State of Play – January 2025

Overview

The American public’s discontent with – and skepticism about – the nation’s healthcare industry is rampant. Less than a quarter of people believe providers and payers are more focused on caring for people than on making a profit.

Starting just as the pandemic erupted into a full-blown global crisis, our research team has regularly surveyed the American public to gain insight into the relationship between the healthcare industry and the people it serves. What we have tracked over the years is a collapse in the public’s trust in our system of care. But also, signs of resilience and opportunities to regain it.

Continuing five years of ongoing research (which can be found at jarrardinc.com/mri), we surveyed more than 1,000 U.S. adults in early January 2025 on their feelings about: healthcare and the institutions that comprise it; their trust of people and organizations involved in it; how they perceive the mission vs. the business of care; who they trust to solve its myriad problems. Some of these questions we’ve tracked over time. Others are new, born from the cauldron of noise surrounding the 2024 election and UnitedHealthcare CEO Brian Thompson’s murder.

What do we know to be true today? Critically, trust that healthcare is fulfilling its mission has plummeted. Americans are frustrated – a sizable number are angry –
about a system more than half say needs an overhaul. Understandably, skepticism is higher among those who have faced financial difficulty related to their care. And almost half fall into that category. In short, the perception is that the system is not working.

But there’s a glimmer of hope.

Roughly 40% of people report being content with their own insurance and their local hospitals. It’s a sentiment that desperately needs strengthening, yet there is a foundation for local providers and payers to build from. In addition, the public continues to overwhelmingly trust nurses and physicians, while expressing skepticism about the validity of information floating around online.
All told, January’s survey shows that local organizations, nurses and doctors are in prime positions to fill the significant cracks in the system that have spread over the past five years.

Key Takeaways

1. Faith in the mission of care has plunged. The perception that hospitals put patients over profits has dropped by two-thirds since December of 2021, and by half since December of 2022. A similar decline has occurred for insurance companies since December of 2022. Meanwhile, the public most trusts hospitals and healthcare workers to improve the quality of care but has more trust in government to reduce the cost. Furthermore, concerns about cost and equity are viewed as the primary reasons why healthcare in the U.S. doesn’t work as well as it should.
2. Discontent – or worse – outpaces satisfaction… The public’s reaction to Thompson’s murder shocked the industry. That response led to a wave of headlines
   flagging the number of Americans expressing anger at the insurance industry and/or healthcare leaders like Thompson, as well as the high percentage who found the murder understandable. Or even justified. We found that about a third of Americans are either frustrated or angry with healthcare in the U.S., as well as health insurance companies and pharma. In contrast, between one in five and one in four are pleased or satisfied. Even among those who aren’t angry about healthcare there is a strong sense that the U.S. healthcare system needs major improvement. Well over half – 57% – say it needs either significant reform or a
   complete redesign.
3. …But personal experience and local connection are in better shape. Despite the discontent with the healthcare system, the American public is more positive about healthcare close to home. About four in 10 say they are satisfied or pleased with local hospitals and their own health insurance company – compared to a third who say the same about provider organizations in general. While it is undoubtedly a bright spot to see satisfaction higher than anger at the local level, the fact remains that well under half express these positive feelings towards local care, highlighting the size of the challenge facing providers and payers.
4. Trust in healthcare workers is resilient and resounding. Nurses and doctors remain the most trusted voices on important health information, even as institutions like hospitals have slipped since the pandemic. In addition, 80% trust their doctor and other healthcare workers when it comes to making good decisions for their care. And while hospitals have lost some ground, trust in doctors and nurses for health information has barely wavered.

The Work Ahead

• Control what can be controlled.
• Influence the things that can be changed.
• Double down on mission.
• Know where you stand and what messages resonate.
• Solidify your base: clinicians and caregivers.
• Engage key stakeholders – authentically.