A new study from Accenture says citizens in 16 countries agree that the government's role in healthcare starts with helping the elderly and disabled access existing services. But beyond that, citizen expectations diverge significantly about what their political leader should do, reflecting individual and collective experiences with their healthcare systems.
Cost is a key concern among U.S. citizens, while capacity issues are chief among residents of other countries. Some 54 percent of Americans said cost is their primary concern, while nearly 40 percent said there is too much bureaucracy and inefficiency in the system. A third of Americans cited fraud and abuse as a concern.
Other findings suggest that governments might better meet the needs of their citizens not by investing directly in healthcare but, rather, by investing in technologies and processes that enable them to become more engaged in both their own care as well as in healthcare policy.
In only two countries (Brazil and Ireland) did citizens say improving health outcomes should be a top government priority. Instead, citizens from most countries believe the government's role should be focused on "balance" – providing fair and equal access to health services for everyone, but especially the elderly and disabled.
That finding surprised Julie McQueen of The Accenture Institute for Health & Public Service Value.
"I thought surely everybody is concerned about health outcomes," she said. "But I think the fact that balance is rated as most important reflects peoples' concern for access to healthcare for themselves and their families."
After balance, the study suggests that governments can better serve their populations by opening up participatory opportunities. Across the board, respondents said government isn’t doing enough to engage them and seek their input before deciding on the priorities for healthcare services. Respondents in 10 countries view this as an area where government is performing least well, with just 21 percent of respondents, on average, rating government performance as very or fairly good.
"It’s interesting and encouraging that despite cultural, socioeconomic and other differences among the 16 countries, there is a great deal of consensus around the need for government to help provide fair and equal access to healthcare. But governments must do more in enabling people to play a role in helping shape the policies and programs to achieve that access," said Greg Parston, director of Accenture’s Institute for Health and Public Service Value. "We’ve see consistently in our research that citizens want to be co-producers of public value."
The study surveyed more than 16,000 people in the general adult populations of Australia, Brazil, Canada, France, Germany, Hong Kong, India, Ireland, Italy, Japan, Mexico, Norway, Singapore, Spain, the United Kingdom and the United States. Participants were interviewed between December 2009 and February 2010.
Accenture officials say preliminary reporting has focused on "big picture" issues, but more analysis will be released in coming days and weeks and made available on the Web at www.accenture.com/ACES.