Americans Borrowed $88 Billion to Pay for Health Care Last Year, Survey Finds

Americans borrowed an estimated $88 billion over the last year to pay for health care, according to a survey released on Tuesday by Gallup and the nonprofit West Health.

The survey also found that one in four Americans have skipped treatment because of the cost, and that nearly half fear bankruptcy in the event of a health emergency.

There was a partisan divide when respondents were asked whether they believed that the American health care system is among the best in the world: Among Republicans, 67 percent of respondents said they believed so; that number was 38 percent among Democrats.

But Democrats and Republicans had similar responses about putting off medical treatment. Asked if they had deferred treatment because of the cost, 27 percent of Democrats said they had, compared with 21 percent of Republicans and 30 percent of independents.

Respondents from across the political spectrum also reported pessimism about their leaders’ abilities to reduce health care costs. About 70 percent of respondents said they had no confidence in their elected officials to bring prices down. And 77 percent said they were concerned that rising health care costs would damage the American economy.

“Our data shows an American public that’s beaten down from this really serious issue,” said Dan Witters, a senior researcher at Gallup.

At the same time, 64 percent of respondents said they were mostly satisfied with their experiences in the health care system. When asked if they were satisfied with how well the system was serving Americans generally, only 39 percent said they were.

The survey’s authors noted that Americans’ feelings were complicated and at times conflicted. But one thing was clear: High health care costs had created significant anxiety.

Even among households earning $180,000 or more a year, a third of respondents said they were concerned about the specter of personal bankruptcy due to a health crisis. (There has been fierce debate among researchers about the extent to which health care costs can be blamed for bankruptcies.)

Many American families earning less than that, of course, feel the effects of high health care costs acutely. They are forced to cut back on other expenses to pay for health care, or skip appointments and prescription refills, creating health risks down the road.

Twelve percent of respondents said they had borrowed money for care, including 11 percent of those with health insurance, who may still face high deductibles and other out-of-pocket expenses.

Most survey respondents said they believed that Americans were paying too much for health care relative to what they receive. Asked to choose between a hypothetical freeze in their health care costs or a 10 percent increase in household income, 61 percent of respondents chose the freeze. Those in low-income households were most likely to choose that option.

“When we’re talking about health care and the debate right now, it usually bifurcates between the financial impact of health care or the health outcomes themselves,” said Tim Lash, chief strategy officer for West Health, a nonpartisan nonprofit that aims to lower health care prices.

“But those two things intersect at access,” which can have dire health consequences, he said.

The organization believes that Congress should allow Medicare to negotiate directly with drug companies; that there should be more transparency about the prices of medicines and procedures; and that the health care industry should shift toward “value-based care” — in which doctors are paid based on patient outcomes — rather than the current “fee-for-service” model.

Mr. Lash noted that other wealthy countries spend much less on health care than the United States does, while achieving better outcomes in areas like life expectancy and infant mortality. Although about 87 percent of Americans have health insurance, according to data from Gallup, an individual’s plan may not cover all costs associated with treatment.

President Trump, who has sought to undo the Affordable Care Act, tweeted about high deductibles under the law on Monday morning, promising that “Good things are going to happen!” and tagging several Republican lawmakers.

The administration asked a federal appeals court to invalidate the law last week, while Democrats announced a health care bill that builds on the Affordable Care Act and seeks to lower premiums, among other goals.

The partnership between West Health and Gallup, the analytics and consulting company, was a first. The survey results are based on phone interviews conducted in English and Spanish in early 2019 with a random sample of 3,500 adults across the country. Gallup and West Health said they will conduct similar surveys in the coming years.