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Exclusive: More Than 70% of Americans Feel Failed by the Health Care System

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More than 70% of U.S. adults feel the health care system is failing to meet their needs in at least one way, according to new data from the Harris Poll, shared exclusively with TIME.

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Despite spending more money per capita on health care than any other wealthy country in the world, the U.S. struggles to match other nations in life expectancy and other health outcomes. The new Harris Poll survey, which was conducted from February to March 2023 and commissioned by the American Academy of Physician Associates, shows that patient satisfaction is also suffering due to the high costs, inaccessibility, and confusing logistics of U.S. medical care.

More than half of the roughly 2,500 U.S. adults who took the survey graded the U.S. health care system a “C” or below. When asked about factors that prevent people in the U.S. from getting care, cost was the most common criticism, followed by the system’s focus on profits, inaccessibility of insurance coverage, and confusion around what is covered by insurance.

Many respondents pointed to similar problems when asked about their own personal issues with the medical system. Only 27% of people who took the survey said the U.S. medical system meets all of their needs, while the rest listed complaints including how long it takes to get an appointment (31% of respondents), high costs (26%), limitations of insurance coverage (23%), and subpar focus on preventive care and wellness (19%).

Those complaints seem to be keeping at least some would-be patients away from the doctor’s office. More than a fifth of people surveyed said they don’t see a single health care provider on a regular basis, and 44% said they’d skipped or delayed needed care in the past two years. Among those who skipped or delayed appointments, 40% said they did so because of costs, while 30% said they couldn’t take time away from work, family, or other obligations.

The survey did, however, suggest some bright spots and paths forward. More than 75% of survey participants said that providers work with them to improve their health, more than 70% said they want stronger relationships with their providers, and more than 65% said they believe their health would improve if they regularly worked with a trusted provider—responses that suggest Americans haven’t totally given up on the system, despite their frustrations.

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Write to Jamie Ducharme at jamie.ducharme@time.com