By Rose Hoban
North Carolinians feeling the heat of rising health care costs say they’re making difficult choices — some even skipping care they need because of the financial pinch.
This is just one finding from a telephone interview poll of 800 North Carolina residents at the beginning of March that asked a broad array of questions about the health care environment — ranging from vaccine support to oral health care costs to Medicaid policy.
One surprising finding was how much common ground there is among people in a state that has sharp political divides, pollsters said.
Nearly three-quarters of people polled said that health care costs are too high, and more than 17 percent said they had skipped needed care because of that.
More than half of the respondents (57.5 percent) told the pollsters that even though they thought health care prices were too high, they swallow the bitter pill and pay anyway.
Meanwhile, fewer than a quarter of the people interviewed (22.6 percent) said that they were satisfied with their health care costs. The largest percentage of satisfied people were those older than 65, the age when most Americans qualify for Medicare. Even so, only about a third of people (32.5 percent) in that age group were comfortable with their health care costs.
In contrast, only 17.5 percent of people younger than 40 said they were okay with their costs for care.
It turns out that North Carolinians, for the most part, align with what people across the country are saying about health care costs. Another poll conducted in March by KFF, a health policy information organization, found that nationwide, about four in 10 (43 percent) of respondents didn’t take their medications as prescribed, either by not filling their prescriptions, splitting pills to stretch them out or getting an over-the-counter drug instead of their prescription — all to cut costs.
According to KFF, that number has climbed from three years ago, when the organization found that about 31 percent of adults were taking health care cost-cutting measures to afford their medications.
Megan Voss, 41, from Chapel Hill has a neurological disease that requires expensive medications. Recently, she had to change from one medication to another, but her insurance company refused to pay for the new drug, which was $700 a month.
“They were willing to pay for the new treatment, but they weren’t willing to pay for the old treatment at the same time, and it takes six to nine months for the new treatment to work,” Voss said. “It took, honestly, a lot longer for me to get the treatment I needed… paying for the medication that I needed out of pocket is impossible at $700 a month.”
New bipartisan initiative
The poll was conducted by a group called “Healthier United,” a project of the Colorado-based Disagree Healthier initiative that wants to get people talking about public policy issues in a way that gets beyond pundits screaming at one another online and on cable news.
“We are not under the impression that North Carolinians or Americans are going to wake up and suddenly agree on things, and that’s why ‘disagree’ is in the title of the initiative. We want to actively disagree,” said Jake Williams, the founder. “We think that we do ourselves a disservice when we just yell and don’t listen, and then we don’t take the time to learn about someone else’s perspective, even if we don’t agree with it. I think that that is really at the heart of our democracy.”
Williams said polling is a “key tool that we use very frequently to find out what challenges folks are facing and what solutions they might support.” He said he was somewhat surprised by the amount of agreement their poll found across partisan lines about health policy.
“I didn’t expect these numbers to come into alignment the way that they did with such consistency,” he said.
Medicaid receives bipartisan support
The pollsters also asked respondents about other aspects of the state’s health care system, such as their attitudes about Medicaid. More than 90 percent of respondents — Republicans, Democrats, old, young — said that the program was “important.”
That across-the-board agreement could be pivotal in coming months as the state legislature makes funding decisions about the program, which provides care for low-income families and workers and people with disabilities.
A legislative fight over Medicaid funding has played a part in why state lawmakers have been unable to agree on a comprehensive budget for the fiscal year that ends June 30. State Department of Health and Human Services leaders have told lawmakers the department needs an additional $300 million to fund the program through the end of the fiscal year, but legislative leaders have been reluctant to dip into state coffers before they reconvene.
In addition, the vast majority of people (81.8 percent) who were asked about Medicaid reimbursement for dentistry said that the program should raise the pay for dentists who provide care to low-income and disabled patients. Right now, Medicaid pays about a third of dentists’ costs for care, leading many providers to refuse to care for patients in the program.
The question noted that Medicaid rates for dentists have not been adjusted since 2008.
Most disagreement around vaccines
One of the biggest differences between respondents from different parties was their attitude toward vaccines.
Overall, nearly three quarters of the people surveyed (73.6 percent) agreed that vaccines have, in general, been safe and effective.
But there was a near 30-point difference between how Republicans and Democrats answered the question. Nearly six in 10 (59.4 percent) of Republican respondents agreed that vaccines are safe and effective compared with the 88.2 percent of the Democrats with that response. Unaffiliated voters fell somewhere in the middle, at 21.6 percent disagreeing with the statement.
Of the folks who disagreed with the use of vaccines, 27 percent said they had hurt people, while another 20.1 percent said they were skeptical of them.
Williams acknowledged that having a quarter of the population skeptical of vaccines could be a public health concern, but he added that the strong overall support was a net positive.
“I was prepared for something worse,” Williams said. “I think this is a case of a very loud minority of voices eclipsing what is a very clear cross-partisan majority.”
Williams had some advice for public health practitioners and how they talk about vaccines.
“Stories stick,” he said. “All it takes is one thing you read online, or someone that’s two circles removed from you and your social group who says that they’re pretty sure that they took the COVID vaccine, and that’s why they had ailment X.
“You’re gonna remember that before you remember the five points of why, scientifically, vaccines are safe and effective,” Williams said. “It’s just easier for us as humans.”
Rose Hoban wrote this story. She examined the polling results, conducted additional research online and spoke to Jake Williams over Zoom. Anne Blythe edited it, and Jen Goode Stevens copyedited it. Crafting the headline was a group effort.
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