Americans Give US Health Care System a C Grade, Calling for Policy Change

In a survey of more than 1000 Americans, nearly three-quarters gave the US health care system a grade of C or lower, highlighting widespread dissatisfaction with costs, access, and government regulation.1

Only half of respondents reported being able to afford their insurance premiums or prescription drugs. | Image credit: EDER – stock.adobe.com

Results from eHealth’s 2025 Healthcare Pulse Survey showed a rough bell curve of grades from respondents. When asked how they would grade health care in the US today:

• 9% gave it an A
• 19% gave it a B
• 34% gave it a C
• 21% gave it a D
• 17% gave it an F

According to the report, individuals covered by Medicaid had a more favorable view of the current health care system than those with employer-based coverage, and were more likely to give the higher grades.

When asked who or what they blame for the current state of health care in the country, respondents mostly cited insurance companies (66%) and pharmaceutical companies or drug costs (60%) as the main culprits, with 42% blaming politicians. Meanwhile, 34% blamed fraud, waste, and abuse in the health system and 23% blamed providers.

Concerningly, only half of respondents reported being able to afford their insurance premiums or prescription drugs. Even more immediate, only half said they can get the care they need when they need it, and less than half have access to the doctors they prefer.

Americans struggling to afford their insurance premiums is unfortunately not news, and these findings are in line with other research. In a commentary in the September 2024 issue of The American Journal of Managed Care®, authors wrote, “Given that American households have a median savings of $8000, it’s no wonder that 47% of Americans with insurance report difficulty with affording health care.”2 Health care costs are also rising at a much higher rate than prices in general, with the authors noting that the Consumer Price Index for medical care increased by 118% between 2000 and 2024, but only increased by 83% for all goods during the same period.

These financial strains bleed over into other aspects of life as well. According to the survey, 46% of respondents said they had to choose between paying medical bills or covering basic living expenses like food and housing within the past 10 years.1 About a third worry more about affording health care than the costs of gasoline, home insurance, and food staples like eggs, meat, and dairy.

“It's a sad commentary on the state of our healthcare system,” Fran Soistman, CEO of eHealth, said in a news release.3 “In fact, a majority tell us that they are willing to reconsider key provisions of the 2010 Affordable Care Act (ACA), if it makes their coverage more affordable.”

While 91% of respondents agreed on the ACA’s principle that nobody should be denied health insurance based on their medical history, 83% also think Americans should have the freedom to choose a health plan that leaves out extra coverage they don’t need if it saves them money, contrary to the ACA’s requirement for broad coverage.1 However, on the other end, 56% believe those who maintain an unhealthy lifestyle should have to pay more for their health insurance.

Americans Want to Ban Drug Advertising

The report also highlighted differing views on the government’s role in health care, with most Republican voters in the survey (79%) saying there is too much government regulation compared with 42% of Democrat voters, though the report did not note the sizes of each cohort. Overall, 57% answered that the government takes “too strong a hand” in regulating health care.

However, it also showcased the similar views when it came to pharmaceutical advertisements. Respondents across the political spectrum expressed openness to and restrictions on drug advertising, with 71% of Republican voters, 67% of Democrat voters, and 63% of independent voters saying they would support a ban on drug company advertisements.

"Newly appointed HHS Secretary Robert F. Kennedy Jr. has proposed barring pharmaceutical companies from directly marketing to consumers, and our research shows most Americans agree with him,” Soistman added.3 “Two thirds (66%) tell us they would support a ban on drug advertisements, including a majority of both Democrat and Republican voters.”

References

1. eHealth. 2025 Healthcare Pulse Survey: eHealth Original Research March 2025. March 11, 2025. Accessed March 11, 2025. https://news.ehealthinsurance.com/_ir/68/20251/Healthcare_Pulse_Survey_2025.pdf
2. D'Andrea G, Nugent-Peterson T. It's time to address our nation's health care price crisis. Am J Manag Care. 2024;30(9):401-403. doi:10.37765/ajmc.2024.89598
3. New eHealth research finds Americans are unhappy with the US healthcare system and open to new ideas. News release. eHealth Inc. March 11, 2025. Accessed March 11, 2025. https://www.prnewswire.com/news-releases/new-ehealth-research-finds-americans-are-unhappy-with-the-us-healthcare-system-and-open-to-new-ideas-302397920.html