公众对美国平价医疗法案的看法

A. Molla, T. Bacon-Baguley, Susan DeVuyst-Miller, W. Wonderlin, E. Benedetti
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摘要

背景/目的:在美国实施平价医疗法案(ACA)为成千上万以前没有保险的人提供了获得健康保险的机会。许多人认为平价医疗法案是对之前保险的改进,而另一些人则认为它增加了医疗成本。本研究的目的是调查个人对ACA的认识和看法。方法:公共卫生、医师助理研究、药学和医学教育领域的研究人员开展了一项调查,以评估ACA的影响。调查内容包括人口统计问题和评估ACA支持情况的陈述,以及ACA对药品和医疗覆盖范围以及个人自付费用的影响的观点。采用方便抽样方法在城市公共场所招募参与者。结果:179名被调查者的人口统计数据包括:中位年龄31岁;84%的白人;37%的已婚;58%完成了至少四年的大学教育;45%的人收入超过5万美元。13人(7%)在ACA之前没有保险,8人(4%)在ACA之后。130人(73%)在ACA之前有处方保险,107人(60%)的覆盖率没有变化,22人(12%)的覆盖率更好,21人(12%)的覆盖率更低。支持ACA的关联是基于政治派别,支持ACA的民主党人多于共和党人(p < 0.001)。71%的人(71%)表示,ACA实施后,保险并没有得到改善。结论:这些发现表明,在中上层阶级个体的样本中,大多数人支持ACA,尽管他们自己的保险缺乏改善,这表明一般人群的个人牺牲正在发生。
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Public perception of the United States’ Affordable Care Act
Background/Objective: Implementation of the Affordable Care Act (ACA) in the US has given opportunity to obtain health insurance for thousands who were previously uninsured. Many believe that the ACA is an improvement over previous insurance, while others view it as making health care more costly. The purpose of this study was to survey individuals regarding knowledge and perceptions of the ACA.Methods: Researchers in public health, physician assistant studies, pharmacy and medical education developed a survey to assess the impact of the ACA. The survey included demographic questions and statements which assessed ACA support, and perspectives of the ACA’s impact on pharmaceutical and medical coverage and personal out of pocket costs. A convenience sampling was used to recruit participants at a public venue in an urban setting.Results: Demographics of the 179 surveyed include: median age 31 years; 84% Caucasian; 37% married; 58% completed a minimum of four years of college; and 45% with income exceeding $50,000. 13 (7%) were uninsured before the ACA, and 8 (4%) after. 130 (73%) had prescription coverage before the ACA with 107 (60%) reported no change in coverage, 22 (12%) better coverage, and 21 (12%) less coverage after the ACA. An association for ACA support was found based on political affiliation with more Democrats than Republicans supporting the ACA (p < .001). 71 (71%) who support the ACA, reported insurance did not improved after the ACA.Conclusions: These findings identify that in a sample of upper middle class individuals, a majority support the ACA despite a lack of improvement in their own insurance indicating that personal sacrifice for the general population is occurring.
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