Quality and inequality characterize U.S. healthcare in global survey

Americans are generally more satisfied with the quality of their healthcare than people in other countries, but they hold more unfavorable views about their system’s affordability and equality of treatment; cost ranks as the #1 problem facing the U.S. healthcare system

The author(s)
  • Nicolas Boyon Senior Vice President and Ipsos Global Advisor Lead
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New York, NY, December 1, 2020 — The United States is among the countries whose people are most likely to rate the quality of their healthcare as good, according to a new Ipsos survey of over 20,000 adults from 27 countries conducted in September and October. Seven in ten Americans surveyed (71%) say the quality of the healthcare they and their family have access to is good or very good, compared to a global average of just 50%.     

However, views on access to healthcare tell a different story, as Americans are especially likely to agree that many people in their country cannot afford good healthcare – 69%  vs. an average of 59% across all 27 countries surveyed, 29% in Canada, and 28% in Great Britain. Furthermore, only 24% of Americans say that their country’s healthcare system provides the same standard of care to everyone, compared to 38% on average globally, 54% in Canada, and 63% in Great Britain.


High satisfaction with the quality of care, middling level of trust

The percentage of Americans who say the quality of the healthcare they have access to is “very good” or “good” (71%) has increased by eight points since 2018.

  • Satisfaction is highest among Americans aged 50-74 (83%), those with a household income of $75,000 or higher (77%), and those with a college degree (76%).
  • Countries showing the highest levels of satisfaction with the quality of their healthcare are Australia (81%), the Netherlands (76%), and Great Britain (74%).

Thinking of the future, two-thirds of Americans (67%) expect the quality of their healthcare to stay the same over the coming years – a much higher proportion than seen on average globally (52%).

  • 21% of Americans are optimistic their healthcare will improve (compared to 32% globally.)
  • Only 11% expect it will get worse (vs. 16% globally and 33% in Great Britain and France.)

Just over half of Americans (52%) say they trust their country’s healthcare system to provide them with the best treatment, up 9 points since 2018.

  • Trust in the system is highest among Americans aged 50-74 (62%) than it is among those under the age of 50.
  • Confidence in getting the best treatment from the local healthcare system averages at 50% globally, similar to the U.S., but it is much higher in Malaysia (75%), China (74%), and Australia (74%).


The U.S. system rates poorly on cost and equal treatment

Seven in ten Americans (69%) agree that many of their fellow citizens cannot afford good healthcare, down from 75% in 2018.

  • This view is more prevalent among women (75% vs. 62% of men) and adults under the age of 50 (73% vs. 63% of those aged 50-74).
  • On average, across the 27 nations surveyed, 59% agree that many people in their country cannot afford good healthcare.
  • The perception that good healthcare is out of reach for many people in their country is more widespread across Latin America and Eastern Europe as well as in South Africa and India than it is in the U.S.; however, it is shared by fewer than three in 10 adults in Sweden, South Korea, Great Britain, the Netherlands, and Canada.

Americans are more than twice as likely to disagree that their country's healthcare system provides the same standard of care to everyone than they are to agree (52% vs. 24%).

  • In contrast, globally, about as many agree (37%) as disagree (38%) that it is the case.
  • Proportionally, fewer in the U.S. agree than in any of the other G7 countries.

 When asked about the biggest problems facing the healthcare system, six in ten Americans (59%) cite the cost of accessing treatment. Bureaucracy is ranked second, though at a distance (35%).

  • The cost of accessing treatment is cited far more in the U.S. than it is on average globally (31%). Chile (62%) is the only country where cost is cited more often than it is in the U.S.
  • On a positive note, the percentage of Americans who single out the cost of accessing treatment in 2020 is 5 points lower than it was in 2018 (64%).
  • The healthcare system-related problems most cited globally are long waiting times (40%, but only 17% in the U.S.) and not having enough staff (39%, but only 16% in the U.S.).


COVID-19 surpasses all other health concerns

About seven in ten adults globally (72%) and in the U.S. (66%) select COVID-19 as one of the biggest health problems facing people in their country today. None of the other 12 problems measured comes close.

  • In the U.S., mental health (33%), cancer (26%), obesity (25%), and drug abuse (20%) round out the top five public health concerns.
  • Americans are more likely to single out mental health, obesity, and drug abuse as major health issues their country faces than are people in most other countries surveyed.
  • 50% of U.S. adults under age 35 and 42% of U.S. females see mental health as one of the biggest health problems in the country.


Only half of Americans support mandatory vaccination against infectious diseases

Americans are among those least likely to agree that vaccinating against serious infectious diseases should be compulsory (50%) – on par with Poland and France and ahead of only Russia (44%) while an average of 64% globally agree.

  • Support for mandatory vaccinations is highest throughout Latin America as well as in Malaysia, Saudi Arabia, and India.


About the Study

This 27-country Global Advisor survey was conducted between September 25 and October 9, 2020 via the Ipsos Online Panel system among 20,009 adults aged 18-74 in Canada, Malaysia, South Africa, Turkey, and the United States, and 16-74 in all other 22 countries.

The sample consists of approximately 1000+ individuals in each of Australia, Belgium, Brazil, Canada, China (mainland), France, Germany, Great Britain, Italy, Japan, Mexico, Spain, Sweden, and the US, and approximately 500+ individuals in each of Argentina, Chile, Hungary, India, Malaysia, the Netherlands, Peru, Poland, Russia, Saudi Arabia, South Africa, South Korea, and Turkey.

The samples in Argentina, Australia, Belgium, Canada, France, Germany, Great Britain, Hungary, Italy, Japan, the Netherlands, Poland, South Korea, Spain, Sweden, and the U.S. can be taken as representative of these countries’ general adult population under the age of 75. The samples in Brazil, Chile, China, India, Malaysia, Mexico, Peru, Russia, Saudi Arabia, South Africa, and Turkey are more urban, more educated, and/or more affluent than the general population. The survey results for these markets should be viewed as reflecting the views of the more “connected” segment of the population.

Weighting has been employed to balance demographics and ensure that the sample’s composition reflects that of the adult population according to the most recent census data. The precision of Ipsos online polls is calculated using a credibility interval with a poll of 1,000 accurate to +/- 3.5 percentage points and of 500 accurate to +/- 5.0 percentage points. For more information on Ipsos’ use of credibility intervals, please visit the Ipsos website. 

Where results do not sum to 100 or the ‘difference’ appears to be +/-1 more/less than the actual, this may be due to rounding, multiple responses, or the exclusion of don't knows or not stated responses.

The publication of these findings abides by local rules and regulations.


For more information on this news release, please contact:

Nicolas Boyon
Senior Vice President, U.S., Public Affairs
+1 646 309 4879
[email protected]

Kate Silverstein
Media Relations Specialist, U.S., Public Affairs
+1 718 755 8829
[email protected]


About Ipsos

Ipsos is the world’s third-largest market research company, present in 90 markets and employing more than 18,000 people.

Our passionately curious research professionals, analysts and scientists have built unique multi-specialist capabilities that provide true understanding and powerful insights into the actions, opinions and motivations of citizens, consumers, patients, customers, or employees. We serve more than 5000 clients across the world with 75 business solutions.

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The author(s)
  • Nicolas Boyon Senior Vice President and Ipsos Global Advisor Lead

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