The Nation’s Pulse: The Texas Medical Center's Consumer & Physician Survey

The annual survey, now in its third year, provides insight into the public’s perception and attitude of hot-button health policy issues. The 2017 survey focuses on questions about the affordability of health care and ways to reduce its cost.

The 2017 web-based survey polls more than 9,000 residents across 15 states and more than 450 physicians nationwide.

 

Data Access

The Texas Medical Center Health Policy Institute’s mission is to promote smart health policy through evidence-based research. As a result, it is making the underlying data from the 2017 physician and consumer surveys available to researchers.

Below, we’ve listed “headlines” from the survey that give researchers an idea of the type of data available to them.

If you’d like access to the full survey results, fill out the form below, and a representative from the TMC Health Policy Institute will respond shortly. If you are seeking data on a particular “headline,” please include the appropriate reference number in the data request form.

Headlines - Consumer Survey

Below is a list of some of the “headlines” that can be seen in the underlying consumer survey data. Please include the reference number shown in parentheses on your data request form if you are seeking data on a particular theme.

Broad Themes

  • Snapshot of red vs. blue states (#12-13)
  • Snapshot of Trump voters’ views on healthcare (#14-15)
  • Detailed findings: Quality of care (#16)
  • Most consumers say the quality of healthcare is good or excellent, especially in blue states (#17)
  • Perceptions of healthcare quality are similar among those who voted for Trump and Clinton in the 2016 election (#18)
  • Those in red states who plan to vote Democratic in 2018 are significantly more likely to rate the healthcare quality as fair or poor (#19)
  • Across all states, healthcare quality is rated significantly lower among the uninsured (#20)
  • Healthcare quality is perceived as generally more positive among consumers with higher income (#21)
  • Over half of consumers do not worry about healthcare quality because it’s generally excellent, with significantly more holding this opinion in blue vs. red states (#22)
  • Regardless of who they voted for, more than half agree they don’t worry about quality as it is generally excellent (#23)
  • Uninsured consumers in all states are significantly less likely to agree that they don’t worry about quality of healthcare as it is generally excellent (#24)
  • About one-third of consumers in red and blue states believe that the quality of healthcare is worse this year than two years ago (#25)
  • In blue states, Trump voters are more likely than Clinton voters to agree that the healthcare quality is worse this year (#26)
  • Uninsured consumers in red and blue states are significantly more likely to agree that the quality of healthcare is worse this year (#27)
  • A small portion of consumers, particularly in red states, report that wait time for PCP visits has increased vs. a year ago (#28)
  • A similar proportion report the increased wait times for the specialist visits, especially for the initial visits in red states (#29)
  • About one in two consumers, particularly those in blue states, report it has become easier to get an appointment (#30)
  • In red states, consumers who voted for Trump are significantly more likely to disagree that it’s easier to get an appointment now (#31)
  • Across all states, basic coverage for all ranks the most important characteristic of a healthcare system, followed by choice as distant second (#32)
  • For Clinton voters, basic coverage for all is by far the most important characteristic of a healthcare system while Trump voters rank choice as No.1 (#33)
  • In red and blue states, Clinton voters rank basic coverage for all the most important characteristic of a healthcare system while Trump voters say choice tops the list (#34)

Detailed Findings: Health Insurance Coverage (#35)

  • Blue states have significantly higher proportion of insured consumers, with government insurance being much more common there than in red states (#36)
  • Having health insurance is very important or absolutely essential to 9 in 10 consumers across red and blue states (#37)
  • Overall, insured consumers value having insurance significantly more than the uninsured, though most uninsured say it’s very important or absolutely essential (#38)
  • Virtually all Trump and Clinton voters in red and blue states recognize the importance of having health insurance for themselves and their families (#39)
  • Consumers in blue states place more importance on all US citizens having health insurance (#40)
  • The vast majority of insured and uninsured consumers agree it is important for all U.S. citizens to have health insurance (#41)
  • Across all states, consumers who voted for Clinton are significantly more likely to consider it important that all US citizens have health insurance (#42)
  • Expanding state insurance system is the top choice in all states, but particularly in blue states; red states more often than blue prefer to give people money to buy insurance or say it is not government’s job (#43)
  • There are no major differences in preferred ways to expand health insurance for insured vs. uninsured consumers (#44)
  • Those who voted for Trump are much more likely to say it is not the government’s responsibility to expand insurance; they are also much less likely to favor the expansion of state insurance (#45)

Detailed Findings: Healthcare Costs and Affordability (#46)

  • Consumers feel they are paying more out-of-pocket now compared to two years ago, especially in red states (#47)
  • Trump voters in blue states are notably more likely to agree out-of-pocket expenses have increased (#48)
  • Consumers in red states (about half) are significantly more likely to have to cut down on other expenses to pay for healthcare (#49)
  • Slightly over half of consumers in red and Swing Non-Expansion states agree that they have to cut down on other expenses to pay for healthcare (#50)
  • In blue states, Trump voters agree that they have had to cut down on other expenses to pay for healthcare; most Clinton voters disagree (#51)

Detailed Findings: Healthcare Costs and Affordability – Insured Respondents (#52)

  • Around two-thirds of insured consumers report paying 5% or more in out-of-pocket expenses; at least one-third find this unaffordable, leading them to cut back on savings, clothing, and food (#52)
  • Compared to red states, many more consumers in blue states report paying only 2% in out-of-pocket expenses; however among those who pay 5% or more at least one-third find it unaffordable (#54)
  • Among lower income categories, roughly around half of insured consumers report that their out-of-pocket healthcare expenses are unaffordable; out-of-pocket expenses of 5% or more are affordable by less than one-quarter (#55)
  • Affordability clearly increases with income, yet no more than four in ten insured consumers with income of $75K+ find out-of-pocket expenses of 5%-20% to be affordable (#56)
  • 2/3 of insured pay 5% or more in Out of Pocket expenses; as expenses increase from 2% to 20% of income, affordability decreases,
    prompting cut-backs. (#57)

Data: Affordability of Out-of-Pocket Healthcare Expenses By Income – Insured (#58)

  • More than half of insured consumers say they are paying more out-of-pocket vs. 2 years ago (#59)
  • Nearly half of insured consumers in red states have cut down on other expenses to pay for healthcare (#60)

Detailed Findings: Healthcare Costs and Affordability – Uninsured Respondents (#61)

  • Data: Affordability of out-of-pocket healthcare expenses by income – uninsured respondents (#62)
  • Expense is, by far, the main reason for being uninsured, especially in red states (#63)
  • Similarly, expense is the main reason for being uninsured in the non-expansion states; ineligibility for Medicare/Medicaid is a very distant second, but is significantly more often mentioned in the swing states (#64)
  • While there are no overwhelming motivation for buying insurance, roughly four in ten consumers say they would buy insurance if they could afford it (#65)
  • Most uninsured consumers say 2% of their monthly household take home pay would be affordable for out-of-pocket health expenses (#66)
  • Across all states, at least two-thirds of uninsured consumers are paying more out-of-pocket this year vs. two years ago (#67)
  • Around three-quarters of uninsured consumers have had to cut down on other expenses to pay for healthcare (#68)

Detailed Findings: Healthcare Costs and Affordability – Attitudes About Health Insurance Costs (#69)

  • Consumers in red states are much more willing than those in blue states to receive care from small group of PCPs or specialists to reduce cost of health insurance (#70)
  • Uninsured consumers in red states are much more willing to receive less expensive coverage for accidents, pregnancy and other chronic conditions (#71)
  • Consumers in non-chronic illnesses households are much more willing to receive less expensive, but more restrictive coverage, and travel longer distances for care in order to reduce healthcare insurance costs (#72)
  • About half in all states support increasing the price of insurance for smoking or ER use for non-emergencies; about one-quarter, however, feel that insurance cost should not increase (#73)
  • Chronically ill are significantly more likely to support increasing insurance for smoking and ER use for non-emergencies, and are less likely to support an increase of health insurance for any reason (#74)
  • Consumers in red states are more likely to say eating healthy is too expensive while blue states are more supportive of “fat taxes”; both support menu labeling & higher insurance for people with poor health habits (#75)
  • Consumers with no chronic illnesses are much more likely to support higher insurance for people with poor health habits, higher prices for foods that lead to obesity and taxes on sugary drinks (#76)
  • About six in ten consumers support charging people with poor health habits more for insurance (#77)
  • Many, especially in blue states, support charging more for foods that lead to obesity (#78)
  • About half support taxing sugary drinks, especially in blue states (#79)
  • Three-quarters of consumers across all states support menu labeling (#80)
  • Just under two-thirds of consumers in red states find eating healthy to be too expensive (#81)

Detailed Findings: Politics and Healthcare (#82)

  • As expected, more voted for Trump in red states and Clinton in blue states (#83)
  • Blue and swing states lean more Democrat in 2018 Midterm elections; consumers in red states are split (#84)
  • Over half of consumers across all states report that candidate’s stance on healthcare will greatly impact their mid-term vote (#85)
  • Even in red states, only a small proportion of consumers say that Trump is doing a good job on healthcare (#86)
  • Knowing what they know now about Trump’s healthcare plans, many consumers, particularly in blue and Swing states, would not vote for Trump (#87)
  • Some see increasing price of insurance for those who smoke, are morbidly obese, or non-adherent as options to decrease costs; others support an affordable health plan that covers major illnesses and accidents (#88)
  • Consumers blame drug companies, insurance companies, and government for rising costs; government is blamed significantly more often in red states vs. blue and Swing states (#89)

Detailed Findings: Politics and Healthcare – General Public vs. Physicians (#90)

  • Increasing the price of insurance for smokers, morbidly obese, or non-adherent is physicians’ top choice to decrease costs; consumers agree, but they also support a plan for major illnesses and incidents, and decreasing payments for expensive drugs (#98)
  • Physicians primarily blame insurance companies for rising healthcare costs while consumers feel that drug and insurance companies, followed by the Federal government deserve the most blame (#99)

Demographics (#100-104)

Online method details (#105-106)

Headlines - Physician Survey

Below is a list of some of the “headlines” that can be seen in the underlying physician survey data. Please include the reference number shown in parentheses on your data request form if you are seeking data on a particular theme.

How Physicians Are Paid

  • On average, over 2/3 of physician pay is fixed; fixed pay is marginally more common among Generalists (#10)
  • About two-thirds of physicians receive at least 75% of their compensation in fixed pay, with roughly half of those getting 100% fixed pay (#11)
  • Proportion of fixed pay is significantly higher among physicians with fewer years (10 or less) in practice (#12)
  • RVU contributes the most to the physicians’ variable pay, especially to Specialists’ variable pay (#13)
  • Physician practices tend to have less than 50% of patients capitated; however, a notable proportion, particularly among Specialists, are not sure (#17)

Physicians' Preferred Compensation

  • Physicians’ ideal compensation is high fixed salary with low incentives, followed by a fixed salary only (#14)
  • With a guaranteed salary plus quality incentive, a sizeable minority of physicians would spend more time with patients, and feel more satisfaction with their practices (#15)
  • Most physicians are neutral on allowing CMS to give bonuses to plans when >50% of physicians have a fixed salary component (#16)

Physician Voting Trends and Political Opinions

  • For the 2018 Mid-term elections, votes are split almost evenly between Democrat and Republican (#19)
  • More than half of physicians say a candidate’s stance on healthcare will greatly impact their mid-term vote (#20)
  • Physicians do not think President Trump is doing a good job on healthcare (#21)
  • About one in four Trump voters think the President is doing a good job on healthcare; the rest are uncertain or negative (#22)
  • Half of all physicians would not vote for President Trump now knowing his plans for healthcare (#23)
  • Only half of Trump voters say they would vote for the President now knowing his plans for healthcare; virtually none of Clinton voters would vote for him (#24)
  • More physicians, both Generalists and Specialists, voted for Clinton than for Trump in the 2016 Presidential election (#18)
  • Among both physicians and consumers, more voted for Clinton than for Trump; the only exception is consumers in red states (#91)
  • Overall, physicians tend to be evenly split between Democrat and Republican in 2018 Midterm elections; consumers lean more Democrat (#92)
  • Over half of physicians and consumers across all states agree that candidate’s stance on healthcare will greatly impact their mid-term vote (#93)
  • Only a small proportion of consumers and even fewer physicians think that Trump is doing a good job on healthcare (#94)
  • Among physicians, only one-quarter of Trump voters think the President is doing a good job on healthcare; notably more Trump voters among general public (45%) share the same opinion (#95)
  • There is a consensus among roughly half of physicians and consumers that they would not vote for Trump now knowing his plans for healthcare (#96)
  • Among Trump voters, just under five in ten physicians and four in ten consumers say they would not vote for Trump now knowing his plans for healthcare (#97)

Physician Views on Rising Health Care Costs

  • Increasing insurance costs for smokers, obese, or non-adherent is seen as likely to reduce healthcare cost (#25)
  • Physicians, particularly Generalists, tend to blame health insurance companies and other payers for rising healthcare costs (#26)

Demographics (#100-104)

Demographics (#100-104)