What's New

Zack Hutchins
Director of Communications

October 3, 2002

Poll: Consumers have little idea what health insurance costs and where premiums go

Consumers whose employers provide health insurance for them generally have little idea how much the insurance costs and what the money goes for, a new poll by Zogby International suggests.

The poll of some 800 upstate consumers was commissioned by Excellus Inc., a Rochester-based not-for-profit company that finances and delivers health care through four upstate divisions.

Respondents estimated, on average, that only 49.5 percent of premiums are spent on health care, with 26.8 percent going to insurers' business expenses and the remaining 23.7 percent going to the insurer's profit.

In fact, 90 percent of Excellus premiums are spent on medical care, 7.5 percent is used for business expenses, and about 2.5 percent is net income for Excellus, the company said in a release.

Less than one-quarter of the respondents think that their employer-provided health insurance is costing $6,000 or more per year. In fact, however, an Excellus family plan costs at least $7,000 a year, and more than 45 percent of the respondents have family coverage.

Business Council President Daniel B. Walsh said the survey shows that "employers and health-insurers need to try to educate consumers about how much health insurance costs, and why." Health-sector economists have long argued that health-care costs are difficult to control in part because consumers whose employers pay all or most of the cost of their health insurance have little idea how high the cost is or how rapidly it is increasing.

In the poll, Zogby surveyed 802 employment-based customers with HMO coverage provided by three Excellus divisions: BlueCross BlueShield of the Rochester Area, BlueCross and BlueShield of Central New York and BlueCross BlueShield of Utica-Watertown. The poll was conducted from September 16 to 21, 2002. The margin of error is +/-3.5 percent. Survey results were released at a news conference Thursday featuring John Zogby, president and CEO of Zogby International.

Of the amount spent on medical care, the average respondent believes 32.8 percent pays for physician services, 30.1 percent goes for hospital services, 24.6 percent reflects prescription drug spending and 12.5 percent for other health services.

In contrast, 42 percent of Excellus' medical expenses go to hospital services, 34 percent is for physician services, 18 percent is used to purchase prescription drugs, and 6 percent is for other health services, Excellus said.

"The polling data makes clear a substantial disconnect between how consumers see their premium dollar being spent and the reality of where the money really goes," said Zogby.

"We predicted there would be an awareness gap but not as large as Zogby's poll identifies," said David Klein, president and chief operating officer for Excellus, Inc. "This clearly gives us targets for education and outreach. We also believe these findings have national applications because we actively sought - but couldn't find - similar polls like this anywhere."