- THURSDAY, Aug. 7 (HealthDay News) — The vast majority of
Americans are dissatisfied with the U.S. health care system, and 82
percent think it needs to be overhauled, a new survey found.

“There is a broad view by the public that our health care system needs
a full overhaul, either to be totally rebuilt or reformed,” said Cathy
Schoen, senior vice president for research and evaluation at The
Commonwealth Fund, which commissioned the survey.

The survey, titled Public Views on U.S. Health Care System
Organization: A Call for New Directions, questioned 1,004 adults on
their views of the U.S. health care system.

The frustration with the current system stems from a shared experience
of inefficient and time-consuming care, Schoen said. “Often paperwork
doesn't arrive, or your records aren't available when you show up. There
are also concerns about getting timely access to care,” she said.

Schoen thinks the survey clearly indicates that Americans want better
organized care. “Also, having a regular doctor who is available to see
you, getting timely referrals, and having more affordable care are
important to people,” she said.

Nine out of 10 people surveyed said the presidential candidates should
propose reforms that would improve the quality of health care, ensure that
all Americans have affordable care, and reduce the number of
uninsured.

Eight in 10 people said they supported efforts to improve health care
performance, access, quality and cost. For example, one in three said
their doctors ordered tests that had already been done or recommended
unnecessary treatment.

Most of the people surveyed expressed frustration with the way their
health care was managed. For instance, 47 percent said their health care
was poorly coordinated; this lack of coordination included not being
informed about test results and having to make several calls to get the
results.

In addition, survey respondents felt that important medical information
wasn't shared between doctors and nurses or communicated between their
doctor and specialists.

Nine of 10 people said it was important that they have one place or one
doctor responsible for their primary care and coordination of all their
care. And, nine of 10 wanted easier access to their medical records.

Seventy-three percent said they had difficulty getting a doctor
appointment, phone advice, or after-hours care without going to the
emergency department. Among insured patients, 26 percent said it was hard
to get same- or next-day appointments when they were sick, and 39 percent
said it was difficult to reach their doctors by phone when they needed
them.

Dr. Steffie Woolhandler, an associate professor of medicine at Harvard
Medical School and co-founder of Physicians for a National Health Program,
thinks Americans are being ill served, given the amount of money spent on
health care in the United States.

“We now spend twice per capita what other developed nations spend on
care, yet we die younger, have worse access to care, and are even behind
on medical computerization,” Woolhandler said. “These survey results are a
clarion call for the health financing mechanism used elsewhere —
nonprofit national health insurance.”

Kathleen D. Stoll, director of Health Policy at Families USA, thinks
the survey reinforces what is already known about Americans' frustration
with the current health care system.

“We have seen the number of uninsured rise. We have seen people facing
higher out-of-pocket costs. We see layers of complications in terms of
billing problems,” she said. “All that adds up to an American public that
is quite ready for health care reform.”

In a separate report titled Organizing the U.S. Health Care System
for High Performance, The Commonwealth Fund outlined its strategies
for improving the health care system.

Among the recommendations was moving away from fee-for-service payments
and paying doctors and hospitals based on the quality of care. In
addition, the report recommends patient incentives that reward them for
choosing doctors and hospitals that provide the most efficient, highest
quality care.

To achieve these goals, the report recommends removing barriers that
prevent doctors from sharing essential information; accrediting doctors
and hospitals based on quality measures; making patient information more
available to doctors at the point of care; and enforcing clear
accountability for patient care.

Moreover, doctors and other health care professionals should be trained
to work as teams. And, switching to electronic health records should be
mandated and supported by the federal government, according to the
report.

More information

For more on health care reform, visit The Commonwealth
Fund.