What Is Needed to Rebuild Trust in U.S. Healthcare?

Trust in the U.S. healthcare system is eroding — but this decline isn’t happening evenly across the system, one leader pointed out.

People largely trust individual clinicians, but they tend to distrust payers, drugmakers and hospital leadership, said Kristin Wikelius, chief program officer at the United States of Care, a national health policy advocacy group.

That split in trust becomes particularly apparent when patients move beyond the exam room. 

Wikelius noted that people routinely run into contradictory answers about costs and coverage, leaving them feeling like the healthcare’s major institutions are opaque at best and self-interested at worst.

“Say someone needs to have a procedure — then they have to figure out for their insurance. Is this provider in-network? What’s it going to cost? They get a set of answers, and then they go ask the provider’s office — and they can’t tell them how much it’s going to cost, and they’re not sure if they’re in-network. And so it feels to people — even when they’re trying to do their due diligence — there’s never a simple answer,” she explained.

To her, better transparency — especially when it comes to costs — and simpler navigation will be key in helping rebuild people’s confidence in the healthcare system.

She pointed out that people are resentful about healthcare’s rising costs.

“Individuals themselves don’t have a place to cost-shift. If your insurance is going up, there’s no place for you to move that cost — you have to find that money. What that means for people is often just foregoing care that they need,” Wikelius remarked.

The expensive nature of healthcare makes it so that many people only seek care when they feel their need is dire — but this “sick-care” system isn’t what they want, she said. People want a more preventive, health-maintaining system, not one that only treats illness. 

Some of this sentiment is reflected in the public support for the “Make America Healthy Again” movement, Wikelius pointed out, noting that there is a strong public appetite for holistic care, healthy food access and avoiding unnecessary medical encounters.

She also highlighted how linking coverage to politics or employment creates major anxiety for Americans.

People dislike that their insurance stability can swing because of new lawmakers or job changes — which is why United States of Care focuses on “durable” policies that can survive political shifts, Wikelius stated. 

“We’re looking for policies that can stand the test of time, so people don’t feel like the coverage or the care that they’re getting is at risk as a result of an election. I think below the surface, there are a lot of areas of continuity — of really nonpartisan agreement and alignment — on changes that we need to make in healthcare,” she declared.

Wikelius said the challenge now is translating that public desire for stability, transparency and preventive care into policies that actually deliver it.

Photo: Maskot, Getty Images