103.5 points).
• People are afraid of losing their insurance in coming year. Nearly one in four people (23.6%) fear losing their health insurance at some point in the next 12 months.
• Americans are worried about being able to afford future care. Nearly half of all Americans (46.0%) are worried that they will not be able to pay for their future health care needs.
• People are skipping needed medical care. Nearly a quarter (22.4%) report that they or a family member delayed seeing a doctor when it was necessary because of concerns about cost over the past year.
• Americans are having trouble paying their medical bills. One in four people (22.7%) report having had trouble paying medical bills during the past year.

“The American people clearly believe that fixing the nation’s health care system is a critical part of fixing the economy,” said Lavizzo-Mourey. “People feel the pinch and are worried about keeping their health care coverage. As the economy continues to falter, health care insecurity is becoming an even greater issue.”

The RWJF Index is comprised of two sub-indices. The Recent Health Cost Barriers Index gauges consumers’ recent experiences accessing health care because of cost concerns and remained steady at 100.0 points in May. The Future Health Cost Concerns Index measures consumers’ worries about accessing health care or health insurance in the future because of cost, and fell 2.6 points in May.

Each month, the University of Michigan’s Survey Research Center will include questions regarding health care, health insurance and the impact on families’ economic situations in its Surveys of Consumers. The questions will provide data for the RWJF Index. The Surveys of Consumers is an ongoing nationally representative survey based on approximately 500 telephone interviews with adults in the United States. For over 50 years, its data have proven to be accurate indicators for understanding and forecasting changes in the national economy. Its Index of Consumer Expectations is an official component of the U.S. Dept. of Commerce’s Index of Leading Economic Indicators.

“While previous surveys have tried to measure Americans’ health care insecurity, none have rigorously tracked it this frequently over time,” said Lynn Blewett, Ph.D., principal investigator and director of SHADAC. “The design of this survey and the creation of the index allow us to assess regularly changes in attitudes and behaviors and will provide a monthly snapshot of attitudes about American health care, health insurance and the impact on our economy.”

The Robert Wood Johnson Foundation Health Care Consumer Confidence Index will be released the third week of every month.