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May 12, 2021
David Burda
Economics Policy System Dynamics

Where Would You Rank the Affordability of Medical Care on a List of the Nation’s Biggest Problems?

Where would you rank healthcare affordability on a list of the biggest problems facing the U.S.? Behind racism but ahead of climate change? Behind gun violence but ahead of unemployment? 

Well, as it turns out, a majority of U.S. adults put healthcare affordability at the top of the list ahead of everything else. I know, right?

That’s according to a survey of a representative sample of 5,109 adults conducted by the Pew Research Center, which is no slouch when it comes to polling representative samples of the U.S. population. Pew released the survey results on April 15 in a 51-page report, which you can download here

I don’t recall the survey results getting much play in the general or the healthcare trade press, especially the bit about healthcare affordability being the country’s worst nightmare. Stories about racism, climate change and gun violence probably and understandably bumped the healthcare angle.

So being the responsible journalist that I am, below is the list of the 15 issues ranked by the percentage of respondents who identified the issue was “a very big problem” in the U.S.:

  • The affordability of healthcare (56 percent)
  • The federal budget deficit (49 percent)
  • Violent crime (48 percent)
  • Illegal immigration (48 percent)
  • Gun violence (48 percent)
  • The coronavirus outbreak (47 percent)
  • Racism (45  percent)
  • Economic inequality (43 percent)
  • Unemployment (41 percent)
  • Climate change (40 percent)
  • The quality of public K-12 schools (39 percent)
  • Domestic terrorism (35 percent)
  • Condition of roads, bridges and other infrastructure (34 percent)
  • International terrorism (26 percent)
  • Sexism (23 percent)

Here are a few things that jumped out at me in that ranking.

First, the affordability of healthcare is the only issue that garnered more than half the vote as a very big problem here. A few came close, but no others crossed the majority threshold. That says something.

Second, the COVID-19 outbreak that’s killed nearly 600,000 people finished sixth on the list. That’s what happens when you politicize epidemiology, science, social distancing and mask wearing, I guess. 

Third, some of the key tenets of the Biden administration’s policy agenda—things like climate change, domestic terrorism, infrastructure—fell toward the bottom of the respondents’ list of priorities.

I guess it also proves the point that I was trying to make in a recent column, and that’s medical care will get less affordable for people as the topic continues to get lip service from the top. If you want to suffer a little more, read “Affordability of Medical Care Stuck on Healthcare’s Back Burner.” As I’ve said before, I don’t mind being wrong, but I really do like being right. 

What are your takeaways from the Pew survey results? Where would you rank healthcare affordability on that list? Think about it and let me know at David.burda@4sighthealth.com.

Thanks for reading.

Keep wearing masks. Keep social distancing. Keep washing your hands. I don’t care if you’re vaccinated.

About the Author

David Burda

Dave Burda began covering healthcare in 1983 and hasn’t stopped since. Dave writes this monthly column “Burda on Healthcare,” contributes weekly blog posts, manages our weekly newsletter 4sight Friday, and hosts our weekly Roundup podcast. Dave believes that healthcare is a business like any other business, and customers — patients — are king. If you do what’s right for patients, good business results will follow.

Dave’s personal experiences with the healthcare system both as a patient and family caregiver have shaped his point of view. It’s also been shaped by covering the industry for 35 years as a reporter and editor. He worked at Modern Healthcare for 25 years, the last 11 as editor.

Prior to Modern Healthcare, he did stints at the American Medical Record Association (now AHIMA) and the American Hospital Association. After Modern Healthcare, he wrote a monthly column for Twin Cities Business explaining healthcare trends to a business audience, and he developed and executed content marketing plans for leading healthcare corporations as the editorial director for healthcare strategies at MSP Communications.

When he’s not reading and writing about healthcare, Dave spends his time riding the trails of DuPage County, IL, on his bike, tending his vegetable garden and daydreaming about being a lobster fisherman in Maine. He lives in Wheaton, IL, with his lovely wife of 35 years and his three children, none of whom want to be journalists or lobster fishermen.


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