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Kaiser/Harvard Health News Index, August 1997

New Survey Findings

Americans’ Confidence in For-Profit Health Care Declines

But Many Still View For-Profit Health Care Organizations Favorably on Key Criteria

For immediate release: August 21, 1997

Contact: Matt James or Heather Balas

Menlo Park, CA — At a time when for-profit health care providers like Columbia/HCA are receiving increasing scrutiny and media attention, Americans’ confidence in for-profit health care has declined, though many still view for-profits favorably. A new survey released in the Kaiser/Harvard Health News Index, compared to a survey just five months ago, shows that fewer Americans today believe for-profit hospitals and health plans offer better quality care, are more responsive, or are more efficient than their nonprofit counterparts. Both surveys also find that Americans believe two to one that the trend to for-profit health care is “bad” for the country.

“The public’s perceptions about for-profit health care are part of a growing angst about the changing health system that is fueling renewed interest in consumer protection and government regulation,” said Drew Altman, President of the Kaiser Family Foundation. “How far the pendulum swings back remains to be seen.”

When asked about hospitals and health plans in March, the majority of Americans thought that for-profit providers offered higher quality care and were more responsive and efficient than nonprofits. Just five months later, public opinion largely leveled between for-profit and nonprofits on two measures: quality and responsiveness. Opinions about efficiency also declined, but a higher percentage of Americans continue to perceive for-profit health care organizations as more efficient than nonprofits.

Noticeable shifts in opinion were identified about both health plans and hospitals, but the changes in opinion were particularly significant regarding hospitals:

  • Americans who said for-profit hospitals were more responsive dropped from 53% to 41%;
  • those who said for-profit hospitals provided better quality care dropped from 55% to 42%; and
  • the opinion that for-profit hospitals were more efficient dropped from 57% to 48%.

While public opinion shifted on for-profit care, attitudes about nonprofit health care providers remained relatively constant in the two surveys. The only exception was the decline in the percentage of Americans who believed that service from nonprofit providers cost less, which dropped from 71% to 57% for hospitals and from 68% to 58% for health plans.

Hospitals Health Plans Nonprofit For-profit Nonprofit For-profit Which kinds of organization… 3/97 8/97 3/97 8/97 3/97 8/97 3/97 8/97 Are more helpful to the community 60% 61% 29% 23% 60% 60% 28% 24% Cost you less 71% 57% 18% 18% 68% 58% 20% 21% Are more responsive to customers 37% 40% 53% 41% 40% 41% 50% 40% Provide better quality care 32% 37% 55% 42% 38% 37% 48% 39% Are more efficient 30% 31% 57% 48% 38% 35% 50% 44%
Sources: August 1997 Kaiser/Harvard Health News Index, March 1997 Kaiser Family Foundation Survey

Health News Index

This data is included in the most recent Kaiser/Harvard Health News Index, a bi-monthly publication tracking the public’s awareness and understanding of leading health news stories. The Index is provided as a service to journalists to help inform their coverage of breaking health stories. In addition to the information above, the Index indicated that 27% of people surveyed followed the Columbia/HCA story closely. Thirty-nine percent of Americans knew that the chain was a for-profit company and 46% knew the government is investigating Columbia/HCA for possible Medicare fraud.


The study was conducted by Princeton Survey Research Associates August 7-10, 1997 and was a national, random sample, telephone survey of 1,000 adults nationwide. Margin of error is